Prebiotics for the management of hyperbilirubinemia in preterm neonates

Abstract

Objective: We evaluated if prebiotics have benefits for the management of hyperbilirubinemia in preterm neonates.

Methods: Preterm neonates were entered into the study when enteral feeding volume met 30 mL/kg/day. They randomly received a mixture of short-chain galacto-oligosacarids/long-chain fructo-oligosacarids or distilled water (placebo) for 1 week. Total serum bilirubin level was measured by transcutaneous bilirubinometry. Stool frequency and meeting full enteral feeding during the study period were considered as secondary outcomes.

Results: Twenty-five neonates in each group completed the trial. Bilirubin level was decreased with the prebiotic (−1.3 ±  1.8 mg/dL, p = 0.004), but not placebo (−0.1 ± 3.3 mg/dL, p = 0.416). Peak bilirubin level was lower with the prebiotic than placebo (8.3 ± 1.7 versus 10.1 ± 2.2 mg/dL, p = 0.003). Stool frequency was increased with the prebiotic (0.7 ± 1.9 defecation/day, p = 0.014), but not with placebo (0.6 ±  1.5 defecation/day, p = 0.133). Average stool frequency (2.4 ±  0.4 versus 1.9 ± 0.5 defecation/day, p = 0.003) and frequently of meeting full enteral feeding (60% versus 16%, p = 0.002) were higher with the prebiotic than placebo.

Conclusions: Prebiotic oligosaccharides increase stool frequency, improve feeding tolerance and reduce bilirubin level in preterm neonates and therefore can be efficacious for the management of neonatal hyperbilirubinemia.

• Jaundice
• neonatal hyperbilirubinemia
• prebiotics
• probiotics
• premature infant

Acknowledgements

We are thankful to the medical and nursing teams of the NICU of the two participating hospitals. We are thankful to the Nutricia MMP Company (Nutricia MMP, Mashhad, Iran), its honorable Chairman, Mr. Shateri, and Mrs. Hadiashar for their sincere cooperation. Also, we are thankful to Dr Ali Gholamrezaei for data analyses.

Declaration of interest

The authors declare no conflict of interest. This study was supported by the Isfahan University of Medical Sciences (grant # 392345).

Supplementary material available online