The effect of probiotics supplementation in neonatal jaundice therapy: A systematic review

Background Neonatal 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.Objectives The purpose of this systematic review is to assess the effect of probiotics supplementation in neonatal jaundice therapy.Methods Four 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.Results Nine 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.Conclusion Probiotics 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.