Hyperbilirubinemia: Should We Adopt a New Standard of Care?

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 824-826
Author(s):  
WILLIAM J. CASHORE
Keyword(s):  
Breast Milk ◽  
Standard Of Care ◽  
Term Infants ◽  
Current State ◽  
Breast Milk Jaundice

The review and recommendations by Newman and Maisels1 in this issue of Pediatrics constitute a provocative critique of our current state of knowledge concerning the risks of hyperbilirubinemia in term infants and should begin a dialogue about the recommended standard of care for jaundiced newborns. For several decades, the use of exchange transfusions to prevent kernicterus and phototherapy to prevent exchange transfusions, the puzzling emergence of low-bilirubin kernicterus, the "discovery" of breast milk jaundice, and concern over the possible contribution of bilirubin to neurologic handicap have combined to encourage preemptive intervention for moderate jaundice in asymptomatic newborns. But has this strategy of anticipatory management become hardened into an overly aggressive pattern of testing and treatment? Newman and Maisels conclude that it has.

scholarly journals Incidence of breast milk jaundice in healthy full-term infants

2007 ◽  
Vol 50 (11) ◽  
pp. 1072 ◽  
Author(s):  
Yong Ho Yoon ◽  
Kyong Eun Choi ◽  
Kyung Ah Kim ◽  
Sun Young Ko ◽  
Yeon Kyung Lee ◽  
...  
Keyword(s):  
Breast Milk ◽  
Full Term ◽  
Term Infants ◽  
Breast Milk Jaundice

scholarly journals Breast Milk Jaundice and Maternal Diet with Chinese Herbal Medicines

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Yi-Hao Weng ◽  
Ya-Wen Chiu ◽  
Shao-Wen Cheng
Keyword(s):  
Breast Milk ◽  
Maternal Diet ◽  
Herbal Medicines ◽  
Term Infants ◽  
Chinese Herbal Medicines ◽  
Transcutaneous Bilirubin ◽  
Chinese Herbal ◽  
Breast Milk Jaundice ◽  
Breast Fed ◽  
Prolonged Jaundice

Our objective was to identify the association between maternal diet with Chinese herbal medicines and prolonged jaundice of breast-fed infants. Healthy infants at 25 to 45 days of age were eligible for enrollment into this prospective study. Jaundice was defined as a transcutaneous bilirubin (TcB) value ≥ 5 mg/dL. A questionnaire survey asking feeding type, stool pattern, and maternal diet was conducted at the time of TcB measurement. A total of 1148 infants were enrolled, including 151 formula-fed, 436 combination-fed, and 561 breast-fed infants. The incidences of jaundice were 4.0% in formula-fed infants, 15.1% in combination-fed infants, and 39.8% in breast-fed infants (P<0.001). In addition, jaundice was noted in 37.1% of preterm infants and 25.0% of term infants (P<0.001). Furthermore, jaundice was more common in breast-fed infants whose mothers did not consume the traditional Chinese herbal medicines than in breast-fed infants whose mothers did consume such medicines (P<0.001). In conclusion, this cohort study has identified late-preterm birth and breast feeding as the contributory factors for prolonged jaundice of apparently well infants. The data indicate that postpartum diet with Chinese herbal medicines is associated with breast milk jaundice.

Postnatally acquired CMV meningitis diagnosed via BioFire FilmArray: A case report

2020 ◽  
pp. 1-6
Author(s):  
A. Stark ◽  
J. Peterson ◽  
K. Weimer ◽  
C. Hornik
Keyword(s):  
Case Report ◽  
Birth Weight ◽  
Breast Milk ◽  
Premature Infants ◽  
Gold Standard ◽  
Very Low Birth Weight ◽  
Definitive Treatment ◽  
Cmv Infection ◽  
Term Infants ◽  
Low Birth Weight Infant

