Does Type of Infant Feeding Affect Phototherapy for Neonatal Hyperbilirubinemia?

Abstract

Phototherapy is the most common method used to treat and prevent neonatal hyperbilirubinemia. Breastfeeding compared with formula feeding is associated with an increased risk of jaundice and kernicterus. The main mechanism is failure of successful initiation of breastfeeding. Breast failure jaundice usually leads to significant weight loss resulting in hyperbilirubinemia. The aim was to determine the relation between type of infant feeding and the efficacy of phototherapy for treatment of hyperbilirubinemia in term newborns. The authors included 90 full-term neonates diagnosed with nonhemolytic, unconjugated hyperbilirubinemia. According to their total bilirubin level, they received conventional phototherapy for treatment. They were divided into 3 groups according to type of feeding: group 1, mixed feeding (MF; breast and formula); group 2, formula feeding (FF; formula); and group 3, breastfeeding (BF). Rebound bilirubin was checked 24 hours after stopping phototherapy. The mean duration of phototherapy was more in the BF group, followed by the MF and FF groups (P < .01). There was a significant positive correlation between bilirubin level and weight loss at the start of phototherapy in the groups studied (r = 0.635; P < .001). Rebound bilirubin level was higher in BF followed by FF and MF newborns, with significant differences (P = .005). These results indicate that phototherapy effectively reduces bilirubin levels in BF newborns with hyperbilirubinemia. These infants show a significantly slower response to this treatment than FF or MF newborns. Prevention of breast milk failure would decrease weight loss, which is associated with high bilirubin at the start of phototherapy.

Effect of Ursodeoxycholic Acid in Unconjugated Hyperbilirubinemia in the Term Neonates Treated with Phototherapy: A Systematic Review

“…However, a recent systematic review concluded that both intermittent and continuous PT appeared to be equally effective for treating UH. 43 El-Sakka et al 44 reported that although PT effectively decreased UCB levels in breastfed neonates, these neonates demonstrate a slower response to PT than a bottle or mixed-fed neonates. However, the result of the studies with breastfed participants in our research showed a similar reduction of TSB levels as others studies.…”

Phototherapy is associated with the decrease in serum globulin levels in neonatal hyperbilirubinemia

“…should be encouraged; conversely, doctors must carefully consider the use of phototherapy in those patients with hyperbilirubinemia that are not high risk, and ensure that sufficient access to breast feeding is available during phototherapy (27)(28)(29)(30).…”