Serum alpha-fetoprotein (AFP) levels in breastfed infants with prolonged indirect hyperbilirubinemia.
The aim of this prospective study was to verify normal serum AFP (alpha-fetoprotein) levels in jaundiced breastfed infants with indirect hyperbilirubinemia.


METHODS
The study was conducted in clinically jaundiced breastfed infants, 20, or more, days old, referred to our outpatient ambulatory. Inclusion criteria were: birth at term after a physiologic pregnancy, with an Apgar score >7 at 1 and 5 min, no evidence of congenital anomalies or diseases, direct bilirubin <1 mg/dl, normal values of alpha-1-antitrypsin, glucose-6-phosphate dehydrogenase, thyroid stimulating hormone, triiodothyronine, tyroxine, and normal growth. 30 non-jaundiced breastfed infants age-weight-matched, were used as control group.


RESULTS
98 jaundiced breastfed infants satisfied inclusion criteria. Their mean serum concentration of AFP was significantly higher than control infants (3548 vs 1095 ng/ml, p<0.001). Serum AFP levels of jaundiced infants were directly associated with serum indirect bilirubin and gamma-glutamyltranspeptidase concentrations.


CONCLUSIONS
The most probable explanation of elevated AFP in jaundiced breastfed infants may be the presence in human milk of one or more factors which affect hepatocyte growth and/or function. Based on our finding we demonstrated that in jaundiced breastfed infants normal range of serum AFP levels are higher than previously published data for healthy infants. Our data can be useful for a right interpretation of AFP levels in breastfed infants with prolonged jaundiced and may be used to avoid unnecessary investigations.
Manganaro
Rosa
R
Department of Paediatric and Surgery Sciences, University of Messina, 98100 Messina, Italy.
Marseglia
Lucia
L
Mamì
Carmelo
C
Saitta
Giuseppe
G
Gargano
Romana
R
Gemelli
Marina
M
D001663:Bilirubin / Q000097:blood; D001942:Breast Feeding; D016022:Case-Control Studies; D003663:Decision Trees; D005865:Gestational Age; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood*; D007231:Infant, Newborn; D000509:alpha-Fetoproteins / Q000032:analysis*; D005723:gamma-Glutamyltransferase / Q000097:blood
C097353:AFP protein, human; D000509:alpha-Fetoproteins; D005723:gamma-Glutamyltransferase; D001663:Bilirubin