The prevalence of prolonged jaundice due to breast milk jaundice in hospitalized newborn; a study among Iranian neonates

Introduction: Breast milk jaundice is considered as the most common cause for neonatal jaundice; however, its epidemiological aspects in some population remain unclear. Objectives: The present study aimed to assess the prevalence of breast milk jaundice and its main determinant among a group of neonates in western Iran. Patients and Methods: This cross-sectional study was conducted on 413 neonates hospitalized due to prolonged jaundice in Besat hospital in Hamadan, Iran. The study information was collected by reviewing the hospital’s recorded files. Results: In total, 413 neonates hospitalized were assessed in this study. The main reason for appearing jaundice included; 72.4% of cases of jaundice were due to breast milk, urinary tract infection in 4.2% of cases, glucose-6-phosphate dehydrogenase deficiency (G6PD) in 5.8% of cases, hypothyroidism in 1.2% of cases. Out of 299 neonates suffering from breast milk jaundice, 126 (42.1%) were male, and 173 (57.9%) were female with the overall average age of 16.68 ± 2.14 days. Jaundice appeared at less than two days of age in 29.4% of neonates, between 15 to 20 days of age in 64.9%, and more than 20 days of age in 5.7% of cases. Conclusion: Breast milk jaundice is considered as the most common reason for neonatal jaundice in our population, which affects more than two-thirds of our neonates. Additionally, the peak age of this phenomenon is between 15 and 20 days. The appearing breast milk jaundice is independent of gender, age, and birth weight or baseline total serum bilirubin level.

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Screening of Glucose-6-Phosphate Dehydrogenase Deficiency in Neonatal Hyperbilirubinaemia at 300-Bedded Pyin Oo Lwin General Hospital

Myanmar Health Sciences Research Journal ◽

10.34299/mhsrj.00952 ◽

2019 ◽

Vol 31 (3) ◽

pp. 226-232

Keyword(s):

General Hospital ◽

G6pd Deficiency ◽

Serum Bilirubin Level ◽

Total Serum ◽

Cross Sectional ◽

Qualitative And Quantitative ◽

Quantitative Measurements ◽

Human Enzyme ◽

High Prevalence ◽

Glucose 6 Phosphate Dehydrogenase

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common human enzyme deficiencies in the world. It is particularly common in populations living in malaria-endemic areas, affecting more than 400 million people worldwide. This hospital- and laboratory-based, cross-sectional descriptive study was conducted with the aim of determining the prevalence of G6PD deficiency among 200 newborns at 300-bedded Pyin Oo Lwin General Hospital during January to March 2017. The participants were 103 girls (58.5%) and 97 boys (41.5%). Both qualitative and quantitative measurements by using Brewer's method and G-SIX kit method were applied for diagnosis of G6PD deficiency. Total serum bilirubin level was measured by Bilirubinometer. Of the 200 newborns, 21(10.5%) were G6PD deficient. The overall prevalence of G6PD deficiency was 10.5% (21/200) and male was predominant than female (17.5% vs 3.9%). Out of 10.5% (21/100)G6PD deficient newborns, 5(23.8%) and 16(76.2%) were mild and moderate G6PD deficiency, respectively. Regarding hyperbilirubinaemia, 9(42.9%), 3(14.3%), 2(19.0%) and 5(23.8%) were severe, moderate and mild hyperbilirubinaemia and normal bilirubin, respectively. This study showed that a significant correlation between the severity of hyperbili- rubinaemia and G6PD activity (p <0.05). Taking into consideration of the above results, the high prevalence can be useful for providing appropriate prevention and early treatment of complications in routine neonatal screening in this area.

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Frequency of Hypocalcemia with Exchange Transfusion in Neonatal Jaundice

10.53350/pjmhs211581849 ◽

2021 ◽

Vol 15 (8) ◽

pp. 1849-1851

Author(s):

Ambreen Ali ◽

Ashfaq Ahmad Shah Bukhari ◽

Shameela Majeed ◽

Saira Gul ◽

Nomana Khalil ◽

...

