Serum Indirect Bilirubin Levels And Meconium Passage In Early Fed Normal Newborns

Boyer, Diane B.; Vidyasagar, Dharmapuri

doi:10.1097/00006199-198705000-00013

Cited by 6 publications

(5 citation statements)

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“…[3,12,[15][16][17][18] In one of the early observational studies, Rosta et al observed that a delay in meconium evacuation was correlated with the higher frequency of pathological jaundice (defined as serum bilirubin > 15 mg/dL) in 742 healthy neonates. [3] Further studies that attempted to increase the volume of meconium and frequency of meconium evacuation using various methods such as rectal stimulation, use of formula feeding observed lower bilirubin levels associated with higher fecal output [16,17,19] thereby pointing toward an association between meconium evacuation and serum bilirubin.…”

Section: Discussionmentioning

confidence: 99%

Effect of induction of meconium evacuation using per rectal laxatives on neonatal hyperbilirubinemia in term infants: A systematic review of randomized controlled trials

et al. 2011

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OBJECTIVE:To study the efficacy of early meconium evacuation using per rectal laxatives on the level of serum bilirubin and the need for phototherapy in healthy term infants. MATERIALS AND METHODS: Systematic review of randomized controlled trials comparing per rectal laxatives versus no intervention was conducted using English language articles identified from the Cochrane Central Register of Controlled Trials, Medline, Ovid, and CINAHL databases and bibliographies of selected articles. Eligible studies were assessed for the risk of bias in conduct and reporting. RESULTS: A total of three trials (n = 469) mostly with "unclear risk" were eligible for inclusion. Two trials used glycerin suppository whereas one used glycerin enema for meconium evacuation. Meta-analysis was not possible due to clinical heterogeneity in the choice of laxatives and frequency of intervention. In all the three studies, serum bilirubin levels at 48 h and the need for phototherapy was not significantly different between the two groups. Passage of first meconium and the transitional stools occurred significantly early in the intervention group compared to controls. CONCLUSION: Early evacuation of meconium using per rectal laxatives does not offer any significant clinical advantage for neonatal jaundice.

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Section: Discussionmentioning

confidence: 99%

Effect of induction of meconium evacuation using per rectal laxatives on neonatal hyperbilirubinemia in term infants: A systematic review of randomized controlled trials

et al. 2011

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“…5 This was supported by clinical observations that earlier meconium evacuation was indeed associated with lower bilirubin levels and decreased risk for clinically significant neonatal jaundice. [10][11][12][13][14][15] Several studies have evaluated the effect of stimulating early meconium evacuation on serum bilirubin levels. Cotrell et al 9 have shown that rectal stimulation not only enhanced early meconium evacuation, but also caused a mean reduction of 1 mg/dL in serum bilirubin levels.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 Previous studies have shown that early meconium evacuation was associated with lower bilirubin levels and decreased risk for clinically significant neonatal jaundice. [10][11][12][13][14][15] It thus seemed plausible that meconium evacuation facilitated with the use of glycerin suppositories might prevent the effect of increased enterohepatic recirculation on serum bilirubin, thus decreasing the risk of neonatal jaundice. However, to date, the data are inconclusive; some claim that it works, 16 whereas others show no effect.…”

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confidence: 99%

Induction of Early Meconium Evacuation: Is It Effective in Reducing the Level of Neonatal Hyperbilirubinemia?

et al. 2005

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This prospective randomized trial evaluated the effect of induction of early meconium evacuation on neonatal jaundice in healthy term neonates. The study group was given glycerin suppository immediately after birth and every 4 hours thereafter, until evacuation of first stool. Glycerin suppository caused faster meconium evacuation but had no effect on mean bilirubin levels at 48 hours. However, males had significantly lower mean bilirubin levels, especially if they also had type A blood group. Glycerin suppository cannot be routinely recommended as a means for reducing the severity of neonatal jaundice. Nonetheless, male newborn with type A blood group may benefit from such a therapy.

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“…The amo unt of toxic or potentially to xic biliru bin that is reabs orbe d fro m th e intes tina l tr act ca n be decreased by co nvers ion of unconjugated bilirubi n to a nonreab sorb abl e fo rm , (3,8,9) a nd by mo re rapid intes tinal tra nsit (3,(10)(11)(12). Poland and Ode ll documented th at t he enterohepatic ci rc ulation of bilirubi n is a major co ntribution to jaundice in the new bo rn (3).…”

mentioning

confidence: 99%

“…Poland and Ode ll documented th at t he enterohepatic ci rc ulation of bilirubi n is a major co ntribution to jaundice in the new bo rn (3). Early fee ding decreased enterohepatic shunting of bilirubin because of more ra pid passage of meconium (10)(11)(12) , which results in lower serum unconj ugated bilirubin (10,11). Glyceri ne supp ositories have been used to facilitate meconium evacuation and bilirubin exc ret ion.…”

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confidence: 99%

Rectal or Axillary Temperature Measurement

Cottrell,

Anderson

1984

J. pediatr. gastroenterol. nutr.

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Physiologic jaundice (5–6 mg/100 ml plasma bilirubin) is common and considered normal in newborn infants during the first week postbirth, but is considered abnormal in older infants. Early meconium passage correlates with lower plasma bilirubin concentrations. Rectal stimulation during rectal temperature measurement may aid passage of meconium containing potentially toxic, absorbable bilirubin. In this study, 100 clinically normal infants were assigned randomly to groups for rectal or axillary temperature measurement. The time of first meconium passage, time of first all‐yellow stool, and total plasma bilirubin were compared between groups. Bilirubin was measured during metabolic screening at 48–80 h postbirth (mean 69 h in both groups). By this time 30 infants in the rectal group, but only 17 in the axillary group, had passed yellow stools (p = 0.011). The rectal group had lower mean (±1 SD) bilirubin (5.5 mg/100 ml ± 2.7 vs. 6.5 ± 3.0, p = 0.042), and a trend toward earlier first meconium (5.9 h ± 5.0 vs. 7.3 ± 5.9, p = 0.096). For clinically normal infants in the first 48–80 h postbirth, these data suggest that rectal stimulation accompanying rectal temperature measurement enhances intestinal bilirubin excretion because of more rapid me conium passage.

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Serum Indirect Bilirubin Levels And Meconium Passage In Early Fed Normal Newborns

Cited by 6 publications

References 0 publications

Effect of induction of meconium evacuation using per rectal laxatives on neonatal hyperbilirubinemia in term infants: A systematic review of randomized controlled trials

Effect of induction of meconium evacuation using per rectal laxatives on neonatal hyperbilirubinemia in term infants: A systematic review of randomized controlled trials

Induction of Early Meconium Evacuation: Is It Effective in Reducing the Level of Neonatal Hyperbilirubinemia?

Rectal or Axillary Temperature Measurement

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