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144Spectrum Disorder (ASD) have altered gut micro-biota. The gut microbiota may control the central nervous system (CNS) by brain-gut axis13, 14).The gut-brain axis is a communication system that integrates neural, hormonal, and immunolog-ical signaling between the gut and brain15). Although the mechanism how the gut microbiota communi-cate with the brain is not yet known, but some studies found that infants treated with probiotics have a better neurological outcomes16-18).One of the popular probiotic strain, Bifidobacte-rium, can directly metabolize bilirubin which is related to the lower activity of β-GD. It is also found that Bifidobacterium can reduce the bilirubin level by increasing stool frequency, decreasing enterohepatic circulation, and lowering intes-tinal7, 19).In this study, we observed the effect of a probi-otic on lowering bilirubin levels through the first 5 days of life by using the transcutaneous bilirubin meter. The validity of this bilirubin meter has been established by a study in Mongolian neonates as a screening tool for neonatal jaundice in both term and late preterm infants10, 20).Study by Mutlu et al21). reported that mean total bilirubin levels on day 3, day 5 and day 10 were significantly lower in the probiotic group receiving Lactobacillus Rhamnosus GG. Based on those results, probiotic has effect on lowering bilirubin level and may reduce the risk of hyperbilirubin-emia. Also in study by Suganthi et al2)., it is found probiotics can lower the serum bilirubin levels significantly in neonates treated with Saccharo-myces boulardii. In this study, we recorded the bili-rubin level on day 1 until day 5 but there were no significant differences in bilirubin levels at day 1 until day 5 between probiotics and control groups. There were also no significant difference when comparing bilirubin level on day 5 with day 1 or day 5 with day 2.We preferred to investigate the effect of single strain preparations rather than combined prepara-tions to get the specific results of each strain. The effect of probiotic in this study may be differ from the above studies2, 9, 21), because we used a different strain of probiotics and there were no infants underwent phototherapy in this study. The effec-tivity of probiotics depends on optimal dose for viability, it means there should be enough or adequate numbers of probiotic strain surviving the barriers such as gastric acid, bile, and competing flora to have beneficial effects22, 23).In early postnatal period, intestinal flora in newborns are insufficient and infants will start accumulating intestinal microbiota until a stable state is reached. This accumulation process is influ-enced by environmental factors including nutrition, i.e. breastfeeding versus formula milk24). Nutrition has a major role and alters neonatal intestinal microbiome colonization patterns. Breast milk contains beneficial components, such as lactoferrin, or secretory IgA, which can stimulate the growth of Bifidobacterium species (spp.). Also, human milk contains live bacteria that might contribute to microbiome development in newborns25). Since breast milk contribute in microbiome development, it is assumed that newborns receiving breast milk have lower bilirubin levels. In this study, the differ-ences between the type of feeding is statistically insignificant so this factor won’t affecting the result of this study.Women who were overweight prior to becoming pregnant tended to have a different microbiota than normal weight and obese women26). Since microbiome are transmitted from mother to infants, pre-pregnancy BMI is reported to be associated with microbiota in early postnatal period. However, in this study we found no significant differences in maternal pre-pregnancy BMI of both groups.In this study, we found that probiotic supplemen-tation caused a significant difference (p = 0.031) in the daily weight gain of infants in probiotic groups. Studies on the use of probiotics (Bifidobacterium and Lactobacillus) suggest that there are associa-tion between administration of probiotics with the improved weight gain. This results showed that early modulation of the gut microbiome by giving probiotics supplement is likely to result in increased weight gain27). Not only in healthy term infants, Kitajima et al28). found that very low birthweight (VLBW) infants receiving probiotics also have a better weight gain, as a result of stabilization of the intestinal flora and accelerated feeding schedules. Studies found that probiotic administration to newborns is safe and have several benefits. Accord-ingly, administration of probiotics to premature infants also found to be safe and can decrease the risk of death, NEC, and sepsis28, 29). In this study, of