By E. M. E. Poskitt (Auth.)
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Extra resources for Practical Paediatric Nutrition
The effect of this is to present the immature liver with a much greater load of bilirubin for conjugation. Hyperbilirubinaemia results (Gourley and Arend, 1986). Infants with breast-milk jaundice are usually gaining weight rapidly and thriving despite their hyperbilirubinaemia. Thriving provides an important clinical difference from the other causes of late hyperbilirubinaemia (infection, hypothyroidism, neonatal hepatitis syndrome) where infants fail to thrive and feed poorly. Vitamin K deficiency Infants are born with low vitamin K levels.
Recognition of the desperate plight of these infants may only come when their mothers visit relatives or baby clinics. The infants are wasted and under weight for age. They are constipated, passing small, greenish, dry stools secondary to their Disadvantages of breast feeding 33 gross underfeeding. Occasionally they may be described as having green diarrhoea. This 'diarrhoea' describes small quantities of green liquid consisting of bile and mucus passed in starvation - 'starvation stools'. The infants may suck vigorously at the breast, but test weighing demonstrates ingestion of totally inadequate volumes of milk.
When standard infant formulas consisted of relatively unmodified cows' milk, many infants suffered, and some died, from the complications of formula, rather than breast, feeding. Modern highly modified formulas are much safer and there is little evidence that the composition of human milk is quantitatively more appropriate for infants than standard formulas based on cows' milk. Qualitatively, however, this is not the case. There are still important compositional differences between human and formula milks which are advantageous for breast-fed infants.