Keyword(s):

Serum Level ◽

Study Design ◽

Selection Criteria ◽

Exchange Transfusion ◽

Neonatal Jaundice ◽

Serum Bilirubin ◽

Cross Sectional Study ◽

Total Serum ◽

Sectional Study ◽

Cross Sectional

Aim: To determine the frequency of hypocalcemia with exchange transfusion in neonatal jaundice. Study design: Descriptive cross-sectional study Place and duration of study: Departments of Pediatrics and Pathology, Naseer Teaching Hospital Peshawar from 1stJanuary 2018 to 31st December 2018. Methodology: One hundred and sixty twopatients of jaundiced neonates having total serum bilirubin >20mg/dl, both gender and patients having age up to 14 days were included. Patients fulfilling the selection criteria had undergone exchange transfusion. Hypocalcaemia was evaluated and considered positive if calcium serum level is <8 mg/dl or <2 mmol/L. Results: 50% of neonates were between 1-5 days, 45% of neonates were between 5-10 days, and 3% of neonates were in age 10-14 days. One hundred and ten (68%) of neonates were males and 52 (32%) of neonates were females. 30% neonates had hypocalcemia while 70% were without hypocalcemia. Conclusion: The incidence of hypocalcemia was found to be 30% with exchange transfusion in neonatal jaundice. Keywords: Hypocalcemia, Exchange transfusion, Neonatal jaundice

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Glucose-6-phosphate dehydrogenase deficiency; the single most important cause of neonatal hyperbilirubinaemia in Kano, Nigeria

Nigerian Journal of Paediatrics ◽

10.4314/njp.v44i2.1 ◽

1970 ◽

Vol 44 (2) ◽

pp. 44-49

Author(s):

ZL Farouk ◽

M Ibrahim ◽

WN Ogala

Keyword(s):

Risk Factor ◽

Neonatal Jaundice ◽

Dehydrogenase Deficiency ◽

Cross Sectional Study ◽

Important Risk Factor ◽

Mortality Pattern ◽

Cross Sectional ◽

Female Ratio ◽

Glucose 6 Phosphate Dehydrogenase ◽

Male To Female

Introduction: Glucose- 6-phosphate dehydrogenase deficiency is the most common enzymatic disorder of the red cell and an important risk factor for neonatal jaundice.Methodology: The aim of the study was to determine the incidence of G-6-PD deficiency among jaundiced neonates, and describe the associated morbidity and mortality pattern in them. A prospective cross sectional study was conducted and we studied one hundred consecutive jaundiced neonates (55 males, 45 females) presenting at Aminu Kano Teaching Hospital from between 2004 and August 2005. G-6-PD activity was assayed by Quantitative spectrophotometric method of Kornberg; serum bilirubin and haemoglobin levels were estimated by standard techniques. Exposure to possible Icterogenic agents, clinical features of kernicterus and the outcome were noted.Results: The incidence of G-6-PD deficiency was found to be 46% with male to female ratio of 3:1 (Χ2 = 15, p = 0.001). A higher proportion (60.6%) of the inborn neonates had G-6-PD deficiency (X2 = 5.5, p = 0.06). Jaundice was noticed significantly earlier in the G-6-PD deficient neonates (mean = 2.0, SD = 1 days) compared to (mean = 2.7, SD = 1.6 days) in the sufficient neonates (t = 2.3, p = 0.02). Sixteen (16%) neonates developed kernicterus, of these 10 (63%) were G-6-PD deficient. The mortality rate among G-6-PD deficient neonates was 15% (7 of 46) twice as much as in the sufficient neonates 7% (4 of 54). Only six neonates 0.6% ware exposed to naphthalene of whom three were G -6PD deficient. Five babies were given traditional medicine two of which were G6-PD deficient.Conclusion: G-6-PD deficiency is an important risk factor for neonatal jaundice. Jaundice appeared early in the deficient neonates. There is high incidence of kernicterus and mortality among them. Low admission weight significantly contributed to the mortality.Key Words: G-6-PD deficiency; Neonatal Jaundice; Kernicterus

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Reliability of Visual Assessment for Diagnosis of Neonatal Jaundice Among Neonates of Black Descent: A Cross-Sectional Study From Tanzania.

