Light therapy for neonatal jaundice

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor II Cao Thi Thanh - Pediatrician - Department of Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital.
Phototherapy is considered one of the most effective, easy and economical treatment for neonatal jaundice. However, the treatment effectiveness of this method also depends a lot on: Intensity - wavelength of light emitted by the lamp, the distance from the jaundice lamp to the newborn, how to choose the right projector for jaundice. fit...

1. Learn about hyperbilirubinemia in newborns

Jaundice in newborns is a phenomenon that occurs when high levels of bilirubin in the blood seep into the skin and tissues, causing jaundice and yellowing of the mucous membranes. Physiological jaundice occurs in almost all newborns and appears around the second day after birth.
For the phenomenon of physiological jaundice, children usually have no symptoms that affect their health, but only urinate or pass yellow stools about 2-3 times/day. This phenomenon will last about 10-15 days after giving birth and will go away on its own without any treatment.
If jaundice is more severe, does not go away for a long time, about 1-2 weeks, there are accompanying symptoms such as anemia, hepatosplenomegaly, stop feeding, sleeping a lot, and bilirubin index of jaundice in newborns. If increased and increased rapidly, it will become a phenomenon of pathological jaundice, especially for premature babies, babies who are not breastfed, formula milk, children with blood group incompatibility with their mothers, infections...
Yellow Pathological skin needs to be treated as soon as possible otherwise it will leave dangerous sequelae, one of which is neurotoxic syndrome.

2. Technical process of neonatal jaundice light

Cases of jaundice in newborns with indications for phototherapy must meet the following criteria:
Jaundice appears within 24 hours of birth. Jaundice with excessive indirect hyperbilirubinemia without signs of pre-toxicity or neurotoxicity. Phototherapy is aimed at preventing jaundice in the case of premature babies, babies born with severe skin trauma and bleeding, children with hemangiomas, etc. are children with congenital uremia or children with jaundice with direct elevation of bilirubin.
The technical process of neonatal jaundice light includes the following steps:
Prepare and notify the baby's family. Examination - evaluate all the organs of the infant. Assess the degree of jaundice in the child. Ensure aseptic, warm and airy hygiene when conducting the light method. Cover the child's eyes with a dark cloth. Use a diaper to cover the child's genitals to limit testicular atrophy, affecting the reproductive function later. Expose the baby's entire body to ensure the maximum amount of light gets into the child's body. Provide enough water for the baby before lighting, preferably breast milk. Place the baby in the incubator in the center of the light. Turn on the light switch and adjust the projector's temperature to suit the baby's body temperature. Change the child's position every 2-4 hours. Check blood Bilirubin levels continuously every 12-24 hours to decide the time of phototherapy for jaundiced children. In addition to the above-mentioned technical procedures for neonatal jaundice, in order to achieve the most effective treatment results, the person performing the method of neonatal jaundice should also note the following issues: :
About yellow lamp projector : Need to choose a yellow lamp projector with blue or white light, preferably blue light, followed by green light and at least white light but effective value will be lower.
The light selected to illuminate the treatment of neonatal jaundice must be light with a wavelength of 400-480 nm because when these rays are emitted, the energy it emits will pass through the skin, to the fat layers lying on the skin. Subcutaneously converts bilirubin molecules indirectly into isomer molecules or photooxidation products that are not harmful to the brain of the child, soluble in water, so they will be eliminated through the liver and kidneys.
About the distance to project jaundice for newborns: In order to effectively treat jaundice with increased indirect bilirubin in newborns, it is necessary to place the projector with the jaundice lamp so that the distance from the lamp to the child is within about 30-50 cm.
About how to shine a yellow light for babies: Use a blue light to shine on the baby's completely exposed skin, cover only the eyes and genitals so that the child's body is most exposed to blue light . Turn the child's body about every 2-4 hours to increase the body's exposure to the light emitted by the lamp. Shine lights continuously, or at intervals. Use 1-way or 2-way lights (in the case of children with severe jaundice and gradually increasing jaundice)
Light exposure time for jaundiced children : Light exposure time for jaundiced children depends on their jaundice status. children as well as indirect and total bilirubin levels when doing blood tests. When the jaundice decreases and the Bilirubin level returns to normal, the indication for irradiation can be stopped. When irradiation is not effective and Bilirubin levels continue to rise, immediately consider the method of changing blood for the child.
If the child has abnormalities in daily activities such as sucking less, sleeping a lot, jaundice... the parents need to take the child to the nearest medical center to be examined and detected jaundice with increased Bilirubin. Indirect. From there, neonatal jaundice light therapy can be applied right at the standard hospital with the highest efficiency.

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Reference source: Portal of the Department of Maternal and Child Health - Ministry of Health
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Jaundice in newborns Differentiating physiological and pathological neonatal jaundice What to do when newborns Prolonged jaundice?