Postnatally acquired cytomegalovirus (CMV) is commonly acquired via breast milk, with premature infants more frequently developing symptoms of CMV infection in comparison to term infants. Meningitis is a rare clinical manifestation of CMV infection. The diagnosis of meningitis is difficult to make in infants, particularly those who are preterm. Consequentially, broad-spectrum empiric antimicrobial coverage is often administered for several days while waiting for current gold standard CSF testing to result. The BioFire FilmArray (BFA) simultaneously tests for 14 different pathogens, including CMV, allowing for quicker diagnosis and shorter time to definitive treatment. Here, we report a very low birth weight infant with postnatally acquired CMV meningitis, the first to our knowledge to be diagnosed using the BioFire FilmArray.

scholarly journals Retinol, α-tocopherol, and selected minerals in breast milk of lactating women with full-term infants in South Korea

2017 ◽  
Vol 11 (1) ◽  
pp. 64 ◽  
Author(s):  
Hyesook Kim ◽  
Byung-Mun Jung ◽  
Bum-Noh Lee ◽  
Yun-Je Kim ◽  
Ji A Jung ◽  
...  
Keyword(s):  
Breast Milk ◽  
South Korea ◽  
Full Term ◽  
Term Infants ◽  
Lactating Women

Breast milk jaundice--early and late

1983 ◽  
Vol 50 (3) ◽  
pp. 339-339 ◽  
Author(s):  
J. P. Orlowski
Keyword(s):  
Breast Milk ◽  
Breast Milk Jaundice

scholarly journals Receipt of Breast Milk by Gestational Age – United States, 2017 (P11-060-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Katelyn Chiang ◽  
Andrea Sharma ◽  
Jennifer Nelson ◽  
Christine Olson ◽  
Cria Perrine
Keyword(s):  
United States ◽  
Breast Milk ◽  
Gestational Age ◽  
Infant Nutrition ◽  
Birth Certificate ◽  
The United States ◽  
Late Preterm ◽  
Term Infants ◽  
Oak Ridge ◽  
Extremely Preterm

Abstract Objectives Breast milk is the optimal source of infant nutrition. For the nearly 1 in 10 infants born prematurely in the United States annually, breast milk is especially beneficial, helping prevent sepsis and necrotizing enterocolitis (NEC) and promoting neurological development. Though the importance of breast milk for preterm infants has been established, national estimates of feeding practices by gestational age are unavailable. Our objective was to describe receipt of breast milk among preterm and term infants delivered in the United States in 2017. Methods Birth certificate data from 48 states and the District of Columbia (n = 3,194,873; 82.7% of all births) were analyzed to describe receipt of breast milk before birth certificate completion among extremely preterm (20-27 weeks), early preterm (28-33 weeks), late preterm (34-36 weeks) and term infants (≥ 37 weeks) with further stratification by maternal and infant characteristics. Results The prevalence of infants receiving breast milk was 83.9% overall and varied by gestational age: 71.3% (extremely preterm), 76.0% (early preterm), 77.3% (late preterm), and 84.6% (term). Disparities in receipt of breast milk by maternal race/ethnicity were noted across gestational ages. Infants delivered to black or American Indian/Alaska Native mothers were the least likely to have received breast milk while those delivered to white, Hispanic, and Asian mothers were more likely to have received breast milk. Differences in receipt of breast milk by other maternal sociodemographic factors also persisted similarly across gestational ages. Among late preterm and term infants, receipt of breast milk was lower for those admitted to the neonatal intensive care unit (NICU) than those not admitted to the NICU. Conclusions Fewer preterm than term infants received breast milk in the first few days of life. Optimal hospital policies and practices that support breast milk feeding and ensure availability of donor milk for high-risk infants may help improve infant nutrition and reduce infant morbidity and mortality. Mothers of infants admitted to the NICU may need additional support given the challenges associated with having a medically fragile infant such as mother-infant separation and extended infant hospitalization. Funding Sources Centers for Disease Control and Prevention, Oak Ridge Institute for Science and Education.

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