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 μM) 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 P Conclusion Breast-fed neonates who are 211 variants in the UGT1A1 , G6PD deficiency, and vaginal delivery are at high-risk for hyperbilirubinemia.