High or rapidly rising bilirubin levels (i.e. physiological jaundice) are observed within 4 days of birth in up to 60% of otherwise healthy babies. These symptoms are rarely related to feeding and only about 10% of babies with jaundice require specialist treatment.1 Breast-feeding should be actively encouraged: colostrum has a laxative effect and helps babies to pass meconium quickly, thereby keeping down the bilirubin levels. If the mother is unable to offer the breast for every feed, expressed milk should be given. If a baby with jaundice is lethargic, unresponsive and reluctant to feed, or if jaundice continues beyond the first 2–3 days, the GP or paediatrician should be consulted immediately, to rule out pathological jaundice.2 With the exception of galactosaemia, breast-feeding can continue during the treatment of pathological  jaundice.

References1. Lazarus C et al. Neonatal hyperbilirubinemia management: a model for change. J Perinatol 2009; 29: S1.

2. Tizzard S et al. Yellow alert! How to identify neonatal liver disease. J Fam Health Care 2008; 18(3): 98–100.

ResourceChildren’s Liver Disease Foundation. Available at http://www.childliverdisease.org/ Visit www.childliverdisease.org. Accessed 12 Nov 2009.

From: Journal of Family Health Care Bulletin. Directory of Breast-Feeding Advice. December 2009. Published with JFHC 2009; 19(6). http://www.jfhc.co.uk/images/stories/breastfeeding.pdf