The Association of Breastfeeding Practices
with Neonatal Jaundice
Sukwadee Ketsuwan RN*, Nongyao Baiya RN*,
Ketsuda Maelhacharoenporn RN*, Pawin Puapornpong MD**
Affiliation :
* Obstetric and Gynecology Nursing Department, HRH Princess Maha Chakri Sirindhorn Medical Center, Nakhon Nayok, Thailand
** Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
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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