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  • Title: Breast-milk jaundice.
    Author: Poland RL.
    Journal: J Pediatr; 1981 Jul; 99(1):86-8. PubMed ID: 7252670.
    Abstract:
    The inhibiting agent of UDP-glucuronyl transferase (UDPGT), inhibition of which is associated with breast milk jaundice syndrome in infants, was thought to be 3(alpha),20(beta)-pregnandiol. European researchers have begun in vitro investigations to discover the inhibiting substance, and all studies have confirmed it is a nonesterified fatty acid. The strong association between breast milk jaundice, elevated values of nonesterified fatty acids, and unstimulated lipase in UDPGT-inhibitory milk was confirmed by electrophoretic technique. The mechanisms responsible for production of prolonged unconjugated hyperbilirubeinemia in infants, however, is not understood. 2 theories have been offered: 1) that milk triglyceride digestion before the milk reaches the duodenum leads to early absorption of most of the liberated glycerol that might otherwise be used by intestinal epithelium to resynthesize triglycerides; or 2) inhibitory human milk may facilitate the enterohepatic recirculation of bilirubin (reabsorption of bilirubin from intestinal lumen). Breast-feeding per se does not result in an increased incidence of neonatal hyperbilirubinemia; it is rather those infants who receive insufficient amounts of breast milk who develop the condition.
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