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Usefulness of auditory brainstem response as early predictor of kernicterus in early breast-feeding jaundice

Korean Journal of Pediatrics 2007;50(9):848-854.
Published online September 15, 2007.
Usefulness of auditory brainstem response as early predictor of kernicterus in early breast-feeding jaundice
Jae Won Jang1, Gil Sang Lee1, Dae Keun Song2, Sung Hee Kim2, Won Duck Kim1, Sang Geel Lee1
1Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
2Department of Otorhinolaryngology, Daegu Fatima Hospital, Daegu, Korea
조기 모유 황달에서 핵황달의 조기 예측도구로서의 청성 뇌간유발 반응 검사의 유용성
장재원1, 이길상1, 송대근2, 김성희2, 김원덕1, 이상길1
1대구파티마병원 소아과
2대구파티마병원 이비인후과
Correspondence: 
Sang Geel Lee, Email: sgleeped@korea.com
Abstract
Purpose
: The present study examined the etiology and risk factors of the early breast-feeding jaundice and the usefulness of auditory brainstem response test as early predictor of kernicterus.
Methods
: Medical records of neonatal jaundice in newborn admitted to Daegu Fatima Hospital between September 2005 and May 2006 were analyzed prospectively. Infants were grouped according to feeding method : breast feeding group (breast feeding only, n=23), mixed feeding group (breast feeding mainly plus addition of fomula feeding, n=13).
Results
: There were no significant differences in gestational age, birth weight, sex, duration of phototherapy, serum bilirubin and hemolytic evidence between the two study groups. First visiting day of life at out patient department was significantly delayed in breast feeding group (8.7?.6 day) compared to mixed feeding group (6.0?.9) (P=0.009). Weight loss was significantly severe in breast feeding group compared to mixed feeding group (P<0.05). In auditory brainstem response test, loss of Wave V in 3 cases was observed and recoverd after blood exchange transfusion in follow up test. Wave III latency had significant correlation to serum bilirubin in auditory brainstem response test (70 dB) (P=0.002).
Conclusion
: Our study suggest that further education about breast feeding and follow up within the first postnatal week would be necessary for early detection and prevention of early breast-feeding jaundice. Test of serum bilirubin and auditory brainstem response would be helpful in determination of blood exchange transfusion.
Key Words: Early, Breast feeding, Jaundice


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