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2)Sakuradai Maternity Clinic, Tokyo, Japan1)Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanCorresponding author: Hiromichi ShojiDepartment of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, JapanTEL: +81-3-3813-3111　FAX: +81-3-5800-0216　E-mail: hshoji@juntendo.ac.jp〔Received　Nov. 4, 2021〕〔Accepted　Nov. 24, 2021〕J-STAGE Advance published date: Feb. 16, 2022Copyright © 2022 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ21-0044-OAObjective: the primary objective was to examine the effect of Bifidobacterium on decreasing the bilirubin level in term neonates delivered by Caesarean Section (CS).Materials and Methods: A total of 153 healthy term neonates delivered by CS were included in this study and were divided into the non-probiotic group (n=99) and probiotic group (n=54) based on the history of probiotics administration. There were no infants who underwent phototherapy. A total of 20 doses of probiotics were given orally from the first day of life. The transcutaneous bilirubin (TcB) levels were measured every day for the first 5 days of life. Data of each infant and mother were gathered from medical records.Results: The bilirubin level per day (day-1 to day-5) in the non-probiotic group was no different from the probiotic group. Differences in bilirubin level between day-5 and day-1, and also between day-5 and day-2 were not different between the two groups. There was a significant (p = 0.03) body weight gain in the probiotic groups with a mean of 36.09 ± 8.23 gram/day. No obvious adverse reactions were seen in both the non-probiotic group and probiotic group.Conclusions: Our findings suggest no significant effects of probiotics on lowering bilirubin levels in the first five days of life. Also, probiotics have a positive effect on body weight gain in healthy term infants, and it is safe to be given to newborns.Key words: caesarean section, hyperbilirubinemia, jaundice, probiotics, transcutaneous bilirubinometer Juntendo Medical Journal2022. 68(2), 140-146Original ArticlesRoles of Probiotics in Reduction of Neonatal Jaundice in Term NewbornsIntroductionApproximately 60% of term and 80% of prema-ture infants have elevated total serum/plasma bili-rubin (TSB) levels, which results in neonatal jaun-dice in the first week of life1). Jaundice is one of the most commonly encountered symptoms during the neonatal period and one of the leading causes of admissions in newborn nurseries throughout the world2). Jaundice in newborns occurs due to high levels of unconjugated bilirubin in the blood that causes by ABO/Rhesus incompatibility, G6PD defi-ciency, infections, prematurity, and metabolic disor-ders3). The etiology of neonatal hyperbilirubinemia is multifactorial, such as physiological factors, isoimmunization, and environmental factors. One of the environmental factors is the dysbiosis or lack of the microbiota in the guts is considered to be one of the pathogenic factors for neonatal jaundice4, 5).At birth, infant’s gut is considered sterile and the early development of intestinal microbiota in neonates born vaginally starts at birth due to the acquisition of organisms from the vaginal micro-biota, other maternal sources, and environmental sources. Therefore, newborns delivered by Caesarean Section (CS) have a bigger risk of dysbiosis and the primary gut flora may be disturbed for up to six months. Also, the intestinal microbial diversity is lower in the first two years of life in infants deliv-ered by CS6). Physiological jaundice is self-limiting and does not need treatment. However, in some cases, bili-Irena SANTOSA1), Hiromichi SHOJI1), Shigeru ITOH2), Toshiaki SHIMIZU1)140