Phototherapy for newborns with jaundice

In more than half of newborns on the second or third day of life, the skin acquires a yellow tint due to increased breakdown of fetal hemoglobin. In most cases, this condition is not dangerous and goes away without treatment, but sometimes babies are prescribed phototherapy.

So called treatment involving the use of special phototherapeutic lamps. They give ultraviolet wavelengths from 400 to 550 nm.

Light waves that affect the body during phototherapy transform bilirubin into a harmless water-soluble isomer, which is excreted with physiological functions within 12 hours. As a result the pigment concentration in the blood decreases, and its toxic effect on the child is prevented.

Phototherapy is prescribed to newborns in such situations:

• When developed physiological form of jaundice - with high rates of bilirubin and an hourly increase of more than 5 µmol / l in term babies and more than 4 µmol / l in babies born prematurely.
• If a during pregnancy, an increased risk of hyperbilirubinemia in the crumbs was revealed.
• When the baby was born morphofunctional immature.
• If the baby has extensive hematomas and hemorrhages.
• When available hemolytic risk anemia (its hereditary form).
• If a baby's blood type is incompatible with maternal, as well as in the case of rhesus conflict.
• During rehabilitation or preparation of the child for surgery.

The level of bilirubin at which phototherapy is administered to an infant with physiological jaundice depends on the weight of the baby:

Phototherapy is not performed if:

• The child has high bilirubin bound fractionwhich does not decrease.
• The baby found liver problems.
• Crumbs diagnosed obstructive jaundice.

1. The baby is completely stripped and placed in a crowez.
2. The crumbs of their eyes are closed with a tight bandage (most often from gauze).
3. In boys, the genitals are also covered with a tissue that does not transmit light.
4. The lamp should be located at a distance of approximately 50 cm from the body of the toddler.
5. The procedure lasts at least 2 hours. If the bilirubin level is too high, the infant must remain under the lamp for 96 hours at all times. Breaks are made only for feedings and they should not exceed 2-4 hours.
6. The position of the body of the crumbs periodically change, every hour putting the baby on the flank, then on the tummy, and then on the back.

Medical personnel should continuously monitor the crumbs during the procedure:

• Every two hours a baby is taken a temperature tracking the risk of overheating.
• To prevent dehydration and overheating, the baby should be getting more fluids (about 10-20% more than the norm per day).
• If the baby’s condition is critical, his blood is checked every 2-6 hours, determining the dynamics of reducing the level of bilirubin.

Phototherapy is terminated if:

• Child strongly overheated.
• On the skin of the baby appeared redness.
• The level of total bilirubin decreased and the level of the free fraction of this pigment does not increase.

After phototherapy procedures baby's skin color may become bronze. Also, often the skin dries out and begins to peel off. In addition to changes in the skin of an infant, there are also possible side effects of light treatment, such as increased drowsiness, increased stool and allergic rash. Treatment such manifestations of phototherapy side effects do not require and pass on their own after a few daysas soon as treatment is stopped.

Nowadays, a phototherapy lamp can be rented and used at home, coordinating all the features of the procedure with the doctor. In addition, more rapid reduction of bilirubin and the disappearance of the yellowness of the skin will be promoted by such measures like frequent breastfeeding, fresh air, sun and air baths.