Neonatal jaundice is a common condition where the yellow pigment bilirubin builds up in the blood, causing the skin and eyes to take on a yellow hue. When bilirubin levels are elevated enough to require treatment, a bilirubin blanket, often called a BiliBlanket, offers a convenient, non-invasive method for home treatment. This portable device uses light therapy to help the baby process excess bilirubin without requiring an extended hospital stay. Home phototherapy allows for continued parental bonding and facilitates breastfeeding.
Understanding Neonatal Jaundice and Bilirubin
Bilirubin is a yellowish byproduct released when old red blood cells break down. In adults, the liver efficiently processes this substance for excretion. Newborns often have immature livers, making them temporarily unable to keep up with the volume of bilirubin produced. This inefficiency leads to the accumulation of unconjugated bilirubin in the blood, causing jaundice.
While jaundice is common, excessively high levels of unconjugated bilirubin pose a serious risk. This type of bilirubin is not water-soluble, meaning it can cross the blood-brain barrier and potentially damage the central nervous system. This severe condition, called kernicterus, is a rare form of brain damage that can lead to permanent neurological complications like cerebral palsy and hearing loss. Treating hyperbilirubinemia (high bilirubin levels) is necessary to prevent this outcome.
How Fiberoptic Phototherapy Works
Treatment for hyperbilirubinemia involves phototherapy, which uses light to change the structure of the bilirubin molecule. Fiberoptic devices, such as the bilirubin blanket, use a specific range of light wavelengths for this chemical conversion. The light emitted is typically in the blue-green spectrum, ranging from approximately 450 to 470 nanometers.
This light is absorbed by the bilirubin in the infant’s skin, converting the fat-soluble, unconjugated bilirubin into water-soluble photoisomers and a molecule called lumirubin. Unlike the original unconjugated form, these new water-soluble products can bypass the liver’s processing system. The infant can then excrete the transformed bilirubin through urine and stool. Since the light source is directly against the baby’s skin via a blanket or pad, parents can hold and feed their child during treatment.
The Process for Obtaining a Bilirubin Blanket
Obtaining a bilirubin blanket requires a prescription from a healthcare provider. The doctor must determine that the infant’s bilirubin levels meet the criteria for home phototherapy, typically between 10 and 15 mg/dL. Once necessity is established, the provider issues an order for the device.
The blanket is not purchased directly but is rented through a Durable Medical Equipment (DME) supplier. These suppliers specialize in providing medical equipment for home use and link the doctor and the family. Parents should contact their insurance provider immediately to verify coverage, as this equipment often falls under the DME benefit and may require pre-authorization.
When contacting the DME supplier, parents should provide the doctor’s prescription details, their insurance information, and the infant’s most recent blood work results. If the initial claim is denied, the DME supplier or the pediatrician’s office may need to submit an appeal. The blanket rental is generally for a short period, often five to seven days, and the supplier coordinates the delivery and setup at the family’s home.
Using the Phototherapy Device Safely at Home
Home phototherapy requires adherence to specific protocols to maximize treatment success. The primary rule is ensuring the infant’s skin has maximum exposure to the light source. This means the baby should only wear a diaper while lying on or wrapped in the fiberoptic pad.
Parents should aim for continuous use, interrupting treatment only briefly for diaper changes, feedings, or cuddles. Frequent feeding (approximately 8 to 12 times a day) is important, as adequate hydration and increased bowel movements help excrete the transformed bilirubin. The baby’s temperature must be checked regularly, typically every three to four hours, to ensure they do not become too warm or too cool.
While the fiberoptic light is contained within the pad, covering the baby’s eyes is recommended if they are not swaddled to ensure comfort. The infant will require several monitoring steps:
- Maintain a log of the phototherapy schedule and the infant’s feeding and elimination patterns.
- Undergo regular follow-up blood tests, often daily.
- Monitor the bilirubin level closely.
- Determine when the phototherapy treatment can be discontinued.