The effect of prebiotics in the management of neonatal hyperbilirubinaemia.
BACKGROUND
Breast milk oligosaccharides such as galacto-oligosaccharides (scGOS) and fructo-oligosaccharides (lcFOS) can influence the intestinal microbial flora. The latter, in turn, can modulate several intestinal and extraintestinal functions, including bilirubin metabolism. Supplementing infant formula with a prebiotic mixture might then be a novel and safe intervention to manage mild neonatal hyperbilirubinaemia.


OBJECTIVE
To investigate the effect of dietary supplementation with prebiotics on moderate hyperbilirubinaemia in healthy, term infants.


METHODS
A prospective, double-blind, clinical trial was performed on seventy-six consecutive newborns who were randomly assigned to receive a formula containing 0.8 g/dL of a mixture from scGOS and lcFOS (ratio 9:1), or maltodextrines as placebo for 28 days. Bilirubin levels were determined by the transcutaneous bilirubin measurement within 2 h after birth (T1), at 24, 48 and 72 h and at 5, 7, 10 and 28 days of life. The number of stool per day was also recorded.


RESULTS
Neonates receiving prebiotics showed a larger number of stools over all the duration of dietary intervention compared to that of those on placebo (Repeated Measures ANOVA p < 0.001; day 28 3.4 +/- 0.0.9 vs 1.7 +/- 0.9, respectively; Dunn test p < 0.05). Neonates whose formula was supplemented with prebiotics showed a lower transcutaneous bilirubin that was statistically significant from 72 h of life (5.46 +/- 1.6 vs 7.07 +/- 2.49, post hoc Dunn test, p < 0.05) throughout the duration of the dietary intervention (day 28 2.41 +/- 0.4 vs 2.85 +/- 0.5, post hoc Dunn test, p < 0.05).


CONCLUSIONS
The addition of prebiotics to standard infant diet might represent a novel strategy to help control neonatal hyperbilirubinaemia.
Bisceglia
M
M
Department of Pediatrics, Ospedale San Giovanni di Dio Via XXV Aprile, Crotone, Italy.
Indrio
F
F
Riezzo
G
G
Poerio
V
V
Corapi
U
U
Raimondi
F
F
D000704:Analysis of Variance; D001663:Bilirubin / Q000097:blood; D019587:Dietary Supplements; D004311:Double-Blind Method; D005243:Feces; D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000628:therapy*; D041943:Infant Formula / Q000737:chemistry; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D009844:Oligosaccharides / Q000627:therapeutic use; D011134:Polysaccharides / Q000627:therapeutic use; D056692:Prebiotics; D011446:Prospective Studies
D009844:Oligosaccharides; D011134:Polysaccharides; D056692:Prebiotics; C008315:maltodextrin; D001663:Bilirubin