Every mother wants the best for her child. And so the long-awaited baby is born. What could be healthier and healthier for him than breastfeeding? Unfortunately, on this path, prepared by nature itself, mother often encounters difficulties. One of them is breast milk jaundice. What it is? Is it possible to maintain breastfeeding with such a diagnosis?
What happens to a newborn?
Statistics inexorably show that approximately 65% of all newborns on the second or third day after birth acquire a golden, yellow-orange color. From inexperienced mothers, one can hear scary stories that a child in the hospital was infected with jaundice, blood got from milk, a newborn's liver fails or the bile ducts are clogged. How are things really?
Jaundice of newborns, despite the frightening name associated with severe liver diseases, is not so scary. This is an indicator of certain processes occurring in the body of the baby, which recently replaced the mother’s womb with diapers and vests.
The baby’s body immediately after birth is forced to rearrange all metabolic processes. At a certain level, its organs and systems can not cope with such a load. Jaundice is one such condition. With it, the level of bilirubin in the baby’s blood rises, and the skin, sclera of the eyes and mucous membranes acquire a yellowish tint.
Distinguish between physiological and pathological forms. Breast milk jaundice is a transient (physiological) condition of the infant.
The mechanism of jaundice
In human blood, there are special blood cells - red blood cells, responsible for the transport of oxygen and carbon dioxide. Their lifespan is not long and is approximately 120 days. Destroyed, they form bilirubin. This is a very toxic substance, so the bloodstream instantly delivers it to the liver, where it is neutralized by liver enzymes and excreted through the biliary tract.
Due to its weakness and immaturity, the baby’s liver can not always cope with the amount of incoming bilirubin. Then it enters the bloodstream, causing yellowing of the skin and mucous membranes.
Jaundice develops when the bilirubin level reaches 50 μmol / liter. Dangerous and requiring immediate treatment is the level of total bilirubin above 256 μmol / liter.
If the value exceeds 600 μmol / liter, then organic damage to the brain and the development of cerebral palsy are possible.
Pathological types of jaundice
There are several types of pathological condition of newborns:
- obstructive jaundice (occurs with pathology of the biliary system);
- parenchymal jaundice (manifested in infectious diseases and toxic damage);
- hemolytic jaundice (develops in newborns in whose blood there is an increased destruction of red blood cells);
- conjugation jaundice (with this type of disease, liver enzymes have a low binding capacity).
All these conditions are dangerous and require constant monitoring by doctors.
The physiological condition of the baby
Jaundice is not always a pathology. More than half of all infants, 1-2 days after birth, turn yellow-orange, regardless of the type of feeding. This is due to the immaturity of the liver enzyme system. The condition is not pathological and usually disappears within 1-2 months.
If any type of jaundice occurs, constant monitoring of the bilirubin level is necessary, since high values require immediate treatment. Depending on the growth rate of the indicators, the child may be prescribed phototherapy or a blood transfusion. The second type of treatment is usually required for hemolytic jaundice resulting from the Rh conflict of the mother and child.
Another physiological form of hyperbilirubinemia is breast milk jaundice, which occurs in naturally-fed infants. Let us dwell on it in more detail.
Breast milk jaundice in newborns
For a sufficiently long time, hyperbilirubinemia in newborns was considered a pathological condition. However, scientists noticed that not all yellowed babies have pathologies of the liver, bile ducts, a conflict with their mother over a blood group or Rh factor. Then the question arose of whether there can be jaundice from breast milk?
Research in this area shows that this is possible. The phenomenon of breast milk jaundice or Aries syndrome has not yet received a scientific explanation. Some researchers attribute it to the ability of breast milk to inhibit processes in the liver. Others suggest that estrogen contained in human milk is to blame. It is believed that they displace bilirubin from bonds with glucuronic acid.
In any case, jaundice of breast milk in newborns is not a pathological condition until the values of bilirubin exceed the indicators that pose a danger to the life and health of the child.
How to distinguish physiological jaundice from Aries syndrome?
Hyperbilirubinemia in breast-fed children is almost three times more common than their peers on artificial feeding. Despite the fact that the true causes of jaundice from breast milk have not yet been identified, recent studies prove that it is completely safe and does not adversely affect the health of the newborn.
Unlike physiological jaundice, which occurs within 20-30 days after birth, Aries syndrome can accompany babies up to 3-4 months. How to distinguish these two states from each other?
To do this is quite simple: you need to interrupt breastfeeding for up to 24 hours and check the level of bilirubin before and after the study. With jaundice from mother’s milk, its level will decrease by about 20%, with physiological hyperbilirubinemia it will remain unchanged.
Since both of these conditions, with satisfactory bilirubin levels, are not dangerous for the newborn, breast-feeding experts do not advise interrupting feeding. Such an experiment provokes a stressful state of the mother and child and can lead to a decrease in lactation.
