Transcutaneous Bilirubin in Exclusively Breastfed Healthy Term Newborns Up to 12 Days of Life Full Text
Pediatrics, 10/07/2011
Draque CM et al. – The transcutaneous bilirubin curve represents the natural history of bilirubinemia in exclusively breastfed healthy term newborns in the first 12 days of life.
Methods- In a prospective cohort study, they performed a 12-day evaluation of 223 healthy, exclusively breastfed, appropriate-for-gestational-age neonates who roomed-in for at least 48 hours.
- Each newborn had forehead transcutaneous bilirubin and body weight measured at the end of 1, 2, 3, 4, 5, 6, 8, 10, and 12 days.
- Regression analysis was used with bilirubin as a third-degree polynomial function of time.
- The 25th, 50th, 75th, 90th, and 95th percentile curves were constructed by using the residual mean square for each day.
- Patients were 46% white, 34% mixed race, and 20% black, the mean birth weight was 3260 g (range: 2560–4090 g), the mean gestational age was 39.4 weeks (range: 37.0–41.9 weeks), 51% were male, 74% were born by vaginal delivery, and 66% had been breastfed since delivery.
- The mean highest weight loss was 4.7% (range: 1%–12%) at the second or third day, and in most infants the weight returned to the birth weight at the fifth day.
- With 2007 total bilirubin measurements, bilirubin concentrations reached the 50th percentile level (5.6 mg/dL) at the third and fourth days and returned to the 24-hour level (4.8 mg/dL) at the sixth day.
- The 95th percentile bilirubin level was 8.2 mg/dL at 24 hours of life, reached 12.2 mg/dL on the fourth day, and declined to 8.5 mg/dL on the 12th day.
