The effects of probiotics on newborn jaundice

AIM: Newborn babies are at greater risk compared to other age groups for various reasons in terms of bilirubin elevation and associated neurotoxicity. One of the most important reasons for this is increased enterohepatic circulation (EHC) of bilirubin. EHC imposes an extra burden of approximately 30% on total serum bilirubin levels. Intestinal microflora are the main factor affecting EHC. This study investigated the effects of probiotic support started immediately after birth on newborn jaundice in babies born by normal spontaneous vaginal delivery (NSVD) and receiving only mother's milk. Materials and Methods: 150 healthy newborns born on term and by NSVD at the Karadeniz Technical University Medical Faculty Gynecology and Obstetrics Department and receiving only mother's milk were divided into study and control groups of 75 members each. Immediately after birth, newborns in the study group received probiotics in liquid drop form (Maflor® drops containing Lactobacillus rhamnosus GG 109 CFU, Mamsel Ilaç, Turkey), at a dosage of 5 drops a day, orally, for 10 days. Newborns in the control group received fluid drops containing saline solution, starting immediately after birth, at 5 drops a day, orally, for 10 days. In addition to routine investigations, cord, 3rd day, 5th day and 10th day bilirubin levels were measured in all subjects from both groups. Defecation frequency was recorded for all subjects. Results: Mean total bilirubin levels on days 3, 5 and 10 were statistically significantly lower in the prebiotic group compared to the control group (p<0.05), while mean defecation frequency was significantly higher (p<0.05). A negative correlation was determined between defecation frequency and total serum bilirubin level (3rd day (r:-0.804, p:<0.001), 5th day (r:-0.818, p:<0.001) and 10th day (r:-0.648, p:<0.001)). No hyperbilirubinemia high enough to require treatment was determined in any newborn. Conclusion: Probiotic support initiated immediately after birth has a positive effect on bilirubin metabolism and can reduce the risk of hyperbilirubinemia. This positive effect of probiotics may be related to increasing numbers of defecations and reducing EHC of bilirubin in association with probable suppression of β-glucuronidase activity.