10.21203/rs.3.rs-228372/v1 ◽

2021 ◽

Author(s):

Ikunda Dionis ◽

Omary Chillo ◽

George M Bwire ◽

Manase Kilonzi ◽

Calvin Ulomi ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Neonatal Jaundice ◽

Visual Assessment ◽

Cross Sectional Study ◽

Total Serum ◽

Sectional Study ◽

Cross Sectional ◽

Predictive Values ◽

Independent Variables ◽

Sensitivity Specificity

Abstract Background: Jaundice is common among neonates and if untreated can lead to kernicterus. Diagnosing of jaundice in neonates using Kramer’s method (visual assessment) is considered user friendly in resource limited areas. However, there are conflicting finding on reliability of the Kramer’s method in diagnosis of neonatal jaundice (NJ) particularly of black descent. Therefore, this study aimed to determine diagnostic accuracy of Kramer’s method in comparison with total serum bilirubin (TSB) test in diagnosis of NJ among neonates of black descent in Tanzania. Methods: A cross-sectional study was conducted between June and July 2020 at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania. A total of 315 neonates were recruited consecutively. In each neonates’ jaundice was assessed by using Kramer’s method and TSB test. A 2 X 2 table was created for determination of sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV), positive and negative likelihood ratios (+LR/-LR) and diagnostic accuracy (effectiveness). Cohen kappa (κ) was used to analyze the agreement between Kramer’s method and TSB. Association between independent variables and presence of jaundice were assessed using chi-square test and the p ˂ 0.05 was considered to be statistical significance. Results: The prevalence of NJ was 49.8% by Kramer’s method and 63.5% by TSB. The Sensitivity, Specificity, PPV, and NPV of the Kramer’s method were 70.5%, 86.1%, 88.8%, and 62.6%, respectively. The +LR and –LR were 5.07 and 0.34 respectively. The diagnostic accuracy of the Kramer’s method was 76.1%. There was a moderate agreement between Kramer’s method and TSB results (κ= 0.524, P˂0.001). No significance relationship between the independent variables and presence of NJ. Conclusion: Kramer’s method was found to be inefficient in detecting NJ among neonates of black descent. However, it can be used as a predictor of NJ and whenever available invasive techniques should be applied.

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Causes of Neonatal Jaundice Requiring Exchange Transfusion

Journal of Comprehensive Pediatrics ◽

10.5812/compreped.109539 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Hassan Boskabadi ◽

Gholamali Maamouri ◽

Maryam Abbasi ◽

Elahe Heidari

Keyword(s):

Risk Factors ◽

Exchange Transfusion ◽

Neonatal Jaundice ◽

Serum Bilirubin Level ◽

Preterm Neonates ◽

Total Serum ◽

Cross Sectional ◽

Abo Incompatibility ◽

Blood Exchange ◽

Rh Incompatibility

Background: Neonatal jaundice is highly prevalent in Asia and has serious complications, such as kernicterus. Therefore, it is very important to identify the risk factors of jaundice requiring exchange transfusion since it can be helpful in the prevention of the disease and early diagnosis of its complications. Objectives: The present study aimed to identify the causes of neonatal jaundice requiring blood exchange. Methods: The present cross-sectional study was performed on 251 term and preterm neonates. The studied newborns were 2-14 days old (born at ≥ 35 weeks of gestation) with jaundice and bilirubin of more than 17 mg/dL and received exchange transfusion during 2011 - 2020 in Ghaem teaching hospital, Mashhad, Iran. The required data of the study variables, such as hyperbilirubinemia risk factors, laboratory tests, the documented history of the mothers and neonates, and physical examination results, were collected through a questionnaire and the medical records of the patients. Finally, the collected data were analyzed in SPSS software (version 20). Results: Based on the results, the mean value of the total serum bilirubin level in neonates who received exchange transfusion was 27.53 ± 10.05 mg/dL. The blood types of about 40% of mothers and their neonates were O and A/B, respectively. Moreover, 11.4% of mothers were Rh-negative; however, their neonates were Rh-positive. The results also revealed that the causes of exchange transfusion were unknown, ABO incompatibility, Rh incompatibility, glucose-6-phosphate dehydrogenase deficiency (G6PDD), and sepsis in 52.7 %, 24%, 7.1%, 5.3%, and 5.3% of the neonates, respectively. Conclusions: The findings of this study suggest that after unknown causes, the most common causes of exchange transfusion were ABO incompatibility, Rh incompatibility, G6PDD, and sepsis. Therefore, since most of these causes can be recognized, it is recommended to perform related tests and take related measures in the Midwifery Department of the hospital to prevent the occurrence and exacerbation of jaundice. Moreover, it is recommended to perform an early follow-up after the discharge.

