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Glenn R. Gourley, MD; Bill Kreamer; Monika Cohnen; Michael R. Kosorok, PhD

Arch Pediatr Adolesc Med. 1999;153:184-188.

Objective  To determine whether an earlier observation, that infants fed a casein-hydrolysate formula (Nutramigen) have lower neonatal jaundice levels than those fed standard formulas, would be repeated in a larger independent group of infants with more frequent measurements and more rigorous statistical analysis.

Design  Newborn infants were fed human milk, a standard whey-predominant formula (Enfamil), or Nutramigen (n=20 for each group) during the first 3 weeks of life. Transcutaneous jaundice index was measured daily for the first week of life and every 2 to 3 days thereafter, using a noninvasive jaundice meter. Linear regression models of the data were constructed, validated, and compared statistically.

Setting  General community hospital with subsequent home visitation.

Participants  Healthy, term newborn infants selected by convenience, based on time of birth.

Intervention  Infants were exclusively fed human milk, Enfamil, or Nutramigen. Formulas were randomly assigned.

Main Outcome Measure  Jaundice index, a transcutaneous measurement of jaundice.

Results  The jaundice index differed significantly among the 3 groups. Paired comparisons showed that the jaundice index of the Nutramigen group was significantly lower than that of the Enfamil group (on days 6-16) and the human milk group (on days 3-20). The jaundice index of the Enfamil-fed group was significantly lower than that of the human milk group on days 13 to 19.

Conclusions  Jaundice levels are lower in neonates fed Nutramigen rather than Enfamil and both these groups have lower jaundice levels than breast-fed infants.

From the Departments of Pediatrics (Dr Gourley and Mr Kreamer), Statistics (Dr Kosorok), and Biostatistics and Medical Informatics (Dr Kosorok), University of Wisconsin School of Medicine and Waisman Center on Mental Retardation and Human Development, Madison, and Justus-Liebig Universität, Giessen, Germany (Ms Cohnen).

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