title: The correlation between frequency and duration of breastfeeding and the severity of neonatal hyperbilirubinemia.
abstract: BACKGROUND
  Inadequate intake of calorie or inadequate breastfeeding can cause neonatal hyperbilirubinemia. The present study was conducted to examine the correlation between frequency and duration of breastfeeding and the severity of neonatal hyperbilirubinemia among newborns admitted to Ghaem Hospital of Mashhad (Iran) due to neonatal hyperbilirubinemia.
  
  
  METHODS
  The present cross-sectional study was conducted on 634 newborns with idiopathic hyperbilirubinemia referred to either Emergency Department or Neonatal Clinic in Ghaem Hospital. The required data were collected through a researcher-made questionnaire covering information related to mothers and babies. The examined neonates were examined based on the frequency and duration of breastfeeding and the severity of hyperbilirubinemia. The collected data were analyzed using statistical tests of Shapiro-Wilk and Chi-squared (SPSS-19.5).
  
  
  RESULTS
  According to the results, at bilirubin levels of 1-12 mg/dl, 12.1-16 mg/dl, 16.1-20 mg/dl and >20 mg/dl, the average frequencies of breastfeeding were respectively 10.66, 9.83, 9.19 and 7.50 times a day. The average serum bilirubin level in newborns with ≤7 times breastfeeding per day (19 mg/dl) was higher than newborns with >7 times breastfeeding per day (16 ml/dl). Additionally, by an increase in the frequency of breastfeeding, the percentage of weight loss decreased in the examined newborns. The results also showed that in newborns with bilirubin levels <20 mg/dl, the severity of hyperbilirubinemia reduced by increased defecation frequency and decreased percentage of weight loss.
  
  
  CONCLUSIONS
  The results of this study showed that increased frequency of breastfeeding, accelerated weight gain and increased defecation frequency reduce the severity of neonatal hyperbilirubinemia. Accordingly, breastfeeding education for mothers with an emphasis on increasing the frequency of breastfeeding is a helpful technique to reduce the severity of hyperbilirubinemia in newborns.
authors.affiliation: a Department of Pediatrics , Faculty Member of School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran.
authors.forename: Boskabadi
authors.initials: B
authors.lastname: Hassan
authors.affiliation: b Department of Midwifery, School of Medicine , Tonekabon Branch, Islamic Azad University , Tonekabon , Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Zakerihamidi
mesh_terms: D001663:Bilirubin / Q000097:blood*; D001942:Breast Feeding / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D002149:Energy Intake; D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000209:etiology*; D007231:Infant, Newborn; D007492:Iran; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D015431:Weight Loss
chemical_list: D001663:Bilirubin
keywords: Breastfeeding; breastfeeding duration; breastfeeding frequency; hyperbilirubinemia; severity of hyperbilirubinemia