Prebiotics in Management of Neonatal Jaundice: Open Label Randomised Control Trial:

Trupti Amol Joshi; Amol Kalyanrao Joshi; Laxmikant Sheshrao Deshmukh

doi:10.21276/ajcpn.2019.7.4.4

Trupti Amol Joshi Associate Professor, Department of Paediatrics, Government Medical College Aurangabad, Maharashtra, India
Amol Kalyanrao Joshi Fellowship Neonatology, Associate Professor, Department of Neonatology, Government Medical College Aurangabad, Maharashtra, India
Laxmikant Sheshrao Deshmukh Professor, Department of Neonatology, Government Medical College Aurangabad, Maharashtra, India

DOI: https://doi.org/10.21276/ajcpn.2019.7.4.4

Keywords: Inulin, Oligo-saccharides, Phototherapy, Bilirubin

Abstract

Background: Approximately 5-35% of neonates develop jaundice requiring treatment during the 1st week of life. Prebiotics, a mixture of Galacto-oligosaccharides (GOS) and Fructo-oligosaccharides (FOS), has been postulated to reduce serum bilirubin levels on principle of interruption of entero-hepatic circulation. Objective: To evaluate the effect of oral supplementation with prebiotics (Fructo-oligosaccharides) in the management of neonatal jaundice. Subjects and Methods: Design & Setting: Open Label, Randomized Control Trial at Level II NICU in public hospital over one year. Participants: Term exclusively breast-fed neonates with Jaundice requiring phototherapy. Intervention: Randomisation of Sixty eligible neonates into Control and Prebiotic groups (n= 30 each). Both groups received phototherapy, and Prebiotic group received additional oral prebiotics. Outcome: Primary outcome measure was a reduction in total serum bilirubin levels (TSB) and duration of phototherapy. The secondary outcome measure was the change in the frequency of stools.Results: Baseline Features were similar in both groups. Overall serum bilirubin levels decreased significantly from enrolment till the omission of phototherapy (17.24 + 1.16 vs. 12.74 + 0.48; P: 0.00). ANOVA depicted no statistical difference between the groups in 12 hourly reductions of TSB (F [3, 232] = 0.14, P: 0.94). Mean duration of phototherapy (in hours) required in prebiotic and control group was similar (50.40 + 9.66 vs. 47.60 + 8.62; P = 0.24). Secondary outcome measures were also similar in both groups.Conclusion: Prebiotics, containing only fructo-oligosaccharides, administered for upto three days, do not have any additional effect on reduction of serum bilirubin levels in neonates with jaundice receiving conventional treatment.

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