Prevalence of Hyperbilirubinemia in Purely Breastfed Term Infants Appropriate for Gestational Age born in a Tertiary Hospital in Quezon City

Abstract

The most common problem in a full-term breastfed infant is neonatal jaundice. Our institution has no written guidelines about management of neonatal jaundice and more evidence is still needed to support the cost and efficacy of the recommended predischarge total bilirubin level determination. To determine the prevalence of clinically significant hyperbilirubinemia in purely breastfed newborns at 37 or more weeks appropriate for gestational age and compare newborns as to risks, management and outcome. A hospital-based cross-sectional retrospective study on 1,394 purely breastfed term, healthy, roomed-in newborns from September 1, 2012 to August 31, 2013. The demographic, clinical and laboratory data were extracted from the medical records and descriptive analysis was done. About 66% developed visible jaundice and 9.8% had clinically significant hyperbilirubinemia. A total of 1.6% were readmitted due to clinically significant hyperbilirubinemia and five of them had significant hyperbilirubinemia, during birth hospitalization. There were 23% of infants with progression of jaundice had a pre-discharge bilirubin taken and stratified based on Bhutani nomogram. Phototherapy was done on all infants in high risk zone and some infants in high-intermediate risk zone but no phototherapy done on infants in low risk zone. Breastfeeding term infants do not have a high risk in developing clinically significant hyperbilirubinemia and risk factors listed in AAP were also not found to be associated. Establishing protocols and implementing policy regarding neonatal jaundice are recommended.