Phototherapy for jaundice (hyperbilirubinemia) in newborns

Phototherapy is the most common treatment for reducing high bilirubin levels that cause jaundice in a newborn.

In the standard form of phototherapy, the baby is placed in an enclosed plastic crib (incubator) and is exposed to a type of fluorescent light that is absorbed by the baby's skin. During this process, the bilirubin in the baby's body is changed into another form that can be more easily excreted in the stool and urine.

A baby with jaundice may need to stay under a phototherapy light for several days. Phototherapy usually does not damage a baby's skin.

During this type of phototherapy:

• The baby is undressed so that as much of the skin as possible is exposed to the light.
• An incubator with a heat control is used to maintain the correct body temperature.
• The baby's eyes are covered to protect the nerve layer at the back of the eye (retina) from the bright light.
• Feeding should continue on a regular schedule. There is no need to stop breast-feeding.
• The bilirubin level is measured at least once a day.

Potential problems that may occur during this standard form of phototherapy include:

• Burns similar to sunburn (from the intense light), skin rashes, and tanning.
• Damage to the nerve layer at the back of the eye (retina), if the eyes are not properly protected.
• Dehydration , if the infant does not receive adequate fluids when feeding.
• Difficulty in maintaining the proper body temperature.

Another type of phototherapy is a fiber-optic blanket or a band. These devices wrap around a baby and can be used at home. Although fiber-optic phototherapy has been shown to reduce bilirubin levels, it takes longer than conventional phototherapy done in a hospital setting. It can be a good alternative for babies with mild jaundice who are otherwise healthy.¹

If your baby is being treated at home for jaundice, it is important that you understand how to use all the equipment. Ask your health professional for help if you have questions or concerns. A home health nurse may visit to make sure all is going well. The amount of bilirubin in your baby's blood may need to be measured daily.

Citations

1. Mills JF, Tudehope D (2001). Fibreoptic phototherapy for neonatal jaundice. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.