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Breast Milk Jaundice: Effect of Bacteria Present in Breast Milk and Infant Feces

Tuzun, Funda; Kumral, Abdullah; Duman, Nuray; Ozkan, Hasan

Journal of Pediatric Gastroenterology & Nutrition: March 2013 - Volume 56 - Issue 3 - p 328–332
doi: 10.1097/MPG.0b013e31827a964b
Original Articles: Hepatology and Nutrition

Objective: Breast milk is an important source of bacteria in establishing the infantile intestinal microbiota that appear to influence the enterohepatic circulation of bilirubin. The aim of the present study was to evaluate the effect of breast milk's microbiological content on the development of breast milk jaundice (BMJ).

Methods: A total number of 60 mother-infant pairs enrolled to the study. Two groups were defined: BMJ group (n = 30), full-term otherwise healthy newborns who were considered BMJ; control group (n = 30), full-term healthy newborns without jaundice. All newborns in the study were exclusively breast-fed. The breast milk samples and the feces of infants were evaluated for content of selected bacterial populations (Bifidobacterium, Lactobacillus, Clostridium, Staphylococcus, and Streptococcus species) with real-time polymerase chain reaction.

Results: Bifidobacterium bifidum content in the breast milk and B adolescentis, B bifidum, and B longum content in the fecal samples were higher in the control group than in the BMJ group. The milk and fecal concentrations of B bifidum were significantly correlated. The concentrations of breast milk B bifidum and fecal B bifidum, B adolescentis, and B longum were found to be negatively correlated with bilirubin levels.

Conclusions: Our results suggest that Bifidobacterium species in breast milk may protect against BMJ.

Department of Pediatrics, Dokuz Eylul University, Izmir, Turkey.

Address correspondence and reprint requests to Professor Dr Abdullah Kumral, Department of Pediatrics, School of Medicine, Dokuz Eylul University, Inciralti, 35340 Izmir, Turkey (e-mail:

Received 5 May, 2012

Accepted 21 October, 2012

The study was financially supported by Dokuz Eylul University, the Foundation of Scientific Research Projects.

The authors report no conflict of interest.

Copyright 2013 by ESPGHAN and NASPGHAN