Therapy for hyperbilirubinemia
Methods of treating jaundice directly depend on the level of bilirubin in the blood. Due to possible serious consequences for the child, one should not let things go by themselves: bilirubin must be controlled. Moreover, the higher its level, the more often you have to do it.
Interestingly, the root cause of hyperbilirubinemia is not very important: both mother's jaundice and yellowing caused by hemolytic disease are treated approximately the same. With an increase in the level of bilirubin to 250 μmol / liter, the child is prescribed phototherapy. Radiation does not translate direct, dangerous bilirubin into a straight line, which is excreted in the urine of the newborn.
Also, the doctor may prescribe dosing with water or glucose solution: this measure allows you to quickly remove dangerous substances from the baby's body. If the bilirubin level rises, despite the measures taken, and the cause of hyperbilirubinemia in breast milk, the mother will be asked to interrupt natural feeding for up to 24 hours.
With pathological types of jaundice, a decision can be made about a blood transfusion. Such measures are usually taken in severe conditions of the infant and the growth of bilirubin at a rate of 5 μmol / liter per hour.
Is it necessary to interrupt natural feeding?
Due to a lack of information about breast milk jaundice in newborns, a young mother may be faced with a categorically negative attitude of doctors regarding the advisability of breastfeeding. If the level of bilirubin in the baby's blood does not exceed 250 μmol / liter, it is worth looking for a pediatrician or neonatologist who is aware of the latest research in this area.
The recommendations of the association’s specialists on breastfeeding advise the following “treatment” for breast jaundice:
- With a non-hazardous level of bilirubin, do not interrupt breastfeeding.
- Put your baby on your chest as often as possible. Mother's milk has a laxative effect: it will help to remove harmful substances much faster.
- The higher the bilirubin level, the calmer and drowsier the child. The more the baby sleeps, the stronger the concentration of harmful substances in his blood rises. It turns out a vicious circle. To break it, you need to wake the baby and put it on his chest.
- A child undergoing phototherapy needs a lot of fluid. If there is not enough milk, and the baby cannot be applied to the breast more often, discuss with your doctor the possibility of feeding with expressed milk or glucose. This option is preferable to the mixture.
- Some breastfeeding counselors recommend boiling breast milk with jaundice, as an alternative to breastfeeding. Upon pasteurization, antibodies and hormones in milk are destroyed. How to boil? At the bottom of the pan, place a towel folded several times, put bottles of milk and pour water to the level of milk. Bring to a boil and boil for three minutes. Remove and cool the bottles. You need to store such milk in the refrigerator for no longer than 24 hours.
- If all of the above methods do not help and bilirubin is growing, it is worth interrupting breastfeeding for 24-48 hours.
Children at risk
Which babies are most prone to jaundice? At risk are:
- premature or low birth weight infants;
- children from multiple pregnancy;
- babies whose mothers have developed diabetes mellitus in pregnant women;
- children born during Rh-conflict pregnancy.
What threatens hyperbilirubinemia?
What are the effects of breast milk jaundice? If the baby's skin casts a golden hue, you can not self-medicate. Bilirubin must be controlled, since its high values can develop into nuclear jaundice, from which one step to cerebral palsy and mental retardation.
At the first signs of hyperbilirubinemia, you must consult a doctor who will draw up an individual visit schedule. If the numbers increase dangerously, you may have to go to hospital for several days.
As a rule, 10 sessions of phototherapy are enough to significantly reduce the level of indirect bilirubin.
Light and modern technology
About 30 years ago, only replacement blood transfusion was used to treat jaundice in newborns, until quite by accident, scientists discovered that when exposed to intense sunlight, fat-soluble, dangerous bilirubin passes into water-soluble and quickly excreted from the body.
It was then that photolamps began to be used to treat hyperbilirubinemia. For the best effect, the baby should have a minimum of clothing - only the genitals and eyes are covered. The baby is in a special box, which does not allow him to freeze.
Today there is fiber optic phototherapy technology. At the same time, the baby is wrapped in a special blanket in which blue lamps are mounted.
The advantage of this method is that you do not have to interrupt the procedure to feed the baby. In addition, the baby, being in the arms of the mother, behaves calmer, tolerates phototherapy better.
Home methods
Is it possible to help a baby with prolonged jaundice if the values of bilirubin do not exceed dangerous values and special therapy is not indicated? In addition to frequent attachments to the breast, a young mother can be advised to lay the baby out in the sun. However, not under direct sunlight, but under the "lace shadow." So the baby will not have sunburn, but he will receive a good dose of ultraviolet radiation, which will help to remove harmful substances from his body faster.
Often with jaundice, various sorbents are recommended: activated carbon, Enterosgel, and Creon. Their effectiveness or uselessness has not yet been proven, therefore, before taking it, you should always consult your doctor.