Early breastfeeding initiation and incidence of severe neonatal jaundice in Chipinge district Zimbabwe

Gladys Mugadza, Mathilda Zvinavashe, Zvanyadza Gumbo, Babill Stray-Pedersen


Background: Neonatal jaundice is the most prevalent condition affecting new born babies especially during the first week of life. About 50-60 % of the new born babies get affected with jaundice in the first week of life. The objective of the present study is to determine early breastfeeding initiation (EBFI) and the incidence of severe neonatal jaundice in in the first week of life in Chipinge District, Zimbabwe.

Methods: A prospective cohort was conducted among 200 (100 early initiators and 100 late initiators) healthy term neonates and screening of jaundice was done on day 3 and day 7 using the transcutaneous bilirubinometry (JM 120). Early breast-feeding initiation was defined as the actual giving of the first breastmilk within an hour of birth and anything beyond an hour was considered as late (WHO, 2010). Jaundice was graded from mild (<10mg/dl), moderate (>10<14mg/dl) to severe (15mg/dl or more).

Results: The Pearson correlation for early breastfeeding and severe neonatal jaundice was significant 2 tailed at (P = 0.01) at 95% CI and significant 2 tailed (P = 0.01) at 95% CI delayed breastfeeding initiation and severe neonatal jaundice.

Conclusions: Early breast-feeding initiation had strong association with severe jaundice, significant 2 tailed at (P = 0.01) at 95% CI and significant 2 tailed (P = 0.01) at 95% CI delayed breastfeeding initiation and severe neonatal jaundice. There is need to assess neonatal jaundice objectively as clinical assessment through eye observation has limitation in picking at risk babies.


Early breastfeeding initiation, Incidence, Severe jaundice

Full Text:



Ujaddughe MO, Eigbedion EO, Ujaddughe ME, Okhiai O, Eigiacheyi MA. An overview of neonatal jaundice: the burden and the way forward. Int Res Med Sci. 2016;4(4):60-2.

Nadir S, Saleem F, Amin K, Mahmood K. Rational use of phototherapy in the treatment of physiologic jaundice neonatorum. J Pharma Sci Res. 2011;3(1):1-13.

Click R, Dahl-Smith J, Fowler L, DuBose J, Deneau-Saxton M, Herbert J. An osteopathic approach to reduction of readmissions for neonatal jaundice. Osteopathic Family Physician. 2013;5(1):1-10.

Maisels MJ, DeRidder JM, Kring EA, Balasubramaniam M. Routine transcutaneous bilirubin measurements combined with clinical risk factors to improve the prediction of subsequent hyperbilirubinemia. J Perinatol. 2009;(29):612-7.

Maisels MJ, Bhutani VK, Bogen D, Newman TB, Stark AR, Watchko JF. Hyperbilirubinemia in the newborn infant ≥35 weeks’ gestation: an update with clarifications. Pediatr. 2009;124(4):1193-8.

Kumral A, Ozkan H, Duman N. Breast milk jaundice correlates with high levels of epidermal growth factor. Pediatr Res. 2009;66:218-21.

Bhutani VK. Editorial: building evidence to manage newborn jaundice worldwide. Indian J Pediatr. 2012;79(2):253-5.

Ennever JF, Sobel, M, McDonagh AF, Speck WT. Phototherapy for neonatal jaundice: in vitro comparison of light sources. Pediatr Res. 2010;18(7):667-70.

Cohen SM. Jaundice in the full-term newborn. Pediatr Nursing. 2006;32(3):202-8.

Geiger AM, Petitti DB, Yao JF. Rehospitalisation for neonatal jaundice: risk factors and outcomes. Paediatr Perinat Epidemiol. 2001;15(4):352-8.

Sgro M, Campbell D, Barozzino T, Shah V. Acute neurological findings in a national cohort of neonates with severe neonatal hyperbilirubinemia. J Perinatol. 2011;31(6):392-6.

Young Infants Clinical Signs Study Group. Clinical signs that predict severe illness in children under age 2 months: a multicentre study. Lancet. 2008;371(9607):135-42.

WHO. Indicators for assessing infant and young child feeding practices. Part 3: Country profiles. Geneva. 2010.

Lamberti LM, Walker CLF, Noiman A, Victora C, Black RE. Breastfeeding and the risk for diarrhoea morbidity and mortality. BMC Public Health. 2011;11:S15.

Okwundu CI, Uthman OA, Smith J. Transcutaneous screening for hyperbilirubinemia in neonates. Cochrane Database of Systematic Reviews 2014;4: CD011060.

Dennery PA, Seidman DS, Stevenson DK. Neonatal hyperbilirubinemia. New England J Med. 2001;344(8):581-90.

Chawla D, Jain S, Dhir S, Rani S. Risk assessment strategy for prediction of pathological hyperbilirubinemia in neonates. Indian Pediatr. 2011;79(2):198-201.

Ip S, Chung M, Kulig J, O’Brien R, Sege R, Glicken S, et al. An evidence-based review of important issues concerning neonatal hyperbilirubinemia. Pediatr. 2004;114(1):e130-53.

Kaur S, Chawla D, Pathak U, Jain S. Pre-discharge non-invasive risk assessment for prediction of significant hyperbilirubinemia in term and late preterm neonates. J Perinatol. 2012;32:716-21.