Phototherapy for Jaundice

Phototherapy is a common treatment procedure used for curing a range of skin problems. This article discusses about this therapy as a remedy for fighting Jaundice in infants.

What Is Phototherapy?

Phototherapy, also known as light therapy is a useful treatment option for newborn Jaundice or neonatal Hyperbilirubinemia. It is generally not used for treating Jaundice in adults as it is only a temporary remedy and adult Jaundice usually results from some more serious underlying condition.

The term ‘phototherapy’ refers to the utilization of light, particularly ultraviolet (UV) light, for treating various medical conditions. In this treatment procedure, certain wavelengths of light are used to cure the symptoms of Jaundice.

Lasers, fluorescent lamps, light-emitting diodes, LED light, dichroic lamps and bright full-spectrum light are used in light therapy with the wavelengths of the lights controlled with specific devices. The therapy is administered for certain period of time and may even be performed at a particular time of day.

Types of Phototherapy

There are 2 different types of light therapy: UVA and UVB.

  • UVA Phototherapy: In this treatment, the light is usually administered along with a type of light sensitizing tablet named psoralen (PUVA therapy). In some cases, a light sensing lotion or cream containing psoralen is also used in certain skin areas such as the feet (topical PUVA). UVA is a part of UV spectrum which is associated with pigmentation.
  • UVB Phototherapy: This is the second type of this treatment and it uses the sun-burning part of UV spectrum. The “narrowband” UVB light therapy is performed using light of only one wavelength.

How does Phototherapy Work?

The ultraviolet light used in the procedure helps to reduce the symptoms of Jaundice. However, it is not capable of curing the condition permanently as it is not only a skin disorder. PUVA treatment is more potent compared to the UVB treatment. Due to this reason, it is used for patients who cannot be treated using UVB.

It uses fluorescent lights, also referred to as bili lights, for reducing the bilirubin levels in the blood of an infant. The light source used in the process emits specific light wavelengths that break down the bilirubin so that it can be eliminated from the body.

The mechanism of action of light therapy generally varies depending on the disorder being treated. It may also involve various other factors such as an alteration in the immune system of the skin, removal of the abnormal cells and reduction in inflammation. Some normal cells may also suffer mild damage during the process. Hence, there is a risk of various long term (like skin cancer) and short term (like burns) side effects.

Phototherapy Procedure

It can be performed at home under expert guidance or at the doctor’s chamber. For carrying out the therapy at home, the necessary equipments need to be set up properly in a suitable position by an expert. The step by step procedure of light therapy is mentioned below:

  • Step 1: Removing all clothes apart from the diapers is the first step of the therapy.
  • Step 2: Then, the eyes of the infant should be covered with medically approved soft eye shields or patches for protection of the eyes from bright lights.
  • Step 3: Once the baby is ready for the treatment, he or she should be placed on a stable flat surface. The light box should be placed properly near the baby but it is important to keep it far enough so that it does not touch or disturb the child in any way.
  • Step 4: The infant should be covered with a fiber optic pad or bili blanket, keeping its lighted section against the skin. The adhesive strips under the blanket should be used for securing the blanket in its proper position. It is important to keep it tight enough so that no more than one finger can fit between the baby’s skin and the blanket.
  • Step 5: The next step is to plug in the light box and turning it on. The light box should be placed according to the doctor’s instruction.
  • Step 6: Regular monitoring of the baby under treatment is important. But one should not interrupt the therapy unless bathing, diaper change or feeding is necessary. It is necessary to check the baby for any signs of skin problems and infections every 2 hours. The temperature of the infant should also be recorded every 4 hours.
  • Step 7: The therapy should continued for as long as prescribed by the physician. In most cases, the treatment is continued until the symptoms of jaundice subside. Regular check up by the doctor is also necessary to make sure that the light therapy is working properly.
  • Step 8:  It is important to accurately record the infant’s body temperature, skin changes, feeding times, amount of food intake as well as the number of diapers required every day.
  • Step 9: Regular blood tests are performed for determining the amount of bilirubin in the baby’s blood. The blood sample is generally collected from the heel of the infant. The blood test results help to determine if the treatment is complete by showing when the blood bilirubin levels become normal.

Phototherapy Side Effects

It can lead to certain side effects in some babies. It is advisable to stop the treatment if the infant shows symptoms such as skin rash and frequent, loose and greenish bowel movements. Dehydration is another potential side effect which can worsen the Jaundice in a patient. Feeding the baby frequently helps to reduce the risk of dehydration.

Unstable body temperature is another possible symptom as the baby may become cold because of lying naked for extended period of time if the room is very cold. The infant may also become overheated if placed under the light box for longer than necessary.

Phototherapy Contraindication

Light therapy cannot be used for treating infants suffering from congenital porphyria or having a family history of porphyria. Otherwise, it is a safe treatment option.

Phototherapy vs. Sunlight

Mild cases of neonatal Jaundice can be treated by controlled exposure to sunlight. However, sunlight cannot be used for treating more severe symptoms of the disorder as there are certain limitations of this treatment option including the following:

  1. Any type of light therapy for jaundice requires the baby to be completely naked apart from only a diaper. But, the immature body organs and systems of newborn babies may be unable to keep them warm enough during treatment, causing them to fall ill.
  2. The sensitive skin of neonates increases the risk of sunburn and other skin problems. It is never advisable to place newborns under direct sunlight.

Due to the above mentioned problems, phototherapy is widely preferred over the use of sunlight to treat Jaundice in infants.

Phototherapy Duration

The duration of this treatment generally varies from one baby to another depending on the length of time the condition is present. The number of light therapy sessions required for the baby to achieve complete recovery is determined by the doctor. In most cases, the treatment continues for several days.

Phototherapy is commonly used for treating the symptoms of Jaundice in newborn babies. However, the care-giver should check for any adverse reaction of the therapy in the infant. It is important to contact the doctor as soon as possible in case of any side effects.

References:

http://www.wisegeek.com/what-is-phototherapy-for-jaundice.htm

http://www.livestrong.com/article/155726-photo-light-therapy-for-jaundice/

http://www.bad.org.uk/site/1223/default.aspx

http://www.drugs.com/cg/phototherapy-for-jaundice-in-newborns-inpatient-care.html

http://www.med.umich.edu/1libr/pa/umphototherapy.htm

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