Blue light therapy, known medically as phototherapy, is a non-invasive treatment for newborn jaundice. It provides a safe way to help a baby’s system manage a yellow pigment called bilirubin. This procedure is a standard of care that helps prevent complications from high bilirubin levels and supports the baby’s natural processes.
Understanding Newborn Jaundice
Jaundice is a common condition in newborns, causing a yellowing of their skin and the whites of their eyes. This yellow color comes from a substance called bilirubin, which is a natural byproduct of the body breaking down old red blood cells. In newborns, this process is amplified because they have a higher concentration of red blood cells, and these cells have a shorter lifespan compared to those in adults.
A newborn’s liver is still developing and may not process bilirubin efficiently. The enzyme that converts bilirubin into an excretable form is only about 1% as active in a newborn as in an adult. This immaturity can lead to a temporary buildup of bilirubin in the blood, resulting in jaundice. While this is a harmless process that resolves in a couple of weeks, high levels can be harmful if untreated.
Physiologic jaundice appears 24 hours after birth and peaks between 48 and 96 hours. Approximately 60% of full-term and 80% of preterm infants will develop some degree of jaundice in their first week. This makes it one of the most frequently encountered medical conditions for newborns.
The Science of Phototherapy
Phototherapy uses light to alter the structure of the bilirubin molecule. Specific wavelengths of blue light, around 460 nanometers, are absorbed by bilirubin in the baby’s skin. This light energy triggers photoisomerization, a process that changes the shape of the bilirubin molecule.
This structural change converts fat-soluble bilirubin into water-soluble isomers. These new forms can be eliminated from the body through urine and stool without being processed by the liver. This bypass allows the body to reduce high bilirubin levels more quickly.
The effectiveness of the therapy depends on several factors, including the light’s intensity, its distance from the infant, and the amount of skin exposed. Exposing as much of the baby’s skin as possible to the light ensures the maximum amount of bilirubin is converted and removed.
The Treatment Process
During phototherapy, a newborn is placed under special lights, wearing only a diaper and protective eye patches to maximize skin exposure. The baby lies in a bassinet or incubator, and the lights are positioned at a specific distance to ensure effectiveness and safety.
In some cases, a fiber-optic blanket or pad that emits light, known as a bili-blanket, may be placed underneath the baby. This method allows for treatment while the baby is being held or fed and is often used for milder cases of jaundice or in combination with overhead lights. Treatment is continuous, with breaks for feeding, diaper changes, and cuddling to promote maternal-infant bonding.
The duration of phototherapy can last for several days, depending on how quickly the baby’s bilirubin levels decrease. In some situations where jaundice is mild and the baby is otherwise healthy, phototherapy may be administered at home with specialized equipment and support from a home health nurse. Throughout the process, medical staff closely monitor the baby’s progress.
Safety and Monitoring During Treatment
Phototherapy is considered a safe treatment with generally mild side effects. The most important safety measure is the use of eye shields or patches to protect the baby’s sensitive retinas from the bright light. Healthcare providers also carefully monitor the infant’s temperature to prevent overheating.
Common side effects are often a sign the treatment is working. These can include loose, dark, or greenish stools, indicating bilirubin is being eliminated from the body. A temporary skin rash or bronze discoloration of the skin can also occur, but these effects resolve after treatment stops.
To prevent dehydration, which can be a risk due to increased fluid loss, regular and frequent feedings are encouraged. In some instances, fluids may be given intravenously to ensure proper hydration. Medical staff will regularly take blood samples to measure bilirubin levels and confirm that the treatment is effectively reducing them.