Jaundice is a common condition in newborns, characterized by the yellowing of the skin and the whites of the eyes. This occurs when there is a high level of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells, in the baby’s blood. While jaundice can often resolve on its own, some cases require medical intervention. Phototherapy is a widely used and effective treatment for neonatal jaundice. This article will explore why phototherapy is used for jaundice, how it works, and what parents need to know about this treatment.
Understanding Jaundice in Newborns
1. What Is Jaundice?
Jaundice in newborns, also known as neonatal jaundice, is a condition where a baby’s skin and the whites of their eyes appear yellow. This yellowing is due to an excess of bilirubin in the blood. Bilirubin is a byproduct of the breakdown of red blood cells, which is a normal process. However, newborns have a higher turnover of red blood cells and their livers are not yet fully developed to efficiently process bilirubin, leading to its accumulation in the body.
2. Types of Jaundice
There are several types of jaundice that can affect newborns:
Physiological Jaundice: This is the most common type, occurring in most newborns. It usually appears 2 to 3 days after birth and resolves within 1 to 2 weeks.
Breastfeeding Jaundice: This type occurs in breastfed babies due to inadequate intake of breast milk, leading to dehydration and reduced bilirubin excretion.
Breast Milk Jaundice: This type appears after the first week of life and can last for several weeks. It is thought to be due to substances in the breast milk that inhibit the breakdown of bilirubin.
Pathological Jaundice: This is less common and occurs when there is an underlying condition causing the jaundice, such as blood group incompatibility, infection, or a liver disorder.
3. Causes of Jaundice
The primary cause of jaundice in newborns is the immaturity of the liver, which is not yet efficient at processing and excreting bilirubin. Other factors that can contribute to jaundice include:
Prematurity: Premature babies are more likely to develop jaundice because their livers are even less mature than those of full-term babies.
Blood Group Incompatibility: If the mother and baby have different blood types, the baby’s red blood cells may be destroyed faster, leading to increased bilirubin levels.
Bruising During Birth: Bruising during delivery can increase the breakdown of red blood cells, leading to higher bilirubin levels.
What Is Phototherapy?
1. Definition of Phototherapy
Phototherapy is a medical treatment that uses light to reduce bilirubin levels in the blood. It is the most common treatment for neonatal jaundice and is highly effective in preventing the complications associated with high bilirubin levels, such as kernicterus, a type of brain damage.
2. How Phototherapy Works
Phototherapy works by exposing the baby’s skin to a specific type of light. The light transforms the bilirubin in the baby’s skin into a form that can be more easily excreted by the liver and kidneys. This process is called photo-oxidation, and it helps to lower the bilirubin levels in the baby’s blood more quickly than the body can on its own.
Blue Light: The most effective light for phototherapy is in the blue spectrum (wavelengths between 460-490 nm). This light penetrates the skin and converts the bilirubin into a water-soluble form that can be excreted in the urine and stool.
Intensive Phototherapy: In some cases, intensive phototherapy, which involves using multiple light sources or increasing the intensity of the light, may be required to reduce bilirubin levels more quickly.
3. Types of Phototherapy
There are different types of phototherapy, depending on the equipment used and the method of application:
Conventional Phototherapy: This involves placing the baby under fluorescent lights in an incubator or a special phototherapy unit. The baby’s eyes are usually covered to protect them from the light.
Fiberoptic Phototherapy: Also known as a biliblanket, this type of phototherapy involves wrapping a fiberoptic pad around the baby. The light is transmitted through the fibers, allowing the baby to be treated while being held or fed.
Combination Phototherapy: Sometimes, a combination of conventional and fiberoptic phototherapy is used for more effective treatment.
Why Is Phototherapy Used for Jaundice?
