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Subject:
From:
Jeanne Mitchell <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 16 Dec 1998 10:15:32 -0600
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This from Medline:

Kernicterus in otherwise healthy, breast-fed term newborns.
Pediatrics 1995 Oct;96(4 Pt 1):730-3   (ISSN: 0031-4005)

Maisels MJ; Newman TB [Find other articles with these Authors]

Department of Pediatrics, William Beaumont Hospital, Royal Oak, MI
48073-6769, USA.

OBJECTIVE. To document the occurrence of classical kernicterus in
full-term, otherwise healthy, breast-fed infants.
METHODS. We reviewed the files of 22 cases referred to us by
attorneys throughout the United States during a period of 18 years, in
which neonatal hyperbilirubinemia was alleged to be responsible for
brain damage in apparently healthy, nonimmunized, full-term infants. To
qualify for inclusion, these infants had to be born at 37 or
more weeks' gestation, manifest the classic signs of acute bilirubin
encephalopathy, and have the typical neurologic sequelae.
RESULTS. Six infants, born between 1979 and 1991, met the
criteria for inclusion. Their peak recorded bilirubin levels occurred 4
to 10 days after birth and ranged from 39.0 to 49.7 mg/dL. All had one
or more exchange transfusions. One infant had an elevated reticulocyte
count (9%) but no other evidence of hemolysis. The other infants had no
evidence of hemolysis, and no cause was found for the hyperbilirubinemia
(other than breast-feeding).
CONCLUSIONS. Although very rare, classic kernicterus can occur in
apparently healthy, full-term, breast-fed newborns who do not have
hemolytic disease or any other discernible cause for their jaundice.
Such extreme elevations of bilirubin are rare, and we do not know how
often infants with similar serum bilirubin levels escape harm. We also
have no reliable method for identifying these infants early in the
neonatal period. Closer follow-up after birth and discharge from the
hospital might have prevented some of these outcomes, but rare,
sporadic cases of kernicterus might not be preventable unless we adopt
an approach to follow-up and surveillance of the newborn that is
significantly more rigorous than has been practiced. The feasibility,
risks, costs, and benefits of this type of intervention need to be
determined.

Me, again.  It would take a thorough read of the article to know what
they meant by "breastfed".  Unfortunately, the article is at the office,
and I'm at home today.
--
Jeanne Mitchell, Austin, TX
http://www.flash.net/~xanth/home.htm
mailto:[log in to unmask]
"You can tell the quality of a person by how
they treat people they don't need." My Dad

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