Pediatric Board Case : Breastfeeding Jaundice vs. Human Milk Jaundice

Pediatric Board Case : Breastfeeding Jaundice vs. Human Milk Jaundice

Posted by Stu Silverstein, MD, FAAP on Jan 12th 2020

Not So Mellow Yellow! 

While this topic is not that complicated when broken down, the terminology can be confusing.. This is especially the case if you do not take that extra moment to " read the questions carefully. 

If you are not careful you easily pick the wrong answer, and when the clock hits 12:00 your board certification carriage will turn into a yellow pumpkin.

Managing Neonatal Jaundice

One of the content specifications is “Managing Neonatal Jaundice”. One of the more confusing challenges is to distinguish “Breastfeeding Jaundice from Human Milk Jaundice”. The terms are very similar and easily confused.

Breast Feeding Jaundice

  • Breastfeeding jaundice:
  • Occurs during the first days of life
  • It is due to decreased caloric intake
  • This results in increased enterohepatic circulation
  • Mild dehydration and delayed passage of meconium are additional factors

How do you treat breastfeeding jaundice?

Well if breastfeeding is the cause, then the solution is to stop breastfeeding indefinitely! Wrong!

Treatment would be increasing breastfeeding with formula supplementation. Indications for supplementation  include an infant that lost more than 10% of the birth weight as well as other factors.

Human Milk Jaundice

Human Milk Jaundice was previously called “Breast Milk Jaundice” This made it even more difficult to distinguish it from “Breastfeeding jaundice”

Human Milk Jaundice:

Occurs between 1-2 weeks of age

Is due to inherent factors in human milk

Treatment of Human Milk Jaundice is to stop breastfeeding temporarily until the problem is resolved

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