Effect of breast milk microbial content on neonatal prolonged jaundice

Neonatal jaundice is a common and usually benign condition that resolves on its own or with minimal intervention but, if sufficiently severe, can cause permanent neurological damage. Prolonged jaundice is defined as jaundice which develops after the ? rst week of life and ongoing over >10 mg/dl after the two weeks of age. Although the breast feeding is the most common cause of the prolonged jaundice, those infants need further evaluation for eliminating the pathological causes.One of the most accepted pathophysiologic mechanism leading breast feeding jaundice is increased enterohepatic circulation due to the breast milk. Intestinal absorption is a key step in the enterohepatic circulation of bilirubin. It is not understood clearly how breast milk increases the intestinal absorbtion of bilirubin. But some authors have been suggested that cytokins and growth factors might be responsible for the increased bilirubin absorbtion.Bacteria population of the intestine seems a possible factor which can affect the bilirubin absorbtion. In the recent years it has been shown that breast milk is a biologic active nutrient enriched with cytokins, growth hormones and bacteria population. The staphilococcus, lactococcus, enterococcus and lactobacillus are the most common determined bacterial species in the human milk. In these species lactobacillus have been suggested to play probiotic action The antiinflamatuar and immune modulating role of probiotics have been demonstrated in several studies. The gastrointestinal effects of probiotics found in the breast milk considered the possible role of bacterial agents in the prolonged breast milk jaundice. Although breast milk related prolonged jaundice have been evaluated for several ways, we have not found any study investigating the role of probiotic properties of breast milk in prolonged jaundice.In the present study, it is aimed to investigate the effect of bacterial content of breast milk and infant feces on prolonged jaundice. For this purpose 30 healthy and 30 breast milk related prolonged jaundice (jaundice ongoing at 15th day) followed up in the newborn outpatient?s clinic of Dokuz Eylul University Faculty Of Medicine included the study. The breast milk samples and feceses of newborns were evaluated in content of selected bacterial population with PCR.By the end of this research, inter-individulal differences has been detected between breast milk and feces samples. Bifidobacterium bifidum content of the breast milk and bifidobacterium adolentis, bifidum and longum content of the feces samples were higher in the control group than the prolonged jaundice group. After corelation analysis breast milk bifidobacterium bifidum and feces bifidobacterium bifidum, aolentis and longum content have been found to be negative correleted with bilirubin level.Our results suggested that bifidobacterium species seem to be protective against breast milk jaundice. If the results of the further studies support our findings, and the efficacy and safety of probiotics gain more clarity in neonatal area, probiotics may be suggested as a treatment modality in breast milk jaundice.