{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:44:09Z","timestamp":1791297849786,"version":"4.1.0"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,8,1]]},"abstract":"<jats:p>Objectives. Neonatal jaundice is a greater problem for infants fed breast milk, compared with formula. This study tested the hypotheses that feeding breastfed newborns \u03b2-glucuronidase inhibitors during the first week after birth would increase fecal bilirubin excretion and would reduce jaundice without affecting breastfeeding deleteriously.<\/jats:p><jats:p>Methods. Sixty-four breastfed newborns were randomized to 4 groups, ie, control or receiving 6 doses per day (5 mL per dose) of l-aspartic acid, enzymatically hydrolyzed casein (EHC), or whey\/casein (W\/C) for the first week. l-Aspartic acid and EHC inhibit \u03b2-glucuronidase. Transcutaneous bilirubin levels (primary outcome) were measured daily (Jaundice Meter [Minolta\/Air Shields, Hatboro, PA] and Bilicheck [Respironics, Pittsburgh, PA]). All stools were collected, and fecal bile pigments, including bilirubin diglucuronide, bilirubin monoglucuronides, and bilirubin, were analyzed with high-performance liquid chromatography. Follow-up assessments included day 7 body weight, day 6\/7 prebreastfeeding\/postbreastfeeding weights, maternal ratings, and ages at formula introduction and breastfeeding cessation.<\/jats:p><jats:p>Results. The groups were comparable at entry. Overall, the l-aspartic acid, EHC, and W\/C groups had significantly lower transcutaneous bilirubin levels than did the control group (75.8%, 69.6%, and 69.2%, respectively, of the control mean, 8.53 mg\/dL, at the bilirubin peak on day 4). The l-aspartic acid, EHC, and W\/C groups had significantly lower transcutaneous bilirubin levels on days 3 to 7. Fecal bile pigment excretion was greatest in the l-aspartic acid group, significantly greater than control values. There were no significant differences in dosages, follow-up measurements, and maternal ratings.<\/jats:p><jats:p>Conclusions. Use of minimal aliquots of l-aspartic acid and EHC for \u03b2-glucuronidase inhibition results in increased fecal bilirubin excretion and less jaundice, without disruption of the breastfeeding experience. Decreased jaundice in the W\/C group, which lacked a \u03b2-glucuronidase inhibitor, suggests a different mechanism.<\/jats:p>","DOI":"10.1542\/peds.2004-1807","type":"journal-article","created":{"date-parts":[[2005,8,2]],"date-time":"2005-08-02T14:55:38Z","timestamp":1122994538000},"page":"385-391","source":"Crossref","is-referenced-by-count":43,"title":["A Controlled, Randomized, Double-Blind Trial of Prophylaxis Against Jaundice Among Breastfed Newborns"],"prefix":"10.1542","volume":"116","author":[{"given":"Glenn R.","family":"Gourley","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanhai","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bill L.","family":"Kreamer","sequence":"additional","affiliation":[{"name":"Waisman Center, University of Wisconsin, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Kosorok","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2005,8,1]]},"reference":[{"key":"2021121003192382800_R1","doi-asserted-by":"crossref","unstructured":"Gourley GR. 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