Double phototherapy is an intensified light therapy for newborn jaundice, used when a baby’s bilirubin levels are high or rising quickly. This treatment uses two light sources to increase the body surface area exposed to the therapeutic light. The goal is to lower bilirubin concentrations in the blood more rapidly than single phototherapy.
The Purpose of Double Phototherapy
Newborn jaundice occurs when a baby has a high level of bilirubin in the blood. Bilirubin is a yellow substance the body creates during the normal process of breaking down old red blood cells. A newborn’s liver is still immature and may not be able to remove bilirubin from the blood quickly enough, causing a yellowing of the skin and eyes.
While most jaundice is mild, high bilirubin levels can be harmful. Double phototherapy delivers a higher intensity of light, known as spectral irradiance, to a larger portion of the baby’s skin. This increased exposure accelerates the breakdown of bilirubin into a form that can be easily excreted from the body.
The decision to use this intensified treatment is based on medical guidelines that consider the baby’s age in hours, gestation, and measured bilirubin level. The primary purpose is to prevent bilirubin from reaching harmful levels by lowering them efficiently.
The Treatment Process
During double phototherapy, the infant is placed in a bassinet or incubator, undressed except for a diaper to maximize skin exposure. The treatment uses two separate light sources simultaneously. This involves an overhead unit with fluorescent or LED lights and a second source, like a fiber-optic blanket or pad, placed underneath them.
The baby wears soft eye shields to protect their eyes from the bright, blue-green wavelength light. This light energy penetrates the skin and converts bilirubin into a water-soluble form through a process called photoisomerization. This change allows the byproducts to be eliminated through urine and stool, and the infant remains under the lights continuously, with short breaks for feeding and care.
Monitoring and Potential Side Effects
The infant is closely monitored by the medical team. Nurses check the baby’s temperature to prevent overheating and watch their hydration status, as the treatment can increase water loss through the skin.
Consistent feeding every two to three hours helps keep the baby hydrated and promotes the excretion of bilirubin. Loose, frequent stools are a common side effect and a positive sign that the treatment is working. Other potential side effects include temporary skin rashes or bronze skin discoloration, which resolve after treatment ends.
To track progress, periodic blood samples are taken from a small heel prick to measure bilirubin levels. This monitoring determines when the levels have returned to a safe range.
Treatment Duration and Effectiveness
Double phototherapy is an effective intervention, with treatment lasting from one to three days. The duration depends on how quickly the infant’s bilirubin levels decrease to a safe threshold.
Treatment is discontinued once blood tests confirm bilirubin has fallen to an acceptable level. Medical professionals will continue to monitor the baby’s levels after phototherapy ends to ensure they do not rebound. The rapid reduction associated with this method often shortens the overall treatment time compared to single-light therapy.