Serum bilirubin levels at 72 hours by selected characteristics in breastfed and formula‐fed term infants delivered by cesarean section

Abstract

The present multicenter study analysed the relative impact of maternal and infant factors on serum bilirubin levels at 72 ± 12 h in exclusively breastfed vs formula‐fed term infants. End‐tidal carbon monoxide levels corrected for ambient air (ETCOc), an index of bilirubin production, were measured in exclusively breastfed (B = 66) or formula‐fed (F = 210) term infants at 2–8 h of age. Inclusion criteria included cesarean section to ensure a 3 d hospitalization, birthweight ±2500 g, gestational age ±37 wk and absence of any illness. The ETCOc for B infants and F infants did not differ significantly (1.3 ± 0.7 ppm vs 1.3 ± 0.8 ppm). The serum bilirubin level at 72 ± 12 h was significantly higher in B infants than in F infants (8.5 ± 3.4mg dl−1 vs 6.7 ± 3.4 mg d l−1, p < 0.001), as was the percentage weight loss from birthweight. Serum bilirubin levels were significantly higher in infants who were male, who did not have meconium‐stained amniotic fluid, and in those whose mothers were insulin‐dependent diabetics or hypertensive. There was no difference between groups in the need for phototherapy or exchange transfusion. Conclusion: Although higher bilirubin levels were observed in group B at 72 ± 12 h compared with group F, this finding was not of clinical or therapeutic consequence in this study. The lack of difference in ETCOc between the groups may be a factor of the timing of ETCOc measurement in this study, or may suggest that early increased bilirubin production is not a significant contributor to jaundice observed in exclusively breastfed infants.

Combining Clinical Risk Factors With Serum Bilirubin Levels to Predict Hyperbilirubinemia in Newborns

“…Although many previous studies have examined clinical risk factors for hyperbilirubinemia, [30][31][32][33][34][35][36] few have combined clinical and laboratory information. Seidman et al 29 studied clinical risk factors combined not only with early TSB levels, but also with the change in TSB levels over the first 2 days.…”

Yenidoğan ünitesine sarılık nedeniyle yatırılan bebeklerin klinik ve laboratuar özellikleri ve risk faktörlerinin araştırılması

“…[12] Yenidoğan sarılığı erkek bebeklerde daha sık görüldüğü bilinmektedir. [13,14] Çalışmamızda hastaların %55'ini erkek bebekler oluşturuyordu. Hiperbilirübinemi düzeyi ile cinsiyet açıdan karşılaştırıldığında istatiksel olarak anlamlı bir fark tespit edilmedi.…”

Weighing the Facts

“…For the first 2 days of life, breastfeeding infants receive only small amounts of colostrum from the breast. [3][4][5] This figure is now being challenged. For a small percentage of infants, too much weight loss may indicate a problem.…”