Background: Jaundice is one of the most common conditions requires medical care in neonates. The yellow colour of the skin and the sclera in neonates is the result of the accumulation of bilirubin, the most common natural consequence of the first week of life as indicated by Bhutani Hour-specific bilirubin nomogram, Bilirubin encephalopathy is a devastating brain injury, which can cause permanent neurodevelopmental handicaps, so prevention& treatment of neonatal hyperbilirubinemia is very important .
Objectives: The aim of this study was to evaluate the efficacy and safety of probiotics on neonatal hyper bilirubinemia.
Methods: It is randomized controlled clinical trial; it included 100Full term neonates who were admitted immediately or shortly after birth due to pathological Hyperbilirubinemia as indicated by Bhutani Hour-specific bilirubin nomogram. To NICU of Al-AZHAR university hospitals the cases dived into Group (A) 50 cases treated by phototherapy in combination with probiotics and group (B) 50 as control treated by Phototherapy only. The serum bilirubin levels were done before and the1st, 4th, 7th days after treatment with probiotics (lactobacillus 5 billion/ sachets) divided into 3 doses daily for 7 days).
The time when therapy showed effects and jaundice faded, Clinical outcomes as well as adverse reactions were recorded.
Results: Serum bilirubin levels of the two groups were similar before treatment. The levels significantly decreased at the 4th and 7th days after treatment of probiotics in group(A )(P<0.05), but there was no significant different after the 1st day of treatment with probiotics (P>0.05) between the two groups, In group (A) the therapy exerted effects after (2.7±0.8) day and jaundice faded after (4.8±0.9) day) while in group (B)) the therapy exerted effects after (3.9±1.7) day and jaundice faded after (5.9±1.8) day, the effective rate of decrease in group (A) significantly exceeded that in group (B), (P=0.007, 0.002).
Conclusion: The use of probiotics is an important adjuvant to phototherapy during management of neonatal hyper bilirubinemia this combination reduce the side effects of phototherapy and the duration of hospital stay for cases of neonatal hyper bilirubinemia.