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Neonatal jaundice
Glycerin
Three articles were obtained and all were excluded as they examined glycerin suppositories or
enemas as prophylaxis for non-haemolytic hyperbilirubinaemia.
See the end of Section 7.4 for the overall Evidence summary and GDG translation from
evidence.
Charcoal
Two articles were obtained and were excluded: one was a non-randomised controlled study and
the other a historical control study. The controlled clinical trial was aborted when the charcoal
preparation used was recalled by the Food and Drug Administration following two reports of
raised serum nickel concentration in adults with erythropoietic rotoporphyria who were treated
with this preparation.
See the end of Section 7.4 for the overall Evidence summary and GDG translation from
evidence.
Pojark Manna
One article was obtained and included.
Description of included studies
This RCT from Iran 225 compared Pojark Manna combined with phototherapy with phototherapy
alone. Neither the method of randomisation nor the allocation concealment was reported. The
study was double-blind. Pojark Manna (’Shirkhest’) is derived from the cotoneaster tricolor
plant. It has a high sugar content and is used as a laxative. Babies randomised to Pojark Manna
received 6 g of Shirkhest, and control babies received a starch solution with caramel added so
as to appear identical to the Shirkhest solution. The mean serum bilirubin in the study was
401 ± 53 micromol/litre. No other demographic details were provided.
Review findings
Phototherapy was discontinued when serum bilirubin fell below 256.5 micromol/litre. The
mean duration of phototherapy was similar in the treatment and the control groups. [EL 1−]
See the end of Section 7.4 for the overall Evidence summary and GDG translation from
evidence.
Traditional Chinese medicine
Three articles were obtained: one was excluded as it was a prophylaxis study, and another as it
was an uncontrolled comparative study. A third study, from Hong Kong, 226 was an in vitro study
of the effects of Yin-chen (Artemisia scoparia) on bilirubin in pooled cord serum. Results
indicated that Yin-chen is effective in displacing bilirubin from circulating albumin, leading to
increased circulating unbound bilirubin.
See the end of Section 7.4 for the overall Evidence summary and GDG translation from
evidence.
Other interventions
Only case reports were identified for homeopathy and acupuncture.
Overall evidence summary for other treatments
The included RCTs were of varying quality. Important clinical outcomes such as the number of
exchange transfusions or possible adverse effects of the interventions were often not reported.
Meta-analysis suggests that a single dose of clofibrate (100 mg/kg body weight) led to
statistically significant reductions in mean serum bilirubin levels and duration of phototherapy
compared with phototherapy alone. However, although all the studies were of good quality,
they were all carried out in one country and may not be generalisable to the UK.
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