Authors

1 PhD, MD, Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran.

2 Associate professor, Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

3 PhD of Health Science, Non-Communicable Pediatric Disease Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran.

4 Associated professor, Non-Communicable Pediatric Disease Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran.

Abstract

Background: Herbal remedies have been implicated as adjunctive therapies in the treatment of neonatal jaundice over the years. The aim of this review was to investigate the therapeutic effects of herbal medicines on neonatal jaundice.
Methods: In this systematic review, a search process was performed in online databases of Scopus, Medline, Web of Science and Cochrane Library based on PRISMA guidelines. Components for searching were “neonatal jaundice” and “herbal medicine”. Relevant articles in English published between January 1900 and October 2020 were extracted. The quality of the articles was assessed by the CONSORT checklist.
Results: Finally, according to the inclusion criteria, 9 studies with a total of 1323 neonates were selected.  The herbal remedies used by the researchers for treatment of neonatal jaundice included Bilineaster drop, alhagi pseudoalhagi, and zizyphus jujuba were used in 8 of the 9 studies. In 5 of these 8 studies the Bilineaster (Purgative manna extract) had significantly reduced serum bilirubin levels of the infants.
Conclusion: Based on the results, the herbal remedies (especially bilineaster) are probability effective as adjuvant therapies along with standard therapies in the treatment of neonatal jaundice. These can reduce the bilirubin level – hospitalization days and re-hospitalization.

