Difference between breast milk jaundice and breast-feeding jaundice: literature review

Evidence shows that the different etiologies of neonatal jaundice, including breastfeeding and breast milk jaundice, have many different aspects. Therefore, the present study aims to conduct a literature review to compare breastfeeding and breast milk jaundice, ehich will furtherly help physicians and healthcare practitioners to have adequate information to properly establish an accurate diagnosis. The precise cause of breast milk jaundice is unclear. The majority of the suggested etiologies include factors found in human breast milk. Other theories point to possible genetic defects in the infected neonates. It has been reported that pregnane-3a,20ß-diol, epidermal growth factor, interleukin (IL)1ß, alpha-fetoprotein, and ß-glucuronidase are several factors that are solid constituents of the breast milk which may attribute to the development of this jaundice. Reports showed that breast milk jaundice usually develops in 20-30% of U.S. neonates, and most of whom are breastfed. Moreover, studies showed that more than one-third of infants on breastfeeding will eventually have high serum bilirubin levels that are ≥5 mg/dl. Evidence showed that the diagnosis should be considered when the levels of serum bilirubin exceed 5 mg/dl. Breast milk jaundice will usually fade away with no interventions, and in some cases, phototherapy inauguration and breast milk discontinuation might be needed. In breastfeeding jaundice, serum bilirubin levels usually peak within the first five or six days of life due to wrong or inadequate breastfeeding practices, and the management should be done by correcting these habits, while phototherapy might be applied when the bilirubin levels exceed 18-20 mg/dl.

Association between elevated serum bilirubin levels with preserved lung function under conditions of exposure to air pollution

Background High serum bilirubin levels have been shown to be associated with an improved pulmonary function test results. Their potential ability to similarly benefit pulmonary function in an environment of polluted air has not been tested. We retrospectively analyzed data of 15,605 apparently healthy individuals in order to evaluate the effect of serum bilirubin levels on forced expiratory volume in 1 s (FEV1). Methods Individuals attended the Tel-Aviv Medical Center Inflammatory Survey for a routine annual health check between February, 2002 and June, 2009 and were divided into low, medium and high serum bilirubin levels. Their FEV1 results were compared under various levels of air pollution. Air pollution and weather data were obtained from air pollution monitoring stations of the Israeli Ministry of Environmental Protection. Results The elevated serum bilirubin concentrations on FEV1 were evaluated under moderate and high pollution levels FEV1 and were significantly higher in participants with high blood bilirubin levels compared to medium or low levels (p < 0.001 and p = 0.018, respectively). Participants with high levels of bilirubin had preserved FEV1 under exposure to high and medium pollution levels of both Nitrogen Oxide (NOx) and Carbon Monoxide (CO) pollutants (p = 0.003 and p = 0.022, respectively). The multivariate regression analysis revealed that the influence of bilirubin under conditions of air pollution remained significant even after adjustment for FEV1 confounders, but the interaction was not significant. Conclusions Elevated serum bilirubin concentrations are associated with preserved lung function in healthy individuals in Israel exposed to high levels of air pollution.