Effect of Zinc Oral Supplementation in Hyperbilirubinemia (ZOSH) on Serum Bilirubin Levels in Neonates Requiring Phototherapy: A Double-blind Randomized Controlled Trial

Neonatal hyperbilirubinemia is one of the common causes of neonatal morbidity. It manifests with the rise of unconjugated bilirubin levels in the neonatal blood, which results in yellowish staining of the skin and sclera. The major contributing factors are the breakdown of RBCs, immaturity of neonates’ liver, lack of intestinal flora, and enhanced enterohepatic circulation (EHC). EHC  contributes significantly to neonatal hyperbilirubinemia, and its blockage might be a therapeutic target for this condition. Zinc due to its bilirubin adsorbing properties has been studied in animal models to reduce EHC  and  serum zinc level in neonates is reported to be one of the factors affecting the severity and incidence of neonatal hyperbilirubinemia. Studies have shown that the use of zinc syrup in preterm infants with indirect hyperbilirubinemia significantly reduced bilirubin levels within 48 hours of treatment. However there are sporadic studies on the effect of zinc on the reduction of hyperbilirubinemia in pre-term neonates and much less in term neonates, therefore there is a need to research further the effects of zinc on hyperbilirubinemia in pre-term and term babies