Phototherapy a treatment for hyperbilirubinemia and jaundice in the newborn that involves the exposure of an infant’s bare skin to intense fluorescent light.

The blue range of light accelerates the excretion of bilirubin in the skin, decomposing it by photooxidation.

The infant is placed nude under the fluorescent lights with the eyes and genitalia covered. The baby is turned frequently, and the body temperature is monitored, using a skin thermistor. All vital signs are carefully noted, and details regarding position of the bulbs, time and duration of treatment, and the infant’s response are charted.

• Jaundice is yellow/green-yellow discoloration of the skin, mucous membranes, sclera and body fluids caused by increased levesl fo circulating bilirubin.
• It usually becomes noticeable at levels of 85mmol/L.
• About 60% of healthy babies become clinically jaundiced in the 1st week of life (i.e. more than half of babies)
• Sources of bilirubin
• 75% of bilirubin production heme from red cell breakdown.
• 25% of bilirubin production  early labeled haemoglobin
• Risk of serum bilirubin above 340 umol/L is more than twice as high in Asian babies compared to Caucasian infants
• Jaundice can be categorised into : physiological and pathological, unconjugated and conjugated
• It is very important to recognise the characteristics of pathological jaundice

PRECAUTIONS

Patients with eye problems should see an ophthalmologist regularly, both before and during phototherapy. Because some ultraviolet rays are emitted by the light boxes used in phototherapy, patients taking photosensitizing medications (medications making the skin more sensitive to light) and those who have sun-sensitive skin should consult with their physician before beginning treatment. Patients with medical conditions that make them sensitive to ultraviolet rays should also be seen by a physician before starting phototherapy. Patients who have a history of mood swings or mania should be monitored closely, since phototherapy may cause excessive mood elevation in some individuals.