Effects of Probiotics on Neonatal Hyperbilirubinemia
Effects of Probiotics on Neonatal Hyperbilirubinemia
This study was designed as a prospective controlled study to investigate the effects of
 probiotic support started immediately after birth on newborn jaundice in breastfed babies
 born by normal spontaneous vaginal delivery.
Objectives: Enterohepatic circulation of bilirubin imposes an extra burden of approximately
 30% on total serum bilirubin levels. Intestinal microflora is the main factor affecting
 enterohepatic circulation. This study investigated the effects of probiotic support started
 immediately after birth on neonatal hyperbilirubinemia in babies born by normal spontaneous
 vaginal delivery and breastfed only.

 Methods: A total of 150 healthy term newborns were included in the study and allocated in the
 study and control groups. Immediately after birth, newborns in the study group received
 probiotic in liquid drop form (Maflor® drops containing Lactobacillus Rhamnosus GG 109 Colony
 Forming Units(CFU), Mamsel Pharmaceuticals, Turkey), at a dose of 5 drops a day orally for 10
 days. Newborns in the control group received 5 drops of saline solution per day orally,
 instead. In addition to routine biochemical examinations;serum bilirubin levels in the cord
 blood, and blood samples of the newborns on the 3rd, 5th and 10th days of birth were measured
 in all subjects in both groups. Defecation frequency was recorded for all subjects.
Inclusion Criteria:

 -  A total of 150 full-term (gestational age ≥37 - <42 weeks) normal spontaneous vaginal
 delivery healthy newborns

 -  Birth weight between the 10th-90th percentiles

 -  Fed by breast milk only

 Exclusion Criteria:

 -  Newborns with familial hematologic disorders

 -  Having signs of hemolysis due to blood group incompatibilities

 -  Bleeding into closed spaces due to birth trauma complications (e.g. cephalohematoma)

 -  Suspected or documented neonatal infection such as chorioamnionitis, intrauterine
 infection, sepsis and urinary tract infection

 -  Perinatal and neonatal hypoxia

 -  Having thyroid dysfunction, respiratory distress or insufficiency, metabolic and
 thermoregulatory dysfunction, hemodynamic instability and congenital heart disease

 -  Maternal phenobarbital usage history during the last month of the pregnancy

 -  Having venous hematocrit (Htc) levels≥65%