What Is Breast Milk Jaundice? Causes, Symptoms And Treatment

The condition occurs when the breast milk compounds prevent the breakdown of bilirubin.

Reviewed by Mary Miller, MA, IBCLC Mary Miller Mary MillerMA, IBCLC facebook_icon Specialty: Lactation specialistExperience: 20 years
Written by Dr Bisny T. Joseph Dr Bisny T. Joseph
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The condition occurs when the breast milk compounds prevent the breakdown of bilirubin.

Jaundice is a condition induced by a liver disorder that causes the skin and whites of the eyes to turn yellow. Breast milk jaundice is a type of jaundice in newborns associated with the ingestion of breast milk.

The condition usually occurs due to substances in the breast milk that inhibit the body’s ability to break down bilirubin (a yellow pigment produced as the body recycles old red blood cells), leading to jaundice. Newborns usually develop breast milk jaundice after the first week of life.

This post will help you understand the causes, signs, diagnosis, treatment, and complications of breast milk jaundice in newborns.

What Is Breast Milk Jaundice?

It is essential to understand jaundice before understanding breast milk jaundice. The red blood cells in the body break down periodically and produce a byproduct called bilirubin. The liver processes this bilirubin and prevents its accumulation. However, in some situations, excess bilirubin persists within the body, causing the compound to accumulate in cells of the body. Since bilirubin has a natural yellow color, it causes the distinctive yellowing of the skin and the whites of the eyes. This condition is called jaundice.

The precise cause of breast milk jaundice is not known. It is believed to occur due to breast milk compounds that inhibit certain liver proteins from breaking down bilirubin (1). The condition usually emerges after the first week of the baby’s life (2).

Breast milk jaundice may last for a few weeks in newborns since bilirubin elimination and metabolism is slower due to immature liver functions.

It is different from breastfeeding jaundice, which is a type of neonatal jaundice that occurs due to reduced intake of breast milk for any reason. Unlike breast milk jaundice, breastfeeding jaundice may cause severe dehydration and weight loss in babies (3).

Signs And Symptoms Of Breast Milk Jaundice

Below are the notable signs and symptoms of breast milk jaundice in babies (4) (5). This type of jaundice typically won’t occur until the end of the first week or two of life.

  • Yellowing of the skin and whites of the eyes
  • Lethargy
  • Trouble latching
  • Loss of appetite
  • High-pitched cry
  • Mild weight loss
  • Fussiness
  • Dark urine
  • Pale stools

Consult a pediatrician/ lactation specialist if your baby displays any of these signs and symptoms.

Risk Factors For Breast Milk Jaundice

Genetic factors may increase the risk of breast milk jaundice in babies. A family history of jaundice could also increase the risk of the condition. Beyond the genetic factors, only a few risk factors are considered since the exact cause is unknown (6).

  • Delay in milk production
  • Poor feeding
  • Increased enterohepatic circulation
  • Dehydration
  • Less calorie intake

Not all babies who experience these conditions develop breast milk jaundice, while some babies may develop breast milk jaundice without displaying any of these factors.

Babies are generally more prone to jaundice due to the following reasons (4).

  • Babies have more red blood cells than adults. These cells have a shorter life span, causing more bilirubin than the liver can process.
  • The immature liver of babies may slowly metabolize the bilirubin.
  • If the baby experiences a delay in the passage of meconium (earliest stool), it may increase bilirubin reabsorption in the intestines.

Prevention Of Breast Milk Jaundice

There is no known way to prevent breast milk jaundice in newborns. It is a physiological condition that usually resolves on its own (7).

Diagnosis Of Jaundice

The diagnosis of jaundice can be made from signs and symptoms, such as the yellow discoloration of the skin. Blood tests and analysis of bilirubin levels could help confirm the diagnosis. A blood culture may help exclude possibilities of other infections (8). The doctor/ lactation specialist may also check for breastfeeding habits of the infant to distinguish breast milk jaundice from breastfeeding jaundice.

Additional tests may be ordered to exclude hemolytic disease of the newborn, cephalohematoma, sepsis, urinary tract infection, liver problems, and other conditions that may cause increased bilirubin levels (3).

Treatment For Jaundice

The following treatments could be given to babies with breast milk jaundice (9) (10).

  • Phototherapy involves keeping a baby under a special light for one or two days in a hospital. This treatment is usually required for severe jaundice. The light changes bilirubin structure and enhances its elimination from the body. Protective glasses cover the eyes of the newborn to prevent eye damage during phototherapy.
  • Increased breastfeeding sessions of eight to 12 times a day could help babies. Excess feeding increases bowel movements and helps the baby get rid of bilirubin through stools.
  • Doctors may prescribe formula feeding for some infants since it may help expel excess bilirubin through stools or urine.
  • Hospitalization and blood transfusion are needed for babies who have higher levels of bilirubin.

