When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant?
a. 2 to 12 hours
b. 12 to 24 hours
c. 2 to 4 days
d. After the fifth day
ANS: C
Breastfeeding-associated jaundice is caused by decreased milk intake related to decreased caloric and fluid intake by the infant before the mother's milk is well established. Fasting is associated with decreased hepatic clearance of bilirubin. Zero to 24 hours is too soon; jaundice within the first 24 hours is associated with hemolytic disease of the newborn. After the fifth day is too late. Jaundice associated with breastfeeding begins earlier because of decreased breast milk intake.
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