Breast feeding practices and severe hyperbilirubinaemia

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Abstract
This study establishes the association between early onset severe hyperbilirubinaemia (serum bilirubin (SBR) level ≥ 272 μmol/L) with no assigned cause and breast feeding. The rates of breast feeding at hospital discharge increased from 46.4 to 75.4% in non-insured (public) women and 58.6 to 89.2% in insured (private) women between 1975 and 1987, and were accompanied by an increase in severe hyperbilirubinamia from 1.6 to 3.1% in public and 0.9 to 3.6% in private babies. The case control study involved 125 term breast feeding infants born between 1 July 1985 and 1 July 1986 with severe hyperbilirubinaemia (SBR level 272 μmol/L) with no assigned cause who were compared with 125 matched controls who had peak SBR levels ≥ 272 μmol/L Severe hyperbilirubinamia was associated with primiparous and non-Caucasian mothers, non-smoking and oxytocin usage. Univariate analysis of feeding practice variables revealed that less frequent breast feeds, greater weight loss and less frequent stools over the first 3 days related to severe hyperbilirubinaemia (P <0.05). Multivariate analysis of the eight significant univariate factors revealed that maternal non-smoking, less frequent breast feeding, less frequent stooling and excessive infant weight loss were the best predictors of severe hyperbilirubinaemia. With the wide promotion of breast feeding, the contribution of individual feeding practices to severe hyperbilirubinaemia demands ongoing analysis and review.