Chang et al identified risk factors for hyperbilirubinemia in a breast-fed infant. The authors are from the Far Eastern Memorial Hospital in Pan-Chiao and National Taiwan University Children's Hospital in Taipei, Taiwan.


Patient selection - Full term infant who are breast-fed and who develop:

(1) hyperbilirubinemia (serum total bilirubin >= 15 mg/dL) at

(2) 3 days of age (early-onset)


Risk factors for hyperbilirubinemia:

(1) vaginal delivery (odds ratio 3.6)

(2) G6PD deficiency (odds ratio 12.2)

(3) variant UDP-glucuronosyltransferase 1A1 gene (UGT1A1) with variation at 211 (odds ratio 2.5)


Diagnosis would require exclusion of other causes.


It may be worth testing the infant for G6PD deficiency and UGT1A1 variant if the infant was not delivered vaginally.


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