The Best Type of Probiotic for the Prevention and Treatment of Neonatal Physiological Jaundice: A Systematic Review and Meta-Analysis Publisher

Summary: Can probiotics ease newborn jaundice? A meta-analysis suggests some strains may reduce phototherapy needs, but effects vary and better trials are needed. #NeonatalHealth #Probiotics

Barekatain B ; Asefi Z ; Kelishadi R ; Yazdi M ; Heidari Beni M
Source: Journal of Research in Medical Sciences Published:2026

Abstract

Background: – Gut microbiota play an important role in bilirubin metabolism and may influence the course of neonatal physiological jaundice. This systematic review and meta-analysis aimed to evaluate the strain-specific efficacy of probiotics in the prevention and adjunctive treatment of neonatal physiological jaundice. Materials and Methods: – A comprehensive search of PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library, World Health Organization databases, and Persian databases (Scientific information database [SID] and Magiran) for studies published up to 2024 was conducted. Randomized controlled trials (RCTs) evaluating probiotics in term and late-preterm neonates (≥35 weeks) with physiological jaundice were included. Data extraction, quality assessment, and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using a random-effects model. Results: – Nineteen RCTs (13 therapeutic and 6 prophylactic) were included. Prophylactic probiotic administration was associated with a reduced need for phototherapy (odds ratio [OR] =0.60; 95% confidence interval [CI]: 0.37–0.96). As an adjunct to phototherapy, probiotics were associated with lower bilirubin levels (mean difference [MD] = −1.61; 95% CI: −3.10–−0.11), shorter phototherapy duration (~5 h), and reduced hospitalization (0.3 days). Reduction in bilirubin was more evident during the 2nd and 3rd days of treatment. Strain-specific differences were observed; Clostridium butyricum and Lactobacillus reuteri demonstrated larger pooled effect sizes for bilirubin reduction, whereas Saccharomyces boulardii showed greater protective effect against phototherapy. Conclusion: – Probiotics may serve as beneficial adjuncts in the prevention and management of neonatal physiological jaundice, with potential strain-dependent differences. Given heterogeneity and limited data for some strains, findings should be interpreted cautiously. Further well-designed, adequately powered RCTs are warranted. © 2026 Journal of Research in Medical Sciences