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Services Provided for Lactating Mothers at Lactation Management Clinic in Selected Tertiary Level Hospitals

Journal of Preventive and Social Medicine ◽

10.3329/jopsom.v38i2.47867 ◽

2020 ◽

Vol 38 (2) ◽

pp. 68-73

Author(s):

Tarannum Tasnim ◽

ANM Shamsul Islam ◽

Mehedi Hasan Azad ◽

Farhana Sharmin

Keyword(s):

Breast Milk ◽

Milk Production ◽

Public Awareness ◽

Cross Sectional Study ◽

Dietary Advice ◽

Tertiary Level ◽

Cross Sectional ◽

Breast Milk Production ◽

Lactating Mothers ◽

Structured Questionnaire

Background: Children are the precious gift from the Almightily Allah and breast milk is an ideal product given to the human being by nature to fulfill all requirements of the offspring until they are matured enough to take adult food. Objective: To assess the services provided for lactating mothers at lactation management centre in selected tertiary level hospitals. Materials and Methods: This cross sectional study was conducted among 100 Lactating mothers who were selected conveniently and were interviewed by pre-tested semi-structured questionnaire and an observational checklist. Collected data were processed and analyzed using SPSS (Statistical Packages for Social Science) software. Results: Lactation management centre (LMC) is supervised by a consultant and separate room is allotted in both out-patient and in-patient departments. Mothers came with lactation problems were more likely in the first month of the baby (73%) and feeling of not enough milk production was common (49%).Highly significant relationship was found between breast problems of lactating mother and age of child (p<0.001). About 84% respondents received practical demonstration on position and attachment of the baby during lactation. About 91% respondents got dietary advice for enough breast milk production, 75% got dietary advice regarding their child’s weaning food chart and69% got health education. Maximum mothers were informed about LMC by doctor & nurse (82%). Conclusion: Information about LMC services should be disseminated across the country. Lactating mothers should be familiarized with LMC and public awareness should be enhanced for effective management of breastfeeding problem to promote, protect and support the breastfeeding. JOPSOM 2019; 38(2): 68-73

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How Knowledge about Stem Cells Influences Attitudes towards Breastfeeding: Case Study of Polish Women

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052382 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2382

Author(s):

Malgorzata Witkowska-Zimny ◽

Dorota Majczyna

Keyword(s):

Stem Cells ◽

Breast Milk ◽

Pregnant Women ◽

Cross Sectional Study ◽

General Knowledge ◽

Cross Sectional ◽

Maternal Experience ◽

Positive Attitudes ◽

Survey Results ◽

University Degree

Maternal breastfeeding is associated with multiple health benefits, both for the child and the mother. Since breastfeeding rates are declining, finding new, future-oriented strategies to strengthen and support mothers’ positive attitudes towards breastfeeding need to be developed. In this paper, we describe how information about the presence of stem cells in breast milk can influence the willingness to breastfeed in the population of Polish pregnant women. A cross-sectional study involving a group of 150 pregnant women was conducted to assess the correlation between their knowledge about stem cells and their attitude towards breastfeeding. Among the respondents, only 6% claimed that they did not know anything about stem cells, but general knowledge about stem cells in the research group was poor. The survey results indicated that city residence, university degree, maternal experience and advanced pregnancy correlated with higher general knowledge regarding stem cells. Most respondents (77.3%) had no knowledge regarding the presence of stem cells in breast milk. Approximately two-thirds of mothers with earlier negative breastfeeding experience declared that information about the presence of stem cells in breast milk could have influenced the decision to continue and extend the time of breastfeeding. Hence highlighting the presence of stem cells in breast milk can be used to encourage breastfeeding as a unique activity.

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Concentrations of Carotenoids and Tocopherols in Breast Milk from Urban Chinese Mothers and Their Associations with Maternal Characteristics: A Cross-Sectional Study

Nutrients ◽

10.3390/nu9111229 ◽

2017 ◽

Vol 9 (11) ◽

pp. 1229 ◽

Cited By ~ 13

Author(s):

Yong Xue ◽

Esther Campos-Giménez ◽

Karine Redeuil ◽

Antoine Lévèques ◽

Lucas Actis-Goretta ◽

...