Pediatricians may pick one or multiple treatment options for your baby. Mild breast milk jaundice does not require hospitalization and resolves on its own.

Complications Of Jaundice

Complications are rare in healthy full-term infants with breast milk jaundice. Very high bilirubin levels may result in kernicterus (bilirubin encephalopathy), a type of brain damage due to bilirubin. Kernicterus can damage the brain and nervous system, increasing the risk of problems such as cerebral palsy (4).

Late preterm infants are often at an increased risk of complications than term infants, likely due to hepatic immaturity and other problems.

Prognosis Of Jaundice

The outcome is good in most healthy babies, even if jaundice lasts for a few weeks (10). Careful monitoring helps most babies recover. Usually, breast milk jaundice resolves within a week or two.

Jaundice lasting more than six weeks regardless of adequate treatment and nutrition may require additional tests to identify the cause.

Jaundice seldom causes any lasting problems. You must not stop breastfeeding unless advised by the physician. The benefits of breastfeeding outweigh the risks, and it may even help the baby excrete bilirubin through the increased passage of stools. Adequate care and nutrition will let the baby outgrow the condition safely.

Frequently Asked Questions

1. How common is breast milk jaundice?

According to experts, breast milk jaundice is an uncommon condition that affects only 0.5 to 2.4% of all newborns (11).

2. What is the difference between breast milk jaundice and breastfeeding jaundice?

Breastfeeding jaundice occurs when the baby’s not receiving enough milk to lower their bilirubin levels. On the other hand, breast milk jaundice occurs due to unknown causes. However, doctors believe that its occurrence is linked to some substance in breast milk that hinders the liver’s ability to process bilirubin (12).

3. Can jaundice in babies cause autism?

Some research studies indicate there is a link between jaundice and autism. However, more research is warranted to validate the relationship (13) (14).

4. Is sunlight good for newborn jaundice?

Experts indicate that sunlight exposure during the daytime can help reduce bilirubin levels. This technique works well when the baby is exposed to sunlight indirectly and undressed (15).

Breastmilk jaundice usually occurs a week after birth when certain components of breastmilk prevent bilirubin breakdown. Immature liver functions and more red blood cells make babies more prone to developing jaundice. Breastmilk jaundice mostly resolves on its own in a few weeks and seldom has long-lasting complications in full-term babies. Do not stop breastfeeding unless advised by the doctor. The benefits of breastfeeding overpower the risks, and it may also help improve the condition. Consult a pediatrician for advice on the care and nutrition of the baby.

Key Pointers

  • Certain substances in breast milk may prevent liver enzymes from processing bilirubin, causing breast milk jaundice.
  • Symptoms include yellow coloration of the skin and eye whites, fussiness, and pale stools.
  • As the exact cause is unknown, genetic factors may predispose some babies to the condition.
  • Doctors may suggest phototherapy, increased feeding sessions, or formula feeding in some cases.

References

1. Jaundice and breastfeeding; U.S. National Library of Medicine
2. Jaundice; CDC
3. Stephanie Bratton, Rebecca M. Cantu, and Mitchell Stern, Breast Milk Jaundice; NCBI
4. Newborn jaundice; NHS UK
5. Jaundice in Newborns (Hyperbilirubinemia); C.S. Mott Children’s Hospital
6. Prashant G Deshpande et al., Breast Milk Jaundice; Medscape
7. Jaundice; La Leche League International
8. What Do You Do For Breast Milk Jaundice?; Pediatric Education
9. Breast milk jaundice; Mount Sinai Health System
10. Breast Feeding and Jaundice; Birth Injury Help Center
11. Breastfeeding and Jaundice; American Pregnancy Association
12. Breast Feeding and Jaundice; Birth Injury Help Center
13. Sanjiv B. Amin et al.; (2011); Is Neonatal Jaundice Associated with Autism Spectrum Disorders: A Systematic Review; NCBI
14. Christina Cordero et al.; (2020); Neonatal jaundice in association with autism spectrum disorder and developmental disorder; NCBI
15. Jaundice in Newborns: Parent FAQs; AAP
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Mary Miller
Mary MillerMA, IBCLC, RLC, CLC, CPD, MCH
Mary Miller received her degrees in Interpersonal Communications and Maternal Health and Lactation and founded the Breastfeeding Support Center of WNY in Buffalo, New York. She has 20 years of experience as a lactation specialist.

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