One of my clients has called wanting more info about an enzyme in
breastmilk that could cause hyperbilirubinemia. Her baby, 3 wk old, born @
34 wks, thriving, gaining 4oz/wk, voids and yellow stools x 6-8/day was tx
for bili of 20.6 with phototx for 2wks. Came off phototx 2days ago, bili
now 16, back on phototx with orders from MD to stop breastfeeding and
exclusively BOTTLE FEED formula as he suspects her breastmilk has an enzyme
in it causing the baby to be jaundiced.  I have advised her to follow his
instructions for formula but only by eyedropper or cup feeding (she
wouldn't take a bottle anyway)and I would get back with her if I could find
any info on this "enzyme".  He wasn't able to explain it to her either. She
is really worried that her milk is making the baby "sick". What a shame. I
of course reassured her that was not the case.  Any info will be
appreciated.

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