Overview
How is breast milk jaundice different from breastfeeding jaundice?
Which factors may contribute to breast milk jaundice?
What is the role of serum alpha fetoprotein levels in the pathophysiology of breast milk jaundice?
What is the role of gut bacteria in the pathophysiology of breast milk jaundice?
How does replacement of breastfeeding with oral glucose solution affect breast milk jaundice?
What are the causes of breast milk jaundice?
What is the prevalence of breast milk jaundice in the US?
What is the global incidence of breast milk jaundice?
What are the racial predilections of breast milk jaundice?
How does the incidence of breast milk jaundice vary by sex?
At what age does breast milk jaundice manifest and what is the duration?
What is the prognosis of breast milk jaundice?
What is the morbidity of breast milk jaundice?
How are breast milk jaundice and breastfeeding jaundice differentiated?
Presentation
Which history findings suggest breast milk jaundice?
What are the indications of breast milk jaundice?
Why is it important to differentiate between physiologic jaundice and breast milk jaundice?
Which physical findings suggest breast milk jaundice?
Which neurologic findings are characteristic of breast milk jaundice?
How is the hydration status of an infant assessed in suspected breast milk jaundice?
DDX
What are the diagnostic considerations for breast milk jaundice?
Which conditions should be included in the differential diagnoses of breast milk jaundice?
What are the differential diagnoses for Breast Milk Jaundice?
Workup
How is breast milk jaundice diagnosed?
What is the role of serum bilirubin measurement in the evaluation of breast milk jaundice?
What is the role of a complete red cell (CBC) count in the workup of breast milk jaundice?
What is the role of urine specific gravity in the workup of breast milk jaundice?
How is hemolysis evaluated in patients with breast milk jaundice?
Which factors suggest hemolytic disease in patients with breast milk jaundice?
Which lab studies are performed if sepsis is suspected in patients with breast milk jaundice?
Which clinical factors suggest sepsis in patients with breast milk jaundice?
What are the signs of cholestatic jaundice in infants with breast milk jaundice?
Treatment
What is the American Academy of Pediatrics Safe and Healthy Beginnings Project?
When should infants with breast milk jaundice be transferred?
What is included in outpatient care for breast milk jaundice?
What should be included in patient education for breast milk jaundice?
What is the role of medications in the treatment of breast milk jaundice?
How does the treatment of breast milk jaundice vary between full-term and preterm infants?
What is the treatment options for breast milk jaundice in healthy term infants?
When is phototherapy indicated in the treatment of breast milk jaundice?
What is the most rapid way to reduce bilirubin levels in breast milk jaundice?
How is phototherapy administered in the treatment of breast milk jaundice?
What are the considerations for phototherapy in infants with breast milk jaundice?
What is included in inpatient treatment of breast milk jaundice?
What is the role of weight monitoring in the treatment of breast milk jaundice?
Which specialist consultation are beneficial in the treatment of breast milk jaundice?
What are the dietary modifications used in treatment of breast milk jaundice?
Which activity modifications are required during the treatment of breast milk jaundice?
How is breast milk jaundice prevented?
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The graph represents indications for phototherapy and exchange transfusion in infants (with a birthweight of 3500 g) in 108 neonatal ICUs. The left panel shows the range of indications for phototherapy, whereas the right panel shows the indications for exchange transfusion. Numbers on the vertical axes are serum bilirubin concentrations in mg/dL (lateral) and mmol/L (middle). In the left panel, the solid line refers to the current recommendation of the American Academy of Pediatrics (AAP) for low-risk infants, the line consisting of long dashes (- - - - -) represents the level at which the AAP recommends phototherapy for infants at intermediate risk, and the line with short dashes (-----) represents the suggested intervention level for infants at high risk. In the right panel, the dotted line (......) represents the AAP suggested intervention level for exchange transfusion in infants considered at low risk, the line consisting of dash-dot-dash (-.-.-.-.) represents the suggested intervention level for exchange transfusion in infants at intermediate risk, and the line consisting of dash-dot-dot-dash (-..-..-..-) represents the suggested intervention level for infants at high risk. Intensive phototherapy is always recommended while preparations for exchange transfusion are in progress. The box-and-whisker plots show the following values: lower error bar = 10th percentile; lower box margin = 25th percentile; line transecting box = median; upper box margin = 75th percentile; upper error bar = 90th percentile; and lower and upper diamonds = 5th and 95th percentiles, respectively.