Phototherapy is a common treatment for newborn jaundice. Jaundice occurs when there is a high level of bilirubin in a baby’s blood. Bilirubin is a yellow pigment produced during the normal breakdown of red blood cells. High levels of bilirubin cause the baby’s skin and whites of the eyes to look yellow. This condition is known as hyperbilirubinemia.
Newborn jaundice is quite common, especially in premature babies. Phototherapy uses light to break down bilirubin in the baby’s skin. This helps to lower bilirubin levels and prevent serious complications. Phototherapy can be done in the hospital or at home with a special phototherapy blanket or bed.
How Phototherapy Works
Phototherapy works by converting bilirubin into a form that can be more easily excreted by the baby’s body. The baby is placed under a special light, often a blue light, which helps to break down the bilirubin. The light penetrates the skin and alters the structure of bilirubin molecules. This process, called photo-oxidation, makes the bilirubin water-soluble, so it can be excreted in the baby’s urine and stool.
The baby may be placed in a phototherapy unit, which looks like a small bed with lights overhead. The baby can be naked except for a diaper to maximize exposure to the light. In some cases, a biliblanket or fiber optic blanket may be used, which the baby can lie on or be wrapped in.
Concerns About Eye Safety
One of the main concerns with phototherapy is the potential effect on the baby’s eyes. The lights used in phototherapy are very bright and can cause eye damage if the eyes are not properly protected. The eyes are very sensitive to light, and excessive exposure can lead to conditions such as retinopathy, cataracts, or other vision problems.
To protect the baby’s eyes, special eye shields or patches are used during phototherapy sessions. These shields are designed to block the light and protect the delicate tissues of the eyes. The baby’s eyes are covered throughout the treatment, and the shields are only removed when the baby is taken out of the phototherapy unit for feeding or other care.
Research on Phototherapy and Eye Safety
Several studies have been conducted to evaluate the safety of phototherapy for newborns, particularly regarding eye health. Research has shown that when proper eye protection is used, phototherapy is safe for newborns’ eyes. The eye shields effectively block harmful light rays and prevent damage to the retina and other parts of the eye.
One study published in the journal “Pediatrics” found no evidence of long-term eye damage in infants who received phototherapy with appropriate eye protection. The study followed infants who underwent phototherapy and assessed their eye health over several years. The results showed no increase in eye problems compared to infants who did not receive phototherapy.
Another study published in the “Journal of Perinatology” concluded that phototherapy, when administered with proper eye protection, does not increase the risk of developing eye conditions such as retinopathy of prematurity. This condition is a common concern for premature infants and can lead to vision loss if not managed properly.
SEE ALSO: What Is Phototherapy Used for in Newborns?
Guidelines for Safe Phototherapy
To ensure the safety of newborns’ eyes during phototherapy, healthcare providers follow strict guidelines. These guidelines include:
Using proper eye protection:
Eye shields or patches specifically designed for phototherapy should be used to cover the baby’s eyes. These shields should fit snugly and block out all light.
Regular monitoring:
Healthcare providers should regularly check the baby’s eyes and skin to ensure there are no adverse effects from the phototherapy. This includes checking the fit of the eye shields and making sure they are not causing any irritation or discomfort.
Limiting exposure time:
Phototherapy sessions should be carefully monitored to avoid excessive exposure. The duration and frequency of phototherapy should be based on the baby’s bilirubin levels and overall health.
Parental education:
Parents should be educated about the importance of eye protection during phototherapy and how to properly use the eye shields. They should also be informed about signs of potential eye problems to watch for.
Alternative Treatments and Considerations
While phototherapy is highly effective in treating newborn jaundice, there are alternative treatments available for cases where phototherapy may not be suitable or effective. These alternatives include:
Exchange transfusion:
In severe cases of jaundice, an exchange transfusion may be necessary. This involves removing the baby’s blood and replacing it with donor blood to quickly lower bilirubin levels.
Intravenous immunoglobulin (IVIG):
For babies with jaundice caused by blood group incompatibility, IVIG can help reduce bilirubin levels by decreasing the breakdown of red blood cells.
Hydration and feeding:
Ensuring the baby is well-hydrated and fed can help lower bilirubin levels. Frequent feeding helps to promote regular bowel movements, which aids in the excretion of bilirubin.
Home phototherapy:
In some cases, home phototherapy may be an option. This allows the baby to receive treatment in a more comfortable and familiar environment. Parents should receive thorough training on how to use the equipment and ensure the baby’s safety.
Potential Risks and Side Effects
Although phototherapy is generally safe, there are some potential risks and side effects to be aware of. These include:
Dehydration:
Phototherapy can increase water loss through the skin, leading to dehydration. It is important to ensure the baby is well-hydrated during treatment.
Temperature regulation:
The baby’s body temperature should be closely monitored, as phototherapy can cause fluctuations. Overheating or cooling can be a concern.
Skin rashes:
Some babies may develop a mild skin rash or bronze discoloration during phototherapy. These usually resolve after treatment is completed.
Electrolyte imbalances:
Prolonged phototherapy can affect electrolyte levels in the baby’s body. Regular blood tests may be needed to monitor and manage any imbalances.
Long-Term Outcomes
The long-term outcomes for babies who receive phototherapy are generally positive. When administered properly, with appropriate eye protection and monitoring, phototherapy effectively treats jaundice without causing lasting harm. Most babies recover fully and do not experience any long-term effects from the treatment.
Parents can be reassured that phototherapy is a well-established and safe treatment for newborn jaundice. Healthcare providers are trained to administer phototherapy safely and to monitor for any potential side effects. The benefits of reducing high bilirubin levels and preventing serious complications far outweigh the risks when proper precautions are taken.
Conclusion
Phototherapy is a crucial treatment for newborn jaundice, helping to reduce high bilirubin levels and prevent serious complications. While there are concerns about the safety of newborns’ eyes during phototherapy, research has shown that with proper eye protection, phototherapy is safe and does not cause long-term eye damage. Healthcare providers follow strict guidelines to ensure the safety and well-being of infants undergoing phototherapy. Parents should feel confident in the effectiveness and safety of this treatment, knowing that their baby’s health is being carefully monitored and managed.
