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Jaundice Associated with Breastfeeding, Pediatric

Jennifer A. F. Tender, MD, IBCLC and Sahira A. Long, MD, IBCLC, FABM Reviewed 10/2018
 


BASICS

DESCRIPTION

The three major categories of unconjugated hyperbilirubinemia associated with breastfeeding: 
  • Physiologic jaundice:

    • Occurs between 1 and 7 days of life

    • Peaks at 3 to 5 days

  • Suboptimal in...

DIAGNOSIS

HISTORY

  • SIJ

    • Weight loss: Infants should not lose >8% of their birth weight. Infants should gain 15 to 30 g/24 h after maternal copious milk production (around day 4 or 5).

    • Frequency and dura...

TREATMENT

  • SIJ

    • Evaluate and treat for insufficient milk intake. Assess latch, position, and milk transfer. Consult a lactation expert if needed.

    • Increase frequency of effective breastfeeding to 8 to 12 t...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow up 2 to 3 days after discharge, earlier if infant at high risk for jaundice. Weight check, physical exam, assessment of hydration, and observation of feedi...

ADDITIONAL READING

  • Academy of Breastfeeding Medicine. Clinical protocols. Guidelines for management of jaundice in the breastfeeding infant equal to or greater than 35 weeks’ gestation. http://www.bfm...

CODES

ICD9

  • 774.39 Other neonatal jaundice due to delayed conjugation from other causes

  • 774.31 Neonatal jaundice due to delayed conjugation in diseases classified elsewhere

  • 774.6 Unspecified fetal and neo...

FAQ

  • Q: Will jaundice cause my baby to have developmental or neurologic problems?

  • A: If hyperbilirubinemia is appropriately monitored and treated, it should not cause any developmental problems.

  • Q: What ...

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