Jaundice in the breastfed infant

The relationship between breastfeeding and jaundice during the newborn and early infancy period is often confusing. Understanding the normal synthesis , metabolism, and transport of bilirubin in the newborn is the underpinning of effective diagnosis and management of jaundice in the breastfed infant. Breastfeeding jaundice is the exaggeration of physiologic jaundice of the newborn that occurs when the infant has-insufficient milk intake, usually b ecause of poor breastfeeding initiation and management. It is the neonatal equivalent of starvation jaundice in the adult. Breastmilk jaundice is a no rmal and regularly occurring increase in serum unconjugated bilirubin, whic h begins at the end of the first week of life and may continue for several weeks and even months thereafter in healthy, thriving infants. An increase in intestinal bilirubin absorption due to an unidentified factor in mature human milk is responsible for breastmilk jaundice.