Breastfeeding Research Today is a free monthly online journal that collates and summarizes the latest research about Breastfeeding, including details on breast feeding benefits, problems, alcohol, diet.

Identification of neonates at risk for hazardous hyperbilirubinemia: emerging clinical insights.

Watchko JF

Department of Pediatrics, Division of Newborn Medicine, University of Pittsburgh School of Medicine, Magee-Womens Research Institute, Magee-Womens Hospital, Pittsburgh, PA 15213, USA. jwatchko@mail.magee.edu

Hyperbilirubinemia is the most common condition requiring evaluation and treatment in neonates. Identifying among all newborns those few at risk to develop marked hyperbilirubinemia is a clinical challenge. Clinical, epidemiologic, and genetic risk factors associated with severe hyperbilirubinemia include late preterm gestational age, exclusive breastfeeding, glucose-6-phosphate dehydrogenase deficiency, ABO hemolytic disease, East Asian ethnicity, jaundice observed in the first 24 hours of life, cephalohematoma or significant bruising, and history of a previous sibling treated with phototherapy. It is increasingly apparent that the etiopathogenesis of severe hyperbilirubinemia is often multifactorial, and emerging evidence suggests that combining risk factor assessment with measurement of predischarge total serum or transcutaneous bilirubin levels will improve hyperbilirubinemia risk prediction.

Published 8 June 2009 in Pediatr Clin North Am, 56(3): 671-87, Table of Contents.
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Articles on Breastfeeding published 1 June 2009:

Are starting and continuing breastfeeding related to educational background? The generation R study.   Pediatrics, 123(6): e1017-27.

OBJECTIVE: To assess the effect of a woman's educational level on starting and continuing breastfeeding and to assess the role of sociodemographic, lifestyle-related, psychosocial, and birth characteristics in this association. METHODS: We used the data of 2914 participants in a population-based prospective cohort study. Information on educational level, breastfeeding, sociodemographic (maternal age, single parenthood, parity, job status), lifestyle-related (BMI, smoking, alcohol use), ... [Abstract] [Full-text]

Articles on Breastfeeding published 6 May 2009:

Intestinal microbiota in exclusively breast-fed infants with blood-streaked stools.   Folia Microbiol (Praha), 54(2): 167-71.

Intestinal microbiota in exclusively breast-fed infants with blood-streaked stools and in healthy exclusively breast-fed babies was compared. Total anaerobes, bifidobacteria, lactobacilli, coliform bacteria, enterococci and clostridia were quantified by cultivation methods in feces of 17 full-term exclusively breastfed patients (aged 16.3 +/- 7.4 weeks) with blood-streaked stools and in the control group of 22 healthy fullterm exclusively breast-fed infants (13.7 +/- 6.4 weeks). Specific ... [Abstract] [Full-text]

Articles on Breastfeeding published 22 April 2009:

Duration of lactation and risk factors for maternal cardiovascular disease.   Obstet Gynecol, 113(5): 974-82.

OBJECTIVE: To examine dose-response relationships between the cumulative number of months women lactated and postmenopausal risk factors for cardiovascular disease. METHODS: We examined data from 139,681 postmenopausal women (median age 63 years) who reported at least one live birth on enrolling in the Women's Health Initiative observational study or controlled trials. Multivariable models were used to control for sociodemographic (age, parity, race, education, income, age at menopause), ... [Abstract] [Full-text]

Articles on Breastfeeding published 21 April 2009:

Effect of early exclusive breastfeeding on morbidity among infants born to HIV-negative mothers in Zimbabwe.   Am J Clin Nutr, 89(5): 1375-82.

BACKGROUND: Early exclusive breastfeeding (EBF) is recommended by the World Health Organization, but EBF rates remain low throughout the world. For infants born to breastfeeding HIV-positive mothers, early EBF is associated with a lower risk of postnatal transmission than is feeding breast milk together with other liquids or foods. No studies conducted in Africa have reported any benefits of EBF for infants born to HIV-negative women. OBJECTIVE: The objective was to compare the rate of sick ... [Abstract] [Full-text]

Can infant feeding choices modulate later obesity risk?   Am J Clin Nutr, 89(5): 1502S-1508S.

Since the concept of lasting programming effects on disease risk in human adults by the action of hormones, metabolites, and neurotransmitters during sensitive periods of early development was proposed >3 decades ago, ample supporting evidence has evolved from epidemiologic and experimental studies and clinical trials. For example, numerous studies have reported programming effects of infant feeding choices on later obesity. Three meta-analyses of observational studies found that obesity ... [Abstract] [Full-text]

Prevalence and predictors of iron deficiency in fully breastfed infants at 6 mo of age: comparison of data from 6 studies.   Am J Clin Nutr, 89(5): 1433-40.

BACKGROUND: Iron deficiency (ID) can occur among exclusively breastfed infants before 6 mo of age. OBJECTIVE: The objective was to determine which subgroups of fully breastfed infants are at highest risk of ID. DESIGN: We assessed the prevalence of ID (ferritin < 12 mug/L) and iron deficiency anemia (IDA; ferritin < 12 mug/L and hemoglobin < 105 g/L) and risk factors associated with ID and IDA at 6 mo among 404 fully breastfed infants with a birth weight >2500 g from 6 studies in ... [Abstract] [Full-text]

Articles on Breastfeeding published 13 April 2009:

Hospital practices and women's likelihood of fulfilling their intention to exclusively breastfeed.   Am J Public Health, 99(5): 929-35.

OBJECTIVES: We sought to assess whether breastfeeding-related hospital practices reported by mothers were associated with achievement of their intentions to exclusively breastfeed. METHODS: We used data from Listening to Mothers II, a nationally representative survey of 1573 mothers who had given birth in a hospital to a singleton in 2005. Mothers were asked retrospectively about their breastfeeding intention, infant feeding at 1 week, and 7 hospital practices. RESULTS: Primiparas reported a ... [Abstract] [Full-text]

Articles on Breastfeeding published 7 April 2009:

Pacifiers and breastfeeding: a systematic review.   Arch Pediatr Adolesc Med, 163(4): 378-82.

OBJECTIVE: To summarize current evidence on the association between infant pacifier use and breastfeeding. DATA SOURCES: MEDLINE, CINAHL, the Cochrane Library, EMBASE, POPLINE, and bibliographies of identified articles. STUDY SELECTION: A search for English-language records (from January 1950 through August 2006) containing the Medical Subject Heading terms pacifiers and breastfeeding was conducted, resulting in 1098 reports. Duplicate and irrelevant studies were excluded, yielding 29 studies ... [Abstract] [Full-text]

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