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Old 04-10-2010
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Default breast milk jaundice

what is the treatment for breast milk jaundice? I have come across really ambiguous answers. It is mostly benign self limiting, but wat if the bilirubin is 20 or more?

is temporary cessation of breast-feeding the correct answer on the test?

Are there any specific clues in the question that point to breat milk jaundice? It begins usually around 1st week of birth, but is there anything more specific?
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Old 04-11-2010
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Default You have to differentiate BMJ from BFJ

The correct answer depends on whether it's Breast Feeding Jaundice or Breast Milk Jaundice.

BFJ is due to inadequate feeding and it appears early in the first week of life. To treat BFJ you have to increase feeding and rehydrate the baby.

BMJ is due to the presence of chemical factors in the milk that inhibit the glucoronyl transferase activity of the baby and it starts after 7 days of life.
To diagnose BMJ you can stop breast feeding for 24 hours and see if the bilirubin level gets down. There's no urgency to treat BMJ as it's completely benign condition and many people say there's even no need to stop feeding even for that diagnostic 24 hours. Just make sure the baby is alright and has no indications of pathologic jaundice.

But in any case (BFJ or BMJ) if the bilirubin level is above 17 mg/dL (294 uM/l) then you have to admin the baby and give phototherapy. Because remember these are indirect types of jaundice and they may cause kernicterus.
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