A 4-Day-Old, Full-Term Boy Is Brought to the Office for His

A 4-day-old, full-term boy is brought to the office for his first visit after an uncomplicated vaginal delivery and unremarkable newborn nursery course.  The patient's mother, gravida 1 para 1, has blood type A positive, and prenatal laboratory results and ultrasound were normal.  Birth weight was 3.4 kg (7 lb 8 oz) and length was 48.5 cm (18 in) .  He has been exclusively breastfed since birth and nurses for 10 minutes on each breast every 4 hours.  The mother's milk began to come in this morning.  The infant passed several dark brown, sticky, meconium stools during the first 2 days of life, but his last stool was yesterday and dark green.  He has 2 wet diapers each day but has not voided today.  The neonate's current weight is 3 kg (6 lb 10 oz) .  He has scleral icterus and jaundice of the face, chest, and abdomen.  The rest of his physical examination is normal.  Laboratory results are as follows:

Which of the following is the most likely cause of this infant's hyperbilirubinemia?

A) Alloimmune hemolytic disease
B) Biliary atresia
C) Breast milk jaundice
D) Breastfeeding jaundice
E) Dubin-Johnson syndrome
F) Galactosemia

Correct Answer:

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