Phototherapy is a common treatment for newborns with jaundice, a condition characterized by high levels of bilirubin in the blood. This article explores the duration of phototherapy treatment for newborns, its effectiveness, and what parents can expect during the process. Understanding the timeline and care involved in phototherapy can help parents navigate this treatment with confidence.
Understanding Jaundice in Newborns
What is Jaundice?
Jaundice is a condition where a newborn’s skin and eyes appear yellow due to high bilirubin levels. Bilirubin is a yellow pigment produced during the normal breakdown of red blood cells. Normally, the liver processes bilirubin, but a newborn’s immature liver may not handle it efficiently, leading to jaundice.
Causes of Newborn Jaundice
Several factors contribute to newborn jaundice:
Physiological Jaundice: This is the most common type and usually appears two to three days after birth. It occurs as the newborn’s liver matures and begins to process bilirubin effectively.
Breastfeeding Jaundice: Inadequate breastfeeding can lead to dehydration and reduced bilirubin elimination.
Breast Milk Jaundice: Certain substances in breast milk can interfere with bilirubin processing.
Hemolytic Jaundice: Blood type incompatibility between the mother and baby can cause excessive red blood cell breakdown.
Symptoms of Newborn Jaundice
The primary symptom of jaundice is a yellowish tint to the skin and eyes. Other symptoms may include:
Poor feeding
Lethargy
Dark urine
Pale stools
Diagnosing Jaundice in Newborns
Physical Examination
A pediatrician can often diagnose jaundice through a physical examination. The yellowing of the skin and eyes is usually evident. The doctor may press a finger against the baby’s skin to check for yellowing.
Bilirubin Levels
To confirm the diagnosis and determine the severity, a blood test measures the bilirubin levels. This test helps guide the treatment plan.
When is Phototherapy Needed?
Criteria for Phototherapy
Phototherapy is recommended based on the bilirubin levels and the age of the newborn. The American Academy of Pediatrics provides guidelines for initiating phototherapy. Generally, phototherapy is considered when:
Bilirubin levels are above 15 mg/dL in infants younger than 48 hours.
Bilirubin levels are above 18 mg/dL in infants 48 to 72 hours old.
Bilirubin levels are above 20 mg/dL in infants older than 72 hours.
Types of Phototherapy
Conventional Phototherapy
Conventional phototherapy uses fluorescent or LED lights placed above the baby in a bassinet or incubator. The baby is undressed, with only the eyes covered for protection. The light helps break down bilirubin into a form that can be excreted.
Fiberoptic Phototherapy
Fiberoptic phototherapy involves a blanket or pad containing fiberoptic cables. The baby lies on the blanket, which emits light directly onto the skin. This method allows more mobility and comfort for the baby.
Intensive Phototherapy
Intensive phototherapy uses higher light intensities or multiple light sources to accelerate bilirubin breakdown. This approach is used for severe jaundice or when conventional phototherapy is insufficient.
Duration of Phototherapy
Initial Treatment Duration
The duration of phototherapy varies based on the bilirubin levels and the baby’s response to treatment. Initially, phototherapy is typically administered for 24 to 48 hours. During this time, the baby is monitored closely to assess bilirubin levels and overall health.
SEE ALSO: What Is Phototherapy Used for in Newborns?
Monitoring Bilirubin Levels
Regular Blood Tests
During phototherapy, blood tests are conducted every 6 to 12 hours to monitor bilirubin levels. These tests help determine the effectiveness of the treatment and guide adjustments.
Transcutaneous Bilirubinometry
A non-invasive device called a transcutaneous bilirubinometer can also be used to measure bilirubin levels through the skin. This method is less stressful for the baby and provides quick results.
Factors Influencing Treatment Duration
Severity of Jaundice
The severity of jaundice significantly influences the treatment duration. Babies with higher bilirubin levels or those who develop jaundice early may require longer phototherapy sessions.
Baby’s Age
Younger infants, especially those born prematurely, may need longer treatment due to their immature liver function and higher risk of severe jaundice.
Response to Treatment
Babies respond differently to phototherapy. Some may show rapid bilirubin reduction within 24 hours, while others may require prolonged treatment to achieve safe levels.
Frequency and Intensity of Phototherapy
Intensive phototherapy or the use of multiple light sources can shorten the treatment duration by accelerating bilirubin breakdown. Conventional phototherapy may take longer for the same effect.
Parental Involvement and Care During Phototherapy
Feeding and Hydration
Breastfeeding and Formula Feeding
Feeding is crucial during phototherapy. Breastfeeding should be continued, as it provides essential nutrients and helps eliminate bilirubin through stool. If breastfeeding is insufficient, formula feeding may be supplemented.
Maintaining Hydration
Proper hydration supports bilirubin excretion. Frequent feeding ensures that the baby stays hydrated and aids in the elimination of bilirubin.
Skin Care and Eye Protection
Eye Patches
To protect the baby’s eyes from the intense light, eye patches are used. These should be checked regularly to ensure they are secure and not causing discomfort.
Skin Monitoring
The baby’s skin should be monitored for signs of dryness or irritation. Keeping the skin clean and moisturized is important, especially in fiberoptic phototherapy where the baby lies on a blanket.
Emotional Support for Parents
Understanding the Treatment Process
Educating parents about phototherapy, its purpose, and the expected duration helps alleviate anxiety. Clear communication with healthcare providers is essential.
Coping with Stress
The experience of having a newborn undergo phototherapy can be stressful. Support from family, friends, and healthcare professionals can help parents cope during this period.
Post-Phototherapy Care
Monitoring for Recurrence
Follow-Up Appointments
After phototherapy, follow-up appointments are necessary to monitor bilirubin levels and ensure jaundice does not recur. Regular check-ups help catch any potential issues early.
Home Care Instructions
Parents should be given clear instructions on feeding, hydration, and signs of jaundice to watch for at home. Knowing when to seek medical attention is crucial.
Preventing Jaundice Recurrence
Adequate Feeding
Ensuring the baby feeds well is key to preventing jaundice recurrence. Breastfeeding support and guidance can be beneficial.
Sunlight Exposure
Moderate sunlight exposure can help maintain bilirubin levels. However, direct sunlight should be avoided due to the baby’s delicate skin.
Conclusion
Phototherapy is a safe and effective treatment for newborn jaundice. The duration of phototherapy varies based on the severity of jaundice, the baby’s age, and response to treatment. Typically, it ranges from 24 to 48 hours, but some cases may require longer sessions. Close monitoring, proper care, and parental support are essential during this period. Understanding the treatment process and knowing what to expect can help parents navigate phototherapy with confidence and ensure the best outcomes for their newborn.
