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Arch Pediatr Adolesc Med. 1999;153:657-658.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Tan's conclusion that "The addition of formula to the feedings for totally breast-fed infants, without the suspension of breast-feeding, would enhance the efficacy of phototherapy and reduce exposure time"¹ may be true, but it would also reduce breast-feeding rates. In the United Kingdom, 32% of babies given bottles in the first week of breast-feeding stopped breast-feeding within 2 weeks, compared with only 9% of those who had no bottles.²

With a mean ± SD phototherapy-starting bilirubin level of 259 ± 20 µmol/L, only 2.3% of Tan's subjects would have had a total bilirubin level of 300 µmol/L or higher. Many pediatricians would not treat even that level of jaundice in a well full-term baby after 48 hours. Furthermore, the 95th percentile for maximum total bilirubin concentration in breast-fed babies in one study was 248 µmol/L,³ and so almost 50% of Tan's cases were below that percentile when treatment started. Although . . . [Full Text of this Article]