breast milk jaundice, jaundice and hyperbilirubinemia in breastfed infants that occur in the first weeks of life as a result of a metabolite in the mother’s milk that inhibits the infant’s ability to conjugate bilirubin to glucuronide for excretion. See also hyperbilirubinemia of the newborn. ▪ OBSERVATIONS: Breast milk jaundice usually peaks around the tenth day of life. Serum bilirubin levels usually exceed 5 mg/100 mL but rarely reach dangerous levels of 20 mg/100 mL, at which point kernicterus may develop. The infant seems normal and healthy, but the skin, the whites of the eyes, and the serum are jaundiced (yellow). ▪ INTERVENTIONS: If serum bilirubin exceeds acceptable levels, breastfeeding should continue frequently to enhance stooling and decrease the chance for enterohepatic circulation. Phototherapy may be used to accelerate excretion of bilirubin through the skin. The use of oral supplementation with glucose water or water alone is not recommended. ▪ PATIENT CARE CONSIDERATIONS: The primary concerns of the nurse are to observe for signs of increasing jaundice, to monitor serum bilirubin levels, and usually to reassure the mother that her child is well and that the jaundice resolves slowly but completely in time.
