Definition: a type of neonatal jaundice caused by insufficient breastfeeding
Pathophysiology: insufficient breast milk intake → lack of calories and inadequate quantities of bowel movements to remove bilirubin from the body → ↑ enterohepatic circulation → increased reabsorption of bilirubin from the intestines → unconjugated hyperbilirubinemia
Clinical features: onset within 1 week
Breast milk jaundice
Definition: a type of neonatal jaundice caused by increased levels of β-glucuronidase in maternal breast milk
Pathophysiology: increased concentration of β-glucuronidase in breast milk → ↑ deconjugation and reabsorption of bilirubin → persistence of physiologic jaundice with unconjugated hyperbilirubinemia
β-Glucuronidase is found in breast milk and the intestinal brush border.
Deconjugation of bilirubin by bacterial β-glucuronidase can lead to pigment stone formation.
Clinical features: onset within 2 weeks after birth; lasts for 4–13 weeks
Treatment
Continued breastfeeding and supplementation with formula feeds
Phototherapy, if required
Clinical features
Diagnostics
Treatment
Complications
Kernicterus (chronic bilirubin encephalopathy)
Develops over first years of life
Pathophysiology: deposition of unconjugated bilirubin (liposoluble) in the basal ganglia and/or brain stem nuclei