About half of all newborns develop jaundice, a common condition that causes yellowing of a baby’s skin and eyes. This article will help you understand more about the different types of jaundice and how breastfeeding affects the condition.

It’s common for newborns to develop jaundice, a condition where the baby’s skin and the whites of her eyes become yellow. This is due to the excess of bilirubin in the blood, a substance produced by the normal breakdown of red blood cells.

Bilirubin is an orange-yellow pigment formed in the liver by the breakdown of red blood cells and bile. Under normal conditions, the liver alters the structure of bilirubin so that it can be excreted in the form of stools (faeces). An excess of bilirubin in the blood, or if the liver cannot remove bilirubin from the body, will cause jaundice. The excess of bilirubin is also known as hyperbilirubinaemia.

Jaundice usually subsides on its own within two to three weeks. According to the American Academy of Pediatrics (AAP), jaundice that persists longer than three weeks may be a symptom of an underlying condition. “Additionally, high levels of bilirubin can put a baby at risk for deafness, cerebral palsy, or other forms of brain damage,” AAP says and recommends that each time babies are measured for vital signs, they should be examined for jaundice as well, or at least every 8 to 12 hours; before discharge from the hospital; and again a few days after discharge.

According to AAP, jaundice is also more common in breastfed babies and tends to last a bit longer. There is no clear reason as to why breastfed babies have higher probabilities of developing jaundice. A theory has suggested that maybe there are elements in breast milk that somehow lowers the capability of the liver to process bilirubin. Newborn jaundice which is related to breastfeeding is known as “breast milk jaundice”.

Breast milk jaundice is a form of jaundice that continues on even after physiological jaundice has decreased. This condition is often seen in healthy, full-term and breastfed babies. Breast milk jaundice is usually hereditary. Babies who have breast milk jaundice (only 0.5% to 2.4% of newborns) may have a surge of bilirubin, but this will level out and eventually decline. Breast milk jaundice has been known to last for 3-12 weeks after birth. This condition seldom results in serious complications. If your baby has breast milk jaundice, monitor your baby’s bilirubin levels and ensure that she is feeding well.

Breast milk jaundice also differs from breastfeeding jaundice. Breastfeeding jaundice occurs due to an inadequate consumption of milk. Sufficient amounts of breast milk increase a baby’s bowel movements, which in turn help to excrete the accumulated bilirubin. Breastfeeding jaundice can happen when a newborn has an unsuitable latch, does not begin breastfeeding well, or is fed with other replacements that affect breastfeeding. Breastfeeding jaundice usually resolves by itself and can be remedied through added feedings and assistance from a lactation consultant to ensure that your baby is having breast milk in sufficient amounts.

Jaundice can also be caused by other health problems – this form of jaundice is known as “pathological jaundice”.

Some causes of pathological jaundice include:

• Abnormally low activity of the thyroid gland (hypothyroidism): The thyroid gland does not produce sufficient hormones
• Incompatible blood groups: When the mother and baby are of different blood types, a mixture of these two types of blood during the pregnancy or birth can result in jaundice
• Rhesus factor disease: A blood condition that can occur from the incompatibility of the mother and baby’s blood, where the mother has rhesus-negative blood while the baby has rhesus-positive blood
• Inherited enzyme deficiency: Enzymes are proteins that rapidly control chemical reactions in the body. Deficiency of the glucose-6-phosphate-dehydrogenase (G-6-PD), an enzyme that aids red blood cell function may cause jaundice as well
• Urinary tract infection
• Crigler-Najjar syndrome: Inherited condition which affects the bilirubin-processing enzyme, resulting in an accumulation of bilirubin
• Blockage or defect in the biliary system: The biliary system consists of bile ducts and gall bladder, responsible for forming and transporting bile (a fluid that digests fatty foods)

With a statistic of jaundice occurrence in newborns at 50-70%, there are no exact ways to prevent your baby from developing jaundice.

However, there are some breastfeeding tips you can follow to prevent this condition from worsening:

• Begin breastfeeding as soon as possible after birth. Studies have shown that when breastfeeding is introduced within the first few hours after birth, you are also more likely to breastfeed your baby effectively.
• Seek help from a lactation professional to ensure that a proper latch is achieved and your baby is fed with sufficient amounts of milk. Improper latch affects the amount of milk a baby receives.
• Feed your baby regularly during his first weeks. Do not put the baby on a “schedule” until the breastfeeding bond has been successfully formed.
• Avoid supplementing or interrupting breastfeeding if possible.

If your baby requires jaundice treatment, he or she may require extra fluids and additional feeds. If your baby is premature or has any additional health conditions, your doctor will provide a customized treatment for jaundice in order to avoid any medical complications. The following treatments are administered on healthy infants who develop breast milk jaundice and breastfeeding jaundice, especially if bilirubin levels are less than 20 milligrams:

The number of feedings is increased to 8-12 times per day. The most effective way to decrease the symptoms of jaundice is to help remove bilirubin. Increased feedings will also increase bowel movements, which in turn excrete
the bilirubin.

If your baby’s bilirubin levels reach 20 milligrams or above, your doctor may recommend you to stop breastfeeding for 24 hours, along with a combination of phototherapy to reduce bilirubin levels.