Pediatr Gastroenterol Hepatol Nutr.  2019 Sep;22(5):453-459. 10.5223/pghn.2019.22.5.453.

Effect of Synbiotic on the Treatment of Jaundice in Full Term Neonates: A Randomized Clinical Trial

Affiliations
  • 1Razi Herbal Medicine Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
  • 2Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran. dr.a.Mohsenzadeh@gmail.com
  • 3Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
  • 4Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • 5Department of Pharmacology and Toxicology, Faculty of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran.

Abstract

PURPOSE
Jaundice accounts for most hospital admissions in the neonatal period. Nowadays, in addition to phototherapy, other auxiliary methods are used to reduce jaundice and the length of hospitalization. This study aimed to investigate the effect of probiotics on the treatment of hyper-bilirubinemia in full-term neonates.
METHODS
In this randomized clinical trial, 83 full-term neonates, who were admitted to the hospital to receive phototherapy in the first 6 months of 2015, were randomly divided into two groups: synbiotic (SG, n=40) and control (CG, n=43). Both groups received phototherapy but the SG also received 5 drops/day of synbiotics. Serum bilirubin, urine, stool, feeding frequency, and weight were measured daily until hospital discharge. A p-value<0.05 was considered statistically significant.
RESULTS
The mean total serum bilirubin in the SG was lower than that in the CG (9.38±2.37 and 11.17±2.60 mg/dL, respectively). The urine and stool frequency in the SG was significantly higher than that in the CG (p<0.05). The duration of hospitalization in the SG was shorter than that in the CG.
CONCLUSION
Use of synbiotics as an adjuvant therapy had a significant treatment effect on jaundice in full-term neonates. Further studies including larger samples with long follow-up periods are essential to confirm the benefits of routine use of synbiotics in neonatal patients with jaundice.

Keyword

Hyper-bilirubinemia; Probiotics; Synbiotics; Phototherapy; Jaundice; Neonate infant

MeSH Terms

Bilirubin
Follow-Up Studies
Hospitalization
Humans
Infant, Newborn*
Jaundice*
Phototherapy
Probiotics
Synbiotics*
Bilirubin

Figure

  • Fig. 1 Flow chart of the study.

  • Fig. 2 Variables examined in the synbiotic (S) and control (C) groups (mean±standard error of the mean).

  • Fig. 3 Variables examined in the symbiotic (S) and control (C) groups during hospital stay (mean±standard error of the mean).


