الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The thesis is aiming at demonstrating the efficacy of agar in decreasing serum bilirubin and what is the appropriate dose in case of physiologic jaundice in healthy full term breast fed neonates. Through a randomized clinical trial a total of 100 full term healthy exclusively breast fed neonates presenting with non-hemolytic jaundice during first week of life., aged ≥ 48 hours, weighed ≥ 2.5kg with total serum bilirubin approaching the phototherapy zone according to standard curve (figure1) were enrolled. Premature neonates and formula fed neonates or mixed feeds, neonates with evidence of hemolysis,with conjugated bilirubin >2 mg/dl, factors exaggerating jaundice (congenital anomalies, sepsis, respiratory distress, enclosed hemorrhage, polycythemia, genetic disorders, congenital hypothyroidism) were excluded from the study. Parental consent was obtained before the study and the neonates included in the study were randomly assigned to one of two groups. group I, all mothers of neonates in this group were encouraged to continue breast feeding and enhance more feeding. group II, all mothers of neonates in this group were encouraged to continue breast feeding and enhance more feeding. In addition, infants received Spanish agar (2 gm. / sachet). Infants of group II were randomized into: group II a Receiving 1000 mg Spanish agar in four divided doses by mouth before feeding for up to 3 days group II b receiving 1500 mg Spanish agar in four divided doses by mouth before feeding for up to 3days. In our study we found that: Mean percent decline of TSB was statistically significantly more in group II agar compared to no treatment group .Mean percent decline of TSB was statistically non-significant when comparing dose1000mg group to 1500mg group.Median number of stool was statistically higher in high dose followed by low agar dose group and lower in breast fed control group. indicating that oral agar has a mild laxative effect. There was no statistically significance difference between mean body weights at the end of the study in group I and II, indicating that oral agar for 3 days using either doses has no effect on weight and deficient breast milk is not contributing to jaundice .No complications were observed due to administration of oral agar. In the treated infants. No diarrhea, bulky stools or signs of intestinal obstruction were noted in the agar-fed infants.Conclusion: Administration of oral agar decrease serum bilirubin in healthy full term breast fed non hemolytic neonates approaching phototherapy level without adverse effects using a dose of 1000 mg or 1500 mg, a dose of 1000 mg can be more reasonable to use thus avoiding over dosing of agar, As long as agar helps to lower serum bilirubin in early life, it is proposed to prevent jaundice from reaching phototherapy level with consequent hospitalization with its impact of parents anxiety and interference with exclusive breast feeding.