Effect of intravenous fluid supplementation on drop in serum bilirubin levels in term babies with severe hyperbilirubinemia

Priyanka Tank, Rakesh Tank, Abhishek Singh


Background: Varied results emerging out of various studies have created a controversy about effect of intravenous fluid supplementation on drop in Serum Bilirubin levels in term babies with severe hyperbilirubinemia. Paucity of literature also warrants this study. The objective of this study is to evaluate the probable effect, if any, of intravenous fluid supplementation in decreasing the serum bilirubin level in healthy term babies with hyperbilirubinemia from Northern India.

Methods: In this prospective study healthy term neonates (37-41 weeks gestation) with serum bilirubin (>18 mg/dl and <25 mg/dl) for treatment with phototherapy were randomly allocated to two groups, study group received intravenous fluid for total 16 hours along with breast feed and control group given only breast feeds.

Results: Baseline variables like sex distribution, age at admission, gestation, birth weight, admission weight, number of babies, appropriate for gestational age, mode of delivery, oxytocin use, incidence of breast feeding and serum bilirubin level at the time of inclusion in study, were comparable in both control and study group. Drop of total serum Bilirubin (TSB) at 4 hours, 8 hours, 24 hours, 36 hours and 48 hours of study were also significantly higher in study group as compared to control group. Although the drop in TSB level at 60 hours between two groups was not significantly different.

Conclusions: Based on our findings it can be concluded that additional intravenous fluid supplementation significantly reduced the serum bilirubin in study group as compared to control group.


Fluid supplementation, Hyperbilirubinemia, Total serum bilirubin

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Mittal P, Tank P, Agarwal Y, Tank R, Singh A, Goyal V. Neonatal Hyperbilirubinemia: an experience of 212 cases from a tertiary care setup. Saudi J Med Pharm Sci. 2017;3(4):278-81.

Dennery PA, Seidman DS, Stevenson DK. Neonatal hyperbilirubinemia. N Engl J Med. 2001;344:581-90.

Tan KL. Phototherapy for neonatal jaundice. Clin Perinatal. 1991;18(3):423-39.

Halamek LP, Stevenson DK. Neonatal jaundice and liver disease. In: Fanaroff AA, Martin RJ, editors. Neonatal-perinatal medicine: disease of the fetus and infant. Sant Louis: Mosby; 2002:1309-50.

Wananukul S, Praisuwanna P. Transepidermal water loss during conventional phototherapy in nonhemolytic hyperbilirubinemia term infants. J Med Assoc Thai. 2001;84(1):46-50.

De Carvalho M, Hall M, Harvey D. Effect of water supplementation on physiological jaundice in breast fed babies. Arch Dis Child. 1981;56:568-9.

Gazzin S, Tiribelli CJ. Bilirubin induced neurological damage. J Matern fetal Neonatal Med. 2011;24(1):154-5.

HYPERBILIRUBINEMIA SO. Practice Parameter: Management. Pediatr. 1994;94(4):558-62.

Boo NY, Lee HT. Randomized controlled trial of oral versus intravenous fluid supplementation on serum bilirubin level during phototherapy of term infants with sever hyperbilirubinemia. J Pediatr Child Health. 2002;38(2):151-5.

AAP Subcommittee on Neonatal Hyperbilirubinemia. Neonatal jaundice and kernicterus. Pediatr. 2001;108:763-5.

Iranpour RR, Nohekhan R, Haghshenas I. Effect of intravenous fluid supplementation on serum bilirubin level in jaundiced healthy neonates during conventional phototherapy. J Res Med Sci. 2004;4:186-90.

Demisroy U, Nalbantoglu B, Nalbantoglu A. Effect of fluid supplementation on serum bilirubin level during phototherapy of exclusively breastfed term infants with Hyperbilirubinemia. Breast feed Med. 2011:1-5.

Maisels MJ, Kring E. Rebound in serum bilirubin level following intensive phototherapy. Arch Pediatr Adolescent Med. 2002;156(7):669-72.

Saeidi R, Heydarian F, Fakehi V. Role of intravenous extra fluid therapy in icteric neonates receiving phototherapy. Saudi Med J. 2009;30(9):1176-9.

Mehta S, Kumar P, Narang A. Fluid supplementation in term neonates with severe Hyperbilirubinemia. J Pediatr. 2005;147:781-5.