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Phototherapy for Jaundice

by Dr. Pamela Bandelaria, pediatrician

Yellowing of the skin, or jaundice, is a common occurrence in newborns. Some newborns are more susceptible to jaundice, but it doesn’t necessarily mean something wrong with them and is a phenomenon that occurs in 10% of babies. It is known as physiologic jaundice. Note that a yellowish color that persists for more than two weeks of life must be evaluated. These do not follow the normal pattern of physiologic jaundice and the yellowish color of the skin may be due to an underlying disease. Furthermore, if the yellowish color reaches the soles of the baby’s feet, it may indicate a dangerous bilirubin level (around 20mg/dL or higher). Extremely high bilirubin levels can cause seizures and brain dysfunction, an effect called kernicterus.

This article will address the concerns associated with jaundice and how to treat this condition. 

Why does my baby have Jaundice?

The baby’s yellow skin occurs due to a phenomenon called hyperbilirubinemia, where Bilirubin builds up in the body. Bilirubin is a yellow pigment that comes from the destruction of red blood cells. Under normal circumstances, Bilirubin is excreted through the bile and into urine and stool.

It is important to note that jaundice is more often than not self-limiting, meaning it can resolve on its own. However, certain treatments can help to speed up the breakdown of Bilirubin and hasten the removal of its excess in the body.  

What can be done if your baby becomes jaundiced?

Phototherapy, or "light therapy," is a treatment doctors prescribe if your newborn appears jaundiced.  Phototherapy involves using light, whether sunlight or a similar form of light, to remove accumulated Bilirubin in the body.

How does phototherapy decrease the yellowish color of your baby's skin?

Light energy is used to change the form of Bilirubin so that it can be excreted in the urine and stool. Bilirubin absorbs the light and undergoes structural changes, converting it into a non-toxic, water-soluble form. Blue light within the spectrum of 460-490nm works best for this purpose.  It is also possible to reduce jaundice easily and cost-effectively at home.

Can I perform light therapy on my baby at home?

By simply exposing your baby to sunlight (preferably filtered with tinting films), you can decrease the body's Bilirubin levels. Sunlight exposure is not only a source of vitamin D for your baby but can also be used to treat mild jaundice. Not only is it simple, but it is cost-effective as well.

How do doctors perform light therapy at the hospital?

In the hospital, machines that emit light within these blue wavelengths are used to decrease jaundice for babies in the hospital. These are placed over the baby and are turned on for a few hours a day, and sometimes continuously for babies with very high levels of Bilirubin. However, if your baby is placed under these machines, the eyes and genitals should be covered and protected because of the risk of UV exposure. 

Jaundice is usually not a cause for concern, and can often successfully be treated at home by exposing them to sunlight.  However, there are certain instances when a yellow color warrants a doctor’s evaluation. .

+ References

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  • Grossweiner, Leonard I.; Grossweiner, James B.; Gerald Rogers, B. H. (2005). "Phototherapy of Neonatal Jaundice" (PDF). The Science of Phototherapy: An Introduction. pp. 329–335. doi:10.1007/1-4020-2885-7_13. ISBN 978-1-4020-2883-0.

  • Slusher TM, Vreman HJ, Olusanya BO, Wong RJ, Brearley AM, Vaucher YE, Stevenson DK. Safety and efficacy of filtered sunlight in treatment of jaundice in African neonates. Pediatrics. 2014 Jun;133(6):e1568-74. doi: 10.1542/peds.2013-3500. PMID: 24864170; PMCID: PMC4531268.

  • Slusher TM, Day LT, Ogundele T, Woolfield N, Owa JA. Filtered sunlight, solar powered phototherapy and other strategies for managing neonatal jaundice in low-resource settings. Early Hum Dev. 2017 Nov;114:11-15. doi: 10.1016/j.earlhumdev.2017.09.008. Epub 2017 Sep 15. Erratum in: Early Hum Dev. 2019 Jan;128:121. PMID: 28919246.

  • Stokowski, L. (2011). Fundamentals of phototherapy for neonatal jaundice. Advances in Neonatal Care. 11 (5S): S10-S21. https://nursing.ceconnection.com/ovidfiles/00149525-201110001-00003.pdf