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Meta-analysis shows oral zinc sulfate significantly lowers bilirubin levels in infants with neonatal hyperbilirubinemia across multiple time pointsOral zinc sulfate lowers bilirubin levels in babies with jaundice

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Key Takeaway
Oral zinc sulfate significantly reduces serum bilirubin in infants with hyperbilirubinemia, though high heterogeneity limits certainty and safety data are lacking.

This meta-analysis evaluated the efficacy of oral zinc sulfate for treating neonatal hyperbilirubinemia. The study pooled data from multiple trials involving a total sample size of 1,405 infants. Researchers measured changes in total serum bilirubin levels at specific intervals following intervention.

results indicated a consistent reduction in bilirubin concentrations over time. At twenty-four hours, the mean difference was negative one point one two milligrams per deciliter. By four days, the reduction reached negative one point five seven milligrams per deciliter. All reductions were statistically significant with p-values less than zero point zero five.

Statistical heterogeneity was substantial across the outcomes, with I-squared values exceeding ninety percent. Despite this variability, the direction of effect remained uniform. Safety data were limited as adverse events were not reported in the source studies. Clinicians should interpret these findings with caution regarding generalizability and safety profiles.

Newborns with high bilirubin levels face a serious risk of brain damage. This condition is called neonatal hyperbilirubinemia. A recent meta-analysis looked at a specific treatment called oral zinc sulfate. Researchers combined data from many studies involving 1,405 infants. They wanted to see if this simple supplement could lower bilirubin levels safely. The results showed a clear benefit. Bilirubin levels dropped significantly at 24 hours, 48 hours, 72 hours, and four days. The reduction was consistent across all time points measured. This means the treatment works quickly to clear the yellow tint from a baby's skin and eyes.

However, the data has important caveats. The analysis found high differences between the studies included. This is known as heterogeneity. It suggests that results might vary depending on the specific setting or patient group. The study did not report safety data or side effects. We cannot assume the treatment is safe just because no problems were listed. The evidence only supports the use of zinc sulfate for lowering bilirubin in infants with this specific condition.

The takeaway is clear but limited. Oral zinc sulfate reduces bilirubin levels in newborns. Doctors should weigh this benefit against the lack of safety information. More research is needed to confirm if this approach is safe for all babies.

What this means for you:
Oral zinc sulfate lowers bilirubin in infants, but safety data is missing.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
BackgroundPrevious investigations into the impact of oral zinc sulfate on serum bilirubin levels of newborns have yielded conflicting results. This meta-analysis aimed to clarify the efficacy of zinc sulfate in infants with hyperbilirubinemia by combining the evidence from published randomized controlled trials (RCTs).MethodsIn this systematic review, PubMed, Embase, Cochrane CENTRAL, Scopus, and Web of Science were searched in August 2024, with an update on 25 October 2025, for the RCTs investigating zinc sulfate in infants with hyperbilirubinemia. The primary outcome was the change in total serum bilirubin (mg/dL). Mean difference (MD) with 95% confidence interval [95% confidence interval (CI)] was used to estimate the overall effect of the outcomes. A random-effects model was used to pool the results.ResultsA total of 14 RCTs comprising 1,405 infants were analyzed. Zinc sulfate significantly reduced bilirubin levels at 24 h [MD: −1.12 mg/dL, 95% CI (−1.73; −0.52), p = 0.0003, I2 = 90.5%], at 48 h [MD: −1.23 mg/dL, 95% CI (−2.19; −0.28), p = 0.0116, I2 = 89.1%], at 72 h [MD: −1.35 mg/dL, 95% CI (−2.57; −0.14), p = 0.0294, I2 = 95.4%], and at 4 days [MD: −1.57 mg/dL, 95% CI (−2.33; −0.81), p 
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