부산대학교 도서관

The present multicenter study analysed the relative impact of maternal and infant factors on serum bilirubin levels at 72 ± 12 h in exclusively breastfed vs formula-fed term infants. End-tidal carbon monoxide levels corrected for ambient air (ETCOc), an index of bilirubin production, were measured in exclusively breastfed (B = 66) or formula-fed (F = 210) term infants at 2-8 h of age. Inclusion criteria included cesarean section to ensure a 3 d hospitalization, birthweight ≥ 2500 g, gestational age ≥ 37 wk and absence of any illness. The ETCOc for B infants and F infants did not differ significantly (1.3 ± 0.7 ppm vs 1.3 ± 0.8 ppm). The serum bilirubin level at 72 ± 12 h was significantly higher in B infants than in F infants (8.5 ± 3.4 mg dl[sup -1] vs 6.7 ± 3.4 mg dl[sup -1], p < 0.001), as was the percentage weight loss from birthweight. Serum bilirubin levels were significantly higher in infants who were male, who did not have meconium-stained amniotic fluid, and in those whose mothers were insulin-dependent diabetics or hypertensive. There was no difference between groups in the need for phototherapy or exchange transfusion. Conclusion: Although higher bilirubin levels were observed in group B at 72 ± 12 h compared with group F, this finding was not of clinical or therapeutic consequence in this study. The lack of difference in ETCOc between the groups may be a factor of the timing of ETCOc measurement in this study, or may suggest that early increased bilirubin production is not a significant contributor to jaundice observed in exclusively breastfed infants. [ABSTRACT FROM AUTHOR]