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Extract: The carboxyhemoglobin level (COHb), an accepted qualitative index of bilirubin production, was measured in normal, full-term, breastfed (n=9) or formula-fed (n=11) infants at 2 days and 2 weeks of life. The mean COHb did not differ significantly at 2 days and 2 weeks in either of the groups, nor did the mean COHb differ between the groups at 2 weeks. The mean serum bilirubin concentration was lower in the formula-fed infants compared to the breastfed infants at 2 weeks. The mean serum bilirubin concentration decreased by only 14% among the breastfed infants, and actually increased in 3 infants by 2 weeks. In comparison, the mean serum bilirubin concentration of the formula-fed infants decreased by 61%, with the serum bilirubin concentration decreasing in each infant by 2 weeks. These findings are consistent with the generally held belief that bilirubin production is not the primary etiology of elevated serum bilirubin concentrations associated with breastfeeding in the second week of life. However, continued high bilirubin production at 2 weeks may contribute to the potential for significant jaundice in some infants with impaired hepatic function or increased enterohepatic circulation of bilirubin. (author)