Effect of breast-feeding frequency on hyperbilirubinemia in breast-fed term neonate

Background Hyperbilirubinemic neonates have significantly less bodyweight gain from nursery discharge to outpatient department (OPD) follow up. We tested the hypothesis that discharge instructions encouraging frequent breast-feeding given in the nursery would increase infant bodyweight gain and decrease the incidence of hyperbilirubinemia. Methods We enrolled consecutively live-born neonates who were discharged from the nursery and who received OPD follow up within the first 2 weeks of birth in 2011. The nursing staff discussed the discharge instructions with the parents at the time of nursery discharge. Parents were asked to fill in a nursing information form to record the frequency of breast-feeding and diaper change per day. Results Parents of 98 breast-fed term neonates provided complete nursing information forms. These 98 neonates were classified into two groups according to breast-feeding frequency, namely <8 times/day (63 neonates) and ≥8 times/day (35 neonates). A significant positive correlation between breast-feeding frequency and diaper change frequency per day indicated that the data were highly reliable. The gestational age, Apgar score, birthweight, and bodyweight at nursery discharge and at OPD were similar between the two groups. Neonates who were breast-fed ≥8 times/day had a significantly lower incidence of hyperbilirubinemia. Conclusions Nursery discharge instructions that encouraged mothers to breast-feed their newborns frequently decreased the rate of hyperbilirubinemia in exclusively breast-fed term neonates.