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Updated: Sep 8, 2025

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Published on: January 27, 2019
The effect of probiotics supplementation in neonatal jaundice therapy: A systematic review
Lisa Amelia Wijaya1, Putu Wila Widiastuti2, Ni Nyoman Metriani Nesa3
1General Practitioner, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia.
Insights
Probiotics show promise in reducing neonatal jaundice by lowering bilirubin levels, potentially improving phototherapy outcomes. Further research is needed to confirm consistent benefits and safety.
Area of Science:
- Neonatology
- Gastroenterology
- Microbiology
Background:
- Neonatal jaundice affects a significant portion of newborns, posing health risks.
- Elevated unconjugated bilirubin levels are the primary cause of neonatal jaundice.
- Probiotics are being explored as an adjunct therapy to phototherapy for jaundice.
Purpose of the Study:
- To systematically review the efficacy of probiotic supplementation in treating neonatal jaundice.
- To assess the impact of probiotics on bilirubin levels and treatment duration in jaundiced neonates.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) from major databases (Google Scholar, PubMed, Cochrane Library).
- Studies adhering to PRISMA guidelines, using Cochrane risk of bias tool (RoB 2) for assessment.
- Inclusion criteria: term/preterm neonates with jaundice requiring phototherapy, comparing probiotics plus phototherapy versus phototherapy alone.
Main Results:
- Nine of 14 RCTs indicated a significant reduction in total serum bilirubin levels with probiotic use.
- Some studies reported improvements in indirect bilirubin, phototherapy duration, and hospital stay.
- Four studies found no significant changes in bilirubin levels; no adverse effects were reported.
Conclusions:
- Probiotic supplementation appears to be a promising adjunctive therapy for neonatal jaundice.
- Further high-quality research is necessary to establish consistent therapeutic effects and evaluate safety profiles.
Abstract:
BackgroundNeonatal jaundice affects 60% of term and 80% of preterm newborns due to high levels of unconjugated bilirubin, leading to significant health issues. Currently, probiotics were used as a promising agent to enhance phototherapy outcomes.ObjectivesThe purpose of this systematic review is to assess the effect of probiotics supplementation in neonatal jaundice therapy.MethodsFour reviewers extracted randomized controlled trial (RCT) studies from Google Scholar, PubMed, and the Cochrane Library as per PRISMA guidelines. The risk of bias will be assessed using the Cochrane risk of bias tool for randomized trials (RoB 2). Inclusion criteria comprised term or preterm neonates diagnosed with any type of jaundice warranting phototherapy, outcome comparison between probiotic supplementation in phototherapy and control group. Study including healthy neonates, prophylaxis effect, non-RCT, and non-English studies were excluded in this study.ResultsNine out of 14 RCT studies showed significant reduction of total serum bilirubin levels with various duration after receiving probiotic supplementation during phototherapy. Some of RCT studies reported significant changes in indirect bilirubin levels, duration of phototherapy, duration of hospital stay. Moreover, there were four studies that found no significant changes on total serum bilirubin levels. No adverse effects or complications are found among those studies.ConclusionProbiotics supplementation in neonatal jaundice therapy was promising beneficial outcome for neonatal jaundice. Further research is required to confirm the consistency of therapeutic effects and adverse reactions.
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