[Icterus prolongatus is a reason for laboratory investigation, also in breastfed neonates].
Three infants, a boy aged 4 months and two girls aged 3 months and 6 weeks, respectively, had jaundice while they were breastfed. Until then, the jaundice had been interpreted as an innocent consequence of the breastfeeding. In the two eldest patients, however, biliary atresia was diagnosed. A hepatoportoenterostomy was performed in the girl when she was 15 weeks old, but both ultimately underwent a liver transplantation with a good clinical outcome. In the youngest patient, the jaundice disappeared spontaneously and retrospectively was indeed probably associated with breastfeeding. Thorough physical examination and biochemical analyses (total and direct bilirubin, gamma-glutamyl-transferase) are important for the identification of neonatal cholestasis syndromes. Laboratory investigation is recommended in any neonate jaundiced after the age of 3 weeks to differentiate pathological neonatal cholestasis from prolonged jaundice related to breastfeeding.
Bekhof
J
J
Afd. Kindergastro-enterologie, Universitair Medisch Centrum Groningen, locatie Beatrix Kinderkliniek, Postbus 30.001, 9700 RB Groningen.
de Langen
Z J
ZJ
Verkade
H J
HJ
D000367:Age Factors; D001656:Biliary Atresia / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001942:Breast Feeding / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007565:Jaundice / Q000209:etiology*; D016031:Liver Transplantation; D008297:Male; D016896:Treatment Outcome