J Med Assoc Thai 2017; 100 (3):255

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The Association of Breastfeeding Practices with Neonatal Jaundice
Ketsuwan S , Baiya N , Maelhacharoenporn K , Puapornpong P Mail

Background: Neonatal jaundice is a common problem in newborns. Inadequate breastfeeding jaundice is an important consideration for the neonatal jaundice. Early breastfeeding initiation and good breastfeeding practices may help to prevent neonatal jaundice.

Objective: To find the association of breastfeeding practices, the time to initiate breastfeeding, the breastfeeding frequency, breast milk volume, and appropriate latching with neonatal jaundice at the early postpartum.

Material and Method: The subjects were postpartum women and newborns who had normal deliveries without complications at the HRH Princess Maha Chakri Sirindhorn Medical Center in the Nakhon Nayok province between July 2013 and June 2014. During postpartum period, the time of the first neonatal suckling, the breastfeeding frequency per day, the breastfeeding duration for each instance, the breast milk volume, and appropriate latching were assessed. The newborns had routine microbilirubin evaluation done at 48 hours postpartum. The data of newborn with neonatal jaundice was collected, analyzed, and compared with no jaundice newborn. The demographic data and breastfeeding factors were analyzed by Chi-square, t-test, and the Fisher’s exact test.

Results: The data of 176 newborns (neonatal jaundice 88 cases and no jaundice newborn 88 cases) and mothers were analyzed. It had shown that the mean time for the initiation of breastfeeding was 1.57±0.6 hours in the no jaundice newborn group and 5.56±3.1 hours in the neonatal jaundice group. The percentages of ‘breastfeeding frequency less than eight times per day’ in the neonatal jaundice and no jaundice newborn groups were 92.0% and 1.1% at day 1 postpartum, and 42.0% and 0.0% at day 2 postpartum, respectively. The percentages of ‘breastfeeding duration less than 10 minutes’ per feeding in the neonatal jaundice group were 35.2% and 13.6% at day 1 and day 2 postpartum. No one in the no jaundice newborn group had breastfeeding durations of less than 10 minutes for each feeding. The percentages of mothers in the neonatal jaundice and no jaundice newborn groups having no milk were 84.1% and 1.1% at day 1, and 4.5% and 0.0% at day 2 postpartum, respectively. The percentages of ‘latch scores greater than 8’ in the neonatal jaundice and no jaundice newborn groups were at 15.9% and 50.0% at day 1, and 31.8% and 95.5% at day 2 postpartum. There were statistically significant differences in the breastfeeding parameters.

Conclusion: The factors of the time of the initiation of breastfeeding, breastfeeding frequency, duration, breast milk volume, and appropriate latching are associated with neonatal jaundice at the second day postpartum.

Keywords: Breastfeeding practices, Time of the initiation of breastfeeding, Breastfeeding frequency and duration, Latch score, Neonatal jaundice


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