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Phototherapy For Jaundice In Newborns

AMBULATORY CARE:

What you need to know about phototherapy:

Phototherapy is light treatment for newborn jaundice. Jaundice is yellowing of your newborn's eyes and skin. It is caused by too much bilirubin in the blood. Bilirubin is a yellow substance found in red blood cells. It is released when the body breaks down old red blood cells. Bilirubin usually leaves the body through bowel movements. Jaundice happens because your newborn's body breaks down cells correctly, but it cannot remove the bilirubin. The light used for phototherapy helps your newborn's body get rid of extra bilirubin. Phototherapy may be done at home. Your newborn may need phototherapy in the hospital if the jaundice is severe.

How to prepare your newborn for phototherapy:

Your newborn's healthcare provider will tell you how to prepare your newborn. Healthcare providers may need to take a sample of your newborn's blood to check his or her bilirubin levels. He or she will need to have blood drawn more than once.

What will happen during phototherapy done in the hospital:

  • One or more lights will be placed above your newborn. He or she will be undressed except for a diaper. He or she will be placed on his or her back to absorb the most light. He or she may also lie on a flexible light pad, or a healthcare provider may wrap him or her in the light pad. Eye covers will be used to protect his or her eyes from the light.
  • Comfort your newborn during treatment. Your newborn may be fussy or irritable during the treatment. Sing or talk softly to your newborn. Give him or her a gentle massage. Try offering a pacifier.
  • Your newborn may feed in his or her usual way during the phototherapy. He or she may need to be fed more often to help get rid of the bilirubin in his or her bowel movements. Healthcare providers may leave the lights on during feedings.
  • Healthcare providers need to know how much liquid your newborn is getting. This includes breast milk, formula, or IV liquid. Tell healthcare providers how much formula your newborn eats or how long he or she breastfeeds. They also need to know how much your newborn urinates and has bowel movements. Save any diapers you change so healthcare providers can weigh and measure them.
  • Healthcare providers will monitor your newborn closely. When your the bilirubin level is low enough, they will turn off the lights. They will do another blood test in 24 hours to check the bilirubin level. If the level stays low enough, your newborn's treatment will be finished.

How to give your newborn phototherapy at home:

The lights will be delivered to your home. You will be taught how to use them. A healthcare provider will do blood tests on your newborn at home to check his or her bilirubin levels. When the level is low enough, the phototherapy lights can be turned off. Another blood test will be done in 24 hours to check the bilirubin level. If the level stays low enough, your newborn's treatment will be finished. The lights will be removed from your home. Your newborn's pediatrician will tell you how many hours a day to do phototherapy. The following will help keep your newborn safe and warm during treatment:

  • Keep the room warm. The temperature in your newborn's room should be between 68°F and 75°F (20°C and 24°C). Close windows and doors to decrease drafts in the room. Make sure your newborn's bedding is dry. This will help him or her stay warm.
  • Turn on the phototherapy lights. They may come inside a case that can be propped open. They may come as a row of lights that your newborn lies under. They may come in a pad that he or she lies on.
  • Undress your newborn except for his or her diaper. Put an eye cover on your newborn's eyes. This will protect his or her eyes from the light.
  • Place your newborn under, or on, the lights as directed. Change your newborn's position every 1 to 2 hours. This exposes all areas of the skin to the lights. This will help the lights break down the bilirubin as quickly as possible. Ask about the best ways to position your newborn.
  • Comfort your newborn during treatment. Your newborn may