About Phototherapy

Phototherapy is a treatment that involves shining ultraviolet light onto the skin. Most often it is used as a treatment for newborns with excessively high bilirubin levels, which is a condition that is common but can be frightening at first to new parents. Babies may have phototherapy in the hospital or at home. There are various ways phototherapy can be administered, but no matter what equipment is used, the baby receiving phototherapy must be monitored, eating well and well hydrated.

Reasons to Use Phototherapy

• The primary reason a newborn needs phototherapy is excessively high bilirubin levels or levels that get too high too fast. Any of these can be caused by infection, liver ailments, prematurity or metabolic disease. Almost all healthy babies develop jaundice in the first few days of life, but very few require phototheray.
  Bilirubin in present in bile in the body and has a dark yellow color. It is a by-product of the breakdown of old red blood cells. The immature liver of a newborn is less efficient at breaking down the bilirubin. This causes a build up of bilirubin, leading to the yellow color of the skin (jaundice). Phototherapy helps the baby to metabolize the excess bilirubin in her blood. According to WebMD, a study from Johns Hopkins University in 2002 showed that bilirubin is an antioxidant that protects babies' cells from damage.

The Process

• The most common place for an infant to receive phototherapy is in the hospital. If this is the case, she will be placed in an isolette (some refer to them as "incubators"), which looks like a large clear plastic box. It is a comfortable bed for the baby and the air inside is warmed. The baby will be undressed and wear eye patches to protect her eyes. In some cases, her diaper will be open to expose as much skin to the light as possible. If she is unable to breast- or bottle-feed, she will be given intravenous fluids to keep her hydrated. The more wet and soiled diapers she has, the quicker the bilirubin will be eliminated. You will still be able to take her out for short periods to hold and feed her. Often a phototherapy light will shine on her from above the isolette. For some infants, a second "bank" of lights is used in front of the clear bed.

Home Phototherapy

• Home phototherapy uses halogen lights and the lights are embedded in "blankets" that can wrap around your baby or in a special bed. In these cases the baby does not need eye patches, as the light does not shine in her eyes. Home phototherapy is not appropriate for every situation. Your pediatrician will help you decide if it is right for your baby.

Time Frame

• Blood tests will determine how long your baby will need phototherapy. Treatment lasts from one to several days depending on how fast the bilirubin levels stabilize.

Sunlight Misconception

• While sunlight is, by definition, the "photo" part of phototherapy, it is not appropriate as treatment for babies with elevated bilirubins. Exposure to the sun can result in a sunburn, and, for any type of light to be an effective therapy, babies must be naked or almost so while exposed to the light; most infants are not able to maintain a stable body temperature outdoors, especially if they are undressed. Clinical phototherapy in the hospital or at home is the only safe choice.