Breast Milk Jaundice
What is Breast Milk Jaundice?
Breast milk jaundice is a type of yellowing of the skin and eyes that happens in healthy breastfed babies. It typically appears after the first week of life, usually between days 7 and 14. This condition affects up to 30 percent of breastfed infants.
Unlike other types of jaundice that may signal a problem, breast milk jaundice is benign. It happens when substances in breast milk slow down the breakdown of bilirubin, a yellow pigment made when red blood cells break down naturally. The bilirubin builds up in the blood and makes the skin look yellow.
This condition is different from breastfeeding jaundice, which happens in the first few days when babies are not getting enough milk. Breast milk jaundice occurs later and actually happens because breastfeeding is going well. It usually goes away on its own by 12 weeks of age without causing harm.
Symptoms
- Yellow tint to the skin that starts on the face and may spread downward
- Yellowing of the whites of the eyes
- Good feeding patterns and weight gain despite yellow coloring
- Normal wet diapers and bowel movements
- Active and alert behavior between feedings
- Symptoms that appear after day 5 to 7 of life
Most babies with breast milk jaundice continue to feed well and gain weight normally. The yellowing is often the only sign parents notice.
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Causes and risk factors
Breast milk jaundice happens when certain substances in breast milk affect how the baby's liver processes bilirubin. These substances may include enzymes and hormones that temporarily slow down bilirubin removal. The exact compounds vary from mother to mother, which is why some breastfed babies develop jaundice while others do not.
Risk factors include exclusive breastfeeding, being born full term, and having an older sibling who had breast milk jaundice. Asian and Mediterranean ethnic backgrounds also increase the likelihood. Babies who are breastfeeding well and gaining weight appropriately are more likely to develop this type of jaundice than babies who are struggling to feed.
How it's diagnosed
Doctors diagnose breast milk jaundice by checking when the yellowing started, how well the baby is feeding, and whether weight gain is normal. Blood tests measure total bilirubin levels to confirm the diagnosis. Urine testing checks for bilirubin in the urine, which should be negative in breast milk jaundice. This helps doctors tell the difference between harmless breast milk jaundice and more serious liver problems.
Rite Aid offers urine bilirubin testing through our flagship panel at Quest Diagnostics locations nationwide. Your doctor may also recommend temporarily stopping breastfeeding for 12 to 24 hours to see if bilirubin levels drop, which confirms the diagnosis. If levels fall quickly, breast milk jaundice is the likely cause.
Treatment options
- Continue breastfeeding frequently, at least 8 to 12 times per day
- Monitor bilirubin levels with regular check-ups as recommended by your doctor
- Watch for signs that levels are too high, such as extreme sleepiness or poor feeding
- Ensure adequate hydration and milk intake to help the baby pass bilirubin through stool
- Place baby in indirect natural light near a window during daytime hours
- Phototherapy light treatment if bilirubin levels rise above safe thresholds
- Temporary interruption of breastfeeding only if levels become very high
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- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Breast milk jaundice is generally not dangerous and does not cause long-term problems. It is a benign condition that resolves on its own by 12 weeks of age in most cases. However, very high bilirubin levels can be harmful, so your doctor will monitor levels to ensure they stay in a safe range.
No, you should continue breastfeeding your baby. Breast milk jaundice does not mean you need to stop nursing. Frequent breastfeeding actually helps your baby pass bilirubin through their stool. Your doctor may suggest a brief pause only if bilirubin levels become very high or if diagnosis is unclear.
Breast milk jaundice typically peaks at 2 to 3 weeks of age. It then gradually decreases over the following weeks. Most babies are completely clear of yellowing by 12 weeks of age, though some mild yellowing may persist a bit longer without causing concern.
Breastfeeding jaundice happens in the first few days of life when a baby is not getting enough breast milk. Breast milk jaundice appears later, after day 5 to 7, in babies who are feeding well. Breastfeeding jaundice is due to insufficient intake, while breast milk jaundice is due to substances in the milk itself.
Formula-fed babies can develop jaundice, but they are less likely to develop breast milk jaundice specifically. However, the benefits of breastfeeding far outweigh the temporary inconvenience of breast milk jaundice. Switching to formula is not recommended unless bilirubin levels become dangerously high.
Doctors use blood tests to measure total bilirubin levels in your baby. A urine test checks whether bilirubin is present in the urine. In breast milk jaundice, urine bilirubin should be negative, which helps rule out liver disease or other serious conditions that need immediate treatment.
Bilirubin levels in breast milk jaundice typically range from 12 to 20 milligrams per deciliter. Levels above 20 may require phototherapy treatment. Your doctor will consider your baby's age, overall health, and how quickly levels are rising when deciding if intervention is needed.
There is no proven way to prevent breast milk jaundice since it depends on natural substances in your breast milk. The best approach is to breastfeed frequently from birth, which helps your baby pass meconium and bilirubin quickly. Early and frequent feeding reduces the severity of all types of newborn jaundice.
No, breast milk jaundice does not mean your milk is unhealthy or inadequate. Your milk is providing all the nutrition your baby needs. The substances causing the jaundice are natural and harmless. Your breast milk continues to be the best food for your baby.
Call your doctor if the yellowing spreads to your baby's arms, legs, or belly. Also call if your baby becomes very sleepy, refuses to feed, or is not having enough wet diapers. Seek immediate care if your baby develops a high-pitched cry, arches their back, or seems very ill, as these may signal dangerously high bilirubin levels.