1. Preventing Complications of High Bilirubin Levels
The primary reason phototherapy is used for jaundice is to prevent the serious complications that can arise from very high levels of bilirubin. If untreated, high bilirubin levels can lead to:
Acute Bilirubin Encephalopathy: This is a condition where high levels of bilirubin enter the brain, causing neurological damage. Symptoms include lethargy, poor feeding, and a high-pitched cry.
Kernicterus: If acute bilirubin encephalopathy is not treated, it can progress to kernicterus, a form of permanent brain damage that can cause hearing loss, cerebral palsy, and intellectual disabilities.
2. Reducing the Need for Blood Transfusions
In cases of severe jaundice, where bilirubin levels are extremely high, a blood exchange transfusion may be necessary to quickly lower the bilirubin levels. Phototherapy helps reduce the need for such invasive procedures by effectively lowering bilirubin levels before they reach critical levels.
3. Non-Invasive and Safe Treatment
Phototherapy is a non-invasive and safe treatment with few side effects, making it an ideal first-line treatment for jaundice. The most common side effects are mild and include:
Dehydration: Phototherapy can increase the baby’s fluid loss through the skin, so it’s important to ensure adequate hydration.
Temperature Regulation: Babies under phototherapy may have difficulty regulating their body temperature, so careful monitoring is required.
4. Shortening the Duration of Jaundice
By accelerating the breakdown and excretion of bilirubin, phototherapy helps shorten the duration of jaundice. This allows the baby to recover more quickly and reduces the time spent in the hospital.
5. Convenience for Parents
Fiberoptic phototherapy, such as the biliblanket, allows parents to continue caring for and bonding with their baby during treatment. This convenience can help reduce the stress and anxiety associated with having a newborn with jaundice.
What to Expect During Phototherapy
1. Preparation for Phototherapy
Before starting phototherapy, the baby will be placed in a warm environment, such as an incubator, to ensure they remain comfortable and maintain their body temperature. The baby’s eyes will be covered with soft pads or goggles to protect them from the bright light.
2. Monitoring During Phototherapy
Throughout the phototherapy treatment, the baby’s bilirubin levels will be regularly monitored through blood tests. Healthcare providers will also monitor the baby’s temperature, hydration status, and overall well-being to ensure they are responding well to the treatment.
3. Duration of Phototherapy
The duration of phototherapy can vary depending on the severity of the jaundice and how quickly the bilirubin levels decrease. In most cases, phototherapy is continued for 1 to 2 days, but it can last longer if needed. The treatment is usually stopped once bilirubin levels drop to a safe range.
4. After Phototherapy
After phototherapy is completed, the baby’s bilirubin levels will be monitored to ensure they do not rise again. In most cases, the jaundice resolves completely, and no further treatment is needed.
When Is Phototherapy Not Enough?
1. Severe Cases Requiring Blood Transfusion
In some severe cases, phototherapy may not be sufficient to lower bilirubin levels quickly enough. When bilirubin levels are dangerously high, a blood exchange transfusion may be necessary. This procedure involves removing a portion of the baby’s blood and replacing it with donor blood to rapidly reduce bilirubin levels.
2. Underlying Conditions
If jaundice is caused by an underlying condition, such as a liver disorder, infection, or blood group incompatibility, additional treatments may be required alongside phototherapy. Treating the underlying cause is essential for resolving the jaundice and preventing further complications.
See also: Understanding Phototherapy: What Light is Used for Jaundice
Conclusion
Phototherapy is a crucial treatment for managing neonatal jaundice, a common condition in newborns. By using light to break down excess bilirubin, phototherapy helps prevent the complications associated with high bilirubin levels, such as brain damage. This non-invasive and safe treatment is effective in reducing the need for more invasive procedures, shortening the duration of jaundice, and allowing for a quick recovery. Parents can take comfort in knowing that phototherapy is a well-established and reliable treatment that ensures the health and safety of their newborn during this critical stage. If you have concerns about your baby’s jaundice or the need for phototherapy, it is always advisable to consult with your healthcare provider for guidance and support.