Keyword(s):

Breast Milk ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Maternal Characteristics ◽

Chinese Mothers

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Infant feeding practice on growth velocity in 4-6 month-olds

Paediatrica Indonesiana ◽

10.14238/pi1.1.2018.36-41 ◽

2018 ◽

Vol 1 (1) ◽

pp. 36

Author(s):

Joko Kurniawan ◽

Alifah Anggraini ◽

Madarina Julia

Keyword(s):

Breast Milk ◽

Infant Feeding ◽

Growth Velocity ◽

Failure To Thrive ◽

Optimal Growth ◽

Cross Sectional Study ◽

Complementary Food ◽

Feeding Practice ◽

Cross Sectional ◽

The Mean

Background In developing countries, 5-10% of infants suffer from failure to thrive. Adequate feeding is the most crucial factor for optimal growth in early life.Objective To assess the differences in growth velocity at 4 to 6 months of age, based on the infant feeding practices.Methods This cross-sectional study involving 4 to 6 month-old babies from 6 public health centres in Yogyakarta was performed from August to November 2016. Data on body weight, and growth velocity as they related to weight at birth were collected. Subjects were divided into groups according to their feeding practices.Results Of 173 subjects, 130 (75%) infants were exclusively breastfed, 19 infants (11%) were given breast milk and formula, 14 (8%) infants were given breast milk and complementary food (8%), and 10 (6%) infants were given formula and complementary food. The mean growth velocity z-scores by group were as follows: exclusively breastfed 0.04 (SD 1.15) (95%CI -0.16 to 0.24), breast milk and formula -0.61 (SD 0.84) (95%CI -1.01 to -0.21), breast milk and complementary food -0.69 (SD 1.14) (95%CI -1.35 to -0.04), formula and complementary food 0.23 (SD 1.50) (95%CI: -0.84 to 1.31). The mean difference in growth velocity between the exclusively breastfed vs. breast milk and formula groups was 0.65 (SD 0.28) (95%CI: 0.10 to 1.20; P=0.02); vs. breast milk and complementary food was 0.73 (SD 0.32) (95%CI: 0.10 to 1.37; P=0.02); and vs. formula and complementary food was -0.19 (SD 0.37) (95%CI: -0.93 to 0.55; P=0.61).Conclusion Exclusively breastfed have the most optimal growth velocity compared to infants who experience other feeding practices.

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Lutein concentration in human milk during early lactation and its relationship with dietary lutein intake

Public Health Nutrition ◽

10.1017/s1368980009004807 ◽

2009 ◽

Vol 12 (10) ◽

pp. 1878-1884 ◽

Cited By ~ 15

Author(s):

Hellas Cena ◽

Anna Maria Castellazzi ◽

Amedeo Pietri ◽

Carla Roggi ◽

Giovanna Turconi

Keyword(s):

Breast Milk ◽

Human Milk ◽

Maternal Plasma ◽

Cross Sectional Study ◽

Early Lactation ◽

Dietary Recommendations ◽

Mature Milk ◽

Cross Sectional ◽

Pregnancy And Lactation ◽

Age Range

AbstractObjectiveThe present study aimed to estimate the lutein concentration in human milk during early lactation and its relationship with dietary lutein intake measured through the administration of a short FFQ.DesignA cross-sectional study in which an FFQ was administered twice: on day 3 (T0) and day 30 (T1) postpartum; meanwhile two breast milk samples were collected. Maternal plasma samples were obtained at T0. The comparison of dietary lutein intakes and likewise lutein concentrations in breast milk at T0 and T1 were analysed with Student’sttest. Pearson’s correlation coefficient was used to determine the association between dietary lutein intake and lutein concentration in milk and plasma, respectively, as well as the correlation between breast milk and plasma lutein concentrations at T0.SettingPavia, northern Italy.SubjectsTwenty-one pregnant women, age range 24–42 years, were recruited during their last trimester on a voluntary basis.ResultsBoth breast milk and plasma lutein concentrations were significantly correlated with dietary lutein intake (r= 0·86,P= 0·0001 andr= 0·94,P= 0·0001, respectively). There was a clear significant correlation between milk and plasma lutein concentrations (r= 0·87,P= 0·0001). Mature milk lutein concentration, although significantly reduced at T1 (P< 0·01), maintained a fairly high correlation with dietary lutein intake (r= 0·82,P= 0·0001).ConclusionsEven though milk lutein concentration decreased during early lactation, it remained significantly correlated with daily lutein intake. Therefore, while awaiting further research, dietary recommendations advising intake of fresh fruit and vegetables rich in lutein, throughout the whole duration of pregnancy and lactation, are extremely useful.

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