Keywords

  1. Martin RJ, Fanaroff AA, Walsh MC. Neonatal-perinatal medicine: diseases of the fetus and infant: Elsevier/Mosby St Louis; 2011.
  2. Weng Y-H, Chiu Y-W, Cheng S-W. Breast milk jaundice and maternal diet with Chinese herbal medicines. Evidence-based complementary and alternative medicine: eCAM. 2012; 2012.
  3. Dennery PA, Seidman DS, Stevenson DK. Neonatal hyperbilirubinemia. New England Journal of Medicine. 2001; 344(8):581-90.
  4. Chou S-C, Palmer RH, Ezhuthachan S, Newman C, Pradell-Boyd B, Maisels MJ, et al. Management of hyperbilirubinemia in newborns: measuring performance by using a benchmarking model. Pediatrics. 2003; 112(6):1264-73.
  5. Mukherjee D, Coffey M, Maisels M, editors. How many babies in the NICU receive phototherapy and for how long? ACTA PAEDIATRICA; 2017: WILEY 111 RIVER ST, HOBOKEN 07030-5774, NJ USA.
  6. Fakhri M, Farhadi R, Mousavinasab SN, Yosefi SS, Hosseinimehr SJ, Azadbakht M. Effect of natural products on jaundice in Iranian neonates. Jundishapur J Nat Pharm Prod, online ahead of print. 2019; 14:e83042.
  7. Mreihil K, Benth JŠ, Stensvold HJ, Nakstad B, Hansen TWR, Group NNPS, et al. Phototherapy is commonly used for neonatal jaundice but greater control is needed to avoid toxicity in the most vulnerable infants. Acta Paediatrica. 2018; 107(4):611-9.
  8. Kianmehr M, Moslem A, Moghadam KB, Naghavi M, Noghabi SP, Moghadam MB. The effect of massage on serum bilirubin levels in term neonates with hyperbilirubinemia undergoing phototherapy. Nautilus. 2014; 128:36-41.
  9. Rahani T, Boskabadi H, Sadeghi T, Boskabadi M, Gharaei R, Pasban F. Comparison of the effect of cotoneaster manna drop ( Bilineaster ) and massage on bilirubin in neonates under phototherapy. Journal of Babol University of Medical Sciences. 2017; 19(11):21-7.
  10. Chu L, Xue X, Qiao J. Efficacy of Intermittent Phototherapy versus Continuous Phototherapy for Treatment of Neonatal Hyperbilirubinemia: A Systematic Review and Meta‐analysis. Journal of Advanced Nursing. 2020.
  11. Wolf MF, Childers J, Gray KD, Chivily C, Glenn M, Jones L, et al. Exchange transfusion safety and outcomes in neonatal hyperbilirubinemia. Journal of Perinatology. 2020:1-7.
  12. Duan L, Gan S, Hu H. A single-center experience on exchange transfusion therapy in 123 full-term cases of severe neonatal hyperbilirubinemia in Wuhan. The Journal of Maternal-Fetal & Neonatal Medicine. 2020:1-7.
  13. Stevenson DK, Wong RJ, editors. Metalloporphyrins in the management of neonatal hyperbilirubinemia. Seminars in Fetal and Neonatal Medicine; 2010: Elsevier.
  14. Zahedpasha Y, Ahmadpour-Kacho M, Hajiahmadi M, Naderi S, Kamali AA. Efficacy of clofibrate on severe neonatal jaundice associated with glucose-6-phosphate dehydrogenase deficiency (a randomized clinical trial). Southeast Asian journal of tropical medicine and public health. 2008; 39(3):557.
  15. Badeli HR, Sharafi R, Sajedi SA. The effect of clofibrate on neonatal hyperbilirubinemia in uncomplicated jaundice. 2008.
  16. Gharehbaghi MM, Sani AM, Refeey M. Evaluating the effects of different doses of ursodeoxycholic acid on neonatal jaundice. The Turkish journal of pediatrics. 2020; 62(3):424-30.
  17. Abdellatif M, Vuong NL, Tawfik GM, Elfaituri MK, Mansour MIM, Zaki MMM, et al. Massage therapy for the treatment of neonatal jaundice: A systematic review and network meta-analysis. Journal of Neonatal Nursing. 2020; 26(1):17-24.
  18. Yu Z, Han S, Guo X, Gao C, Ji C. Chinese herbal medicines for the treatment of neonatal jaundice. Cochrane Database of Systematic Reviews. 2020; 2020(6).
  19. Wu R-h, Feng S, Han M, Caldwell P, Liu S-g, Zhang J, et al. Yinzhihuang oral liquid combined with phototherapy for neonatal jaundice: a systematic review and meta-analysis of randomized clinical trials. BMC complementary and alternative medicine. 2018; 18(1):228.
  20. Karakukcu C, Ustdal M, Ozturk A, Baskol G, Saraymen R. Assessment of DNA damage and plasma catalase activity in healthy term hyperbilirubinemia infants receiving phototherapy. Mutation Research/Genetic Toxicology and Environmental Mutagenesis. 2009; 680(1-2):12-6.
  21. Wickremasinghe AC, Kuzniewicz MW, Grimes BA, McCulloch CE, Newman TB. Neonatal phototherapy and infantile cancer. Pediatrics. 2016; 137(6).
  22. Newman TB, Wu YW, Kuzniewicz MW, Grimes BA, McCulloch CE. Childhood seizures after phototherapy. Pediatrics. 2018; 142(4).
  23. Maimburg RD, Olsen J, Sun Y. Neonatal hyperbilirubinemia and the risk of febrile seizures and childhood epilepsy. Epilepsy Research. 2016; 124:67-72.
  24. Fallah R, Ali Fallahzadeh M, Noori-Shadkam M. Evaluation of safety and efficacy of purgative manna (billinaster drop) and glycerin suppository in icterus of healthy term newborns. Current drug safety. 2014; 9(1):29-33.
  25. Ameli Z, Assarroudi A, Akrami R. Effect of Bilineaster drop on neonatal hyperbilirubinemia. Evidence Based Care. 2017; 6(4):66-73.
  26. Badgujar SB, Patil MB. Ethnomedicines for jaundice used in tribal areas of North Maharashtra. Indian Journal of Natural Products and Resources. 2008; 7(1):79-81.
  27. Yeung C, Leung C, Chen Y. An old traditional herbal remedy for neonatal jaundice with a newly identified risk. Journal of paediatrics and child health. 1993; 29(4):292-4.
  28. Fok TF. Neonatal jaundice—traditional Chinese medicine approach. Journal of Perinatology. 2001; 21(1):S98-S100.
  29. Yin J, Wennberg RP, Miller M. Induction of hepatic bilirubin and drug metabolizing enzymes by individual herbs present in the traditional Chinese medicine, yin zhi huang. Developmental pharmacology and therapeutics. 1993; 20:186-94.
  30. Fakhri M, Farhadi R, Mousavinasab N, Hosseinimehr SJ, Yousefi SS, Davoodi A, et al. Preventive effect of purgative manna on neonatal jaundice: A double blind randomized controlled clinical trial. Journal of ethnopharmacology. 2019; 236:240-9.
  31. Ameli Z, Assarroudi A, Akrami R. Effect of Bilineaster drop on neonatal hyperbilirubinemia. Evidence Based Care Journal. 2017; 6(4):66-73.
  32. Mohammadi B, Daliri A, Sadeghi H, Mohammadi J. Comparison of the Effect of Purgative Manna and Alhagi Pseudalhagi Usage on Healing Icterus of Infants. Journal of Clinical Care and Skills. 2019; 1(2):89-93.
  33. Zeng J, Wang SJ, Li YM, Li HS, Luo Q, Huang YY, et al. Yinzhihuang oral liquid in the treatment of neonatal jaundice: a meta-analysis. Pharmaceutical Biology. 2017; 55(1):554-9.
  34. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Journal of clinical epidemiology. 2009; 62(10):e1-e34.
  35. http://www.consort-statement.org/consort-2010.
  36. Mahyar A, Mehrpisheh S, Khajeh B, Ayazi P, Oveisi S, Mahyar S, et al. The Effect of Purgative Manna and Clofibrate on Neonatal Unconjugated Hyperbilirubinemia. Acta Medica Iranica. 2019.
  37. Monsef A, Eghbalian F, Rahimi N. Comparison of purgative manna drop and phototherapy with phototherapy treatment of neonatal jaundice: A randomized double-blind clinical trial. Osong public health and research perspectives. 2019; 10(3):152.
  38. Rafieian-Kopaei M, Khoshdel A, Kheiri S, Shemian R. Cotoneaster: A safe and easy way to reduce neonatal jaundice. Journal of clinical and diagnostic research: JCDR. 2016; 10(4):SC01.
  39. Ebrahimimd S, Ashkani-Esfahani S, Poormahmudibs A. Investigating the efficacy of Zizyphus jujuba on neonatal jaundice. Iranian Journal of Pediatrics. 2011; 21(3):320.
  40. Nassirian H, Eslami ST. Effects of cichorium intybus on bilirubin. Indian J Pediatr. 2008; 75(4):331-3.