Question

Which one of the following is not the reason for a very high load of bilirubin in a newborn?

• A. Mother's milk contain a high amount of bilirubin.
• B. Insoluble bilirubin in the intestine is reabsorbed by the blood.
• C. Excessive red blood corpuscles in the newborn burst, releasing bilirubin.
• D. The liver of the newborn is too young to cope up with the heavy load of bilirubin.

Answer 1

The correct option is A Mother's milk contain a high amount of bilirubin.

Physiologic jaundice is the most common type of jaundice in babies. It is caused because of

1. Breakdown of RBC due to shorter neonatal RBC life span which increases bilirubin production (hemolysis).
2. New Borns have an immature hepatic system for the uptake, conjugation, and secretion of bilirubin.
3. Neonates do not have enzyme UDP glucurnyl transferase, due to this hydrolysis of conjugated bilirubin increases, which is then reabsorbed by the intestine and recycled into circulation.

However, Mothers milk does not contain a high amount of bilirubin. But there is an another type of jaundice called Breast Milk Jaundice that persists after physiologic jaundice subsides in an otherwise healthy baby. "Breast milk Jaundice" must also be differentiated from "breastfeeding jaundice", which is caused due to insufficient intake of milk. As an adequate amount of milk causes an increase in baby's bowel movements and helps in secreting the buildup of bilirubin. Thus, the correct answer is option A.