title: 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.
authors.affiliation: a Division of Neonatology, Department of Pediatrics , Isfahan University of Medical Sciences , Isfahan , Iran .|b Child Growth and Development Research Center, Isfahan University of Medical Sciences , Isfahan , Iran , and.
authors.forename: Amir Mohammad
authors.initials: AM
authors.lastname: Armanian
authors.affiliation: a Division of Neonatology, Department of Pediatrics , Isfahan University of Medical Sciences , Isfahan , Iran .|b Child Growth and Development Research Center, Isfahan University of Medical Sciences , Isfahan , Iran , and.
authors.forename: Behzad
authors.initials: B
authors.lastname: Barekatain
authors.affiliation: a Division of Neonatology, Department of Pediatrics , Isfahan University of Medical Sciences , Isfahan , Iran .
authors.forename: Maryam
authors.initials: M
authors.lastname: Hoseinzadeh
authors.affiliation: c Department of Health , Al-Mahdi University , Isfahan , Iran.
authors.forename: Nima
authors.initials: N
authors.lastname: Salehimehr
mesh_terms: D001663:Bilirubin / Q000097:blood*; D003672:Defecation; D004750:Enteral Nutrition / Q000379:methods; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D019102:Infant, Very Low Birth Weight / Q000097:blood; D007363:Intensive Care Units, Neonatal; D007492:Iran; D016014:Linear Models; D009844:Oligosaccharides / Q000008:administration & dosage*; D056692:Prebiotics / Q000008:administration & dosage*; D012044:Regression Analysis
chemical_list: D009844:Oligosaccharides; D056692:Prebiotics; D001663:Bilirubin
keywords: Jaundice; neonatal hyperbilirubinemia; prebiotics; premature infant; probiotics