Risk of Hyperbilirubinemia in Breast-Fed Infants

Objective To investigate the risk factors for hyperbilirubinemia in infants who are exclusively breast-fed . Study design A prospective study was conducted to investigate the effects of birth body weight, sex, mode of delivery, glucose-6-phosphate dehydrogenase (G6PD) deficiency, variant UDP-glucuronosyltransferase 1A1 (UGT1A1) gene, and hepatic solute carrier organic anion transporter 1B1 (SLCO1B1) gene on hyperbilirubinemia in neonates who were breast-fed. Hyperbilirubinemia was diagnosed when a full term neonate had a bilirubin, level >= 15.0 mg/dL (256. 5 mu M) in serum at 3 days old. The polymerase chain reaction-restriction fragment length polymorphism method was used as a means of detecting the known variant sites in the UGT1A1 and SLCO1B1 gene. Results Of 252 infants born at term who were exclusively breast-fed, 59 (23.4%) had hyperbilirubinemia. The significant risk factors were a variant nucleotide 211 in UGT1A1 (2.48; 95 % CI, 1.29 to 4.76 ; P = .006), G6PD deficiency (12.24; 95% CI, 1.08 to 138.62; P < .05), and vaginal delivery (3.55; 95% CI, 1.64 to 7.66; P < . 001). Conclusion Breast-fed neonates who are 211 variants in the UGT1A1, G 6PD deficiency, and vaginal delivery are at high-risk for hyperbilirubinemia.