The role of probiotics in preventing neonatal hyperbilirubinemia

Introduction: Neonatal jaundice is a common condition and an important cause of hospital admissions. This report reviews the efficacy of Lactobacillus reuteri and Saccharomyces boulardii in preventing high bilirubin levels and associated phototherapy admissions. Materials and Methods: This was a prospective, randomized study involving three groups. Group 1 was designated as a control and received no intervention. During the first 4 days of life, Group 2 received a concentrated dose of L. reuteri whereas Group 3 received a concentrated dose of S. boulardii. Bilirubinemia levels were assessed on day 4. Results: The sample size consisted of 98 subjects, including 36 in control Group 1, 31 in Group 2, and 31 in Group 3. The mean bilirubinemia at day 4 was 14.7 mg/dl in control Group 1, 13.8 mg/dl in Group 2, and 14.9 mg/dl in Group 3 (P > 0.05). Group 2 accounted for the most subjects (45%) in the low-to-intermediate-risk zone, compared to 30% in control Group 1 and 29% in Group 3 (P < 0.05). Eight subjects required light therapy, including two in Group 2 and three in each of control Group 1 and Group 3 (P > 0.05). Conclusions: The use of probiotics to prevent neonatal hyperbilirubinemia or bring down phototherapy admissions does not appear to be cost-effective.