Reference

1. Alex M, Gallant DP. Toward understanding the connections between infant jaundice and infant feeding. J Pediatr Nur. 2008; 23:429–438.
Article
2. Martin RJ, Fanaroff AA, Walsh WM. Fanaroff and Martin's neonatal perinatal medicine diseases of the fetus and infant. Philadelphia: Mosby;2006.
3. Cohen SM. Jaundice in the full-term newborn. Pediatr Nurs. 2006; 32:202–208. PMID: 16802676.
4. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004; 114:297–316. PMID: 15231951.
5. Mahé E, Beauchet A, Aegerter P, Saiag P. Neonatal blue-light phototherapy does not increase nevus count in 9-year-old children. Pediatrics. 2009; 123:e896–e900. PMID: 19403483.
6. McDonagh AF. Bilirubin, copper-porphyrins, and the bronze-baby syndrome. J Pediatr. 2011; 158:160–164. PMID: 20888578.
Article
7. Bhutani VK, Johnson-Hamerman L. The clinical syndrome of bilirubin-induced neurologic dysfunction. Semin Fetal Neonatal Med. 2015; 20:6–13. PMID: 25577653.
Article
8. McDonagh AF, Maisels MJ. Bilirubin unbound: déjà vu all over again? Pediatrics. 2006; 117:523–525. PMID: 16452373.
9. Nag N, Halder S, Chaudhuri R, Adhikary S, Mazumder S. Role of bilirubin as antioxidant in neonatal jaundice and effect of ethanolic extract of sweet lime peel on experimentally induced jaundice in rat. Indian J Biochem Biophys. 2009; 46:73–78. PMID: 19374257.
10. Stanton C, Gardiner G, Meehan H, Collins K, Fitzgerald G, Lynch PB, et al. Market potential for probiotics. Am J Clin Nutr. 2001; 73(2 Suppl):476S–483S. PMID: 11157361.
Article
11. Cummings JH, Macfarlane GT, Macfarlane S. Intestinal bacteria and ulcerative colitis. Curr Issues Intest Microbiol. 2003; 4:9–20. PMID: 12691258.
12. Salminen S, Bouley C, Boutron-Ruault MC, Cummings JH, Franck A, Gibson GR, et al. Functional food science and gastrointestinal physiology and function. Br J Nutr. 1998; 80 Suppl 1:S147–S71. PMID: 9849357.
Article
13. Sur D, Manna B, Niyogi SK, Ramamurthy T, Palit A, Nomoto K, et al. Role of probiotic in preventing acute diarrhoea in children: a community-based, randomized, double-blind placebo-controlled field trial in an urban slum. Epidemiol Infect. 2011; 139:919–926. PMID: 20670468.
Article
14. Prescott SL, Björkstén B. Probiotics for the prevention or treatment of allergic diseases. J Allergy Clin Immunol. 2007; 120:255–262. PMID: 17544096.
Article
15. Hoyos AB. Reduced incidence of necrotizing enterocolitis associated with enteral administration of Lactobacillus acidophilus and Bifidobacterium infantis to neonates in an intensive care unit. Int J Infect Dis. 1999; 3:197–202. PMID: 10575148.
Article
16. Maruo Y, Nishizawa K, Sato H, Sawa H, Shimada M. Prolonged unconjugated hyperbilirubinemia associated with breast milk and mutations of the bilirubin uridine diphosphate- glucuronosyltransferase gene. Pediatrics. 2000; 106:E59. PMID: 11061796.
Article
17. Porter ML, Dennis BL. Hyperbilirubinemia in the term newborn. Am Fam Physician. 2002; 65:599–606. PMID: 11871676.
18. Armanian AM, Barekatain B, Hoseinzadeh M, Salehimehr N. Prebiotics for the management of hyperbilirubinemia in preterm neonates. J Matern Fetal Neonatal Med. 2016; 29:3009–3013. PMID: 26513278.
Article
19. Chen Z, Zhang L, Zeng L, Yang X, Jiang L, Gui G, et al. Probiotics supplementation therapy for pathological neonatal jaundice: a systematic review and meta-analysis. Front Pharmacol. 2017; 8:432. PMID: 28713275.
Article
20. Deshmukh J, Deshmukh M, Patole S. Probiotics for the management of neonatal hyperbilirubinemia: a systematic review of randomized controlled trials. J Matern Fetal Neonatal Med. 2019; 32:154–163. PMID: 28823200.
Article
21. Torkaman M, Afsharpaiman SH, Hoseini MJ, Moradi M, Mazraati A, Amirsalari S, et al. Platelet count and neonatal sepsis: a high prevalence of Enterobacter spp. Singapore Med J. 2009; 50:482–485. PMID: 19495516.
22. Goldin BR, Gorbach SL. The relationship between diet and rat fecal bacterial enzymes implicated in colon cancer. J Natl Cancer Inst. 1976; 57:371–375. PMID: 1003518.
23. Goldin BR, Gorbach SL. Effect of Lactobacillus acidophilus dietary supplements on 1,2-dimethylhydrazine dihydrochloride-induced intestinal cancer in rats. J Natl Cancer Inst. 1980; 64:263–265. PMID: 6766509.
24. Osborn LM, Reiff MI, Bolus R. Jaundice in the full-term neonate. Pediatrics. 1984; 73:520–525. PMID: 6709433.
Article
25. Ahmadipour S, Mohsenzadeh A, Alimadadi H, Salehnia M, Fallahi A. Treating viral diarrhea in children by probiotic and zinc supplements. Pediatr Gastroenterol Hepatol Nutr. 2019; 22:162–170. PMID: 30899692.
Article
26. Preer GL, Philipp BL. Understanding and managing breast milk jaundice. Arch Dis Child Fetal Neonatal Ed. 2011; 96:F461–F466. PMID: 20688866.
Article
Full Text Links
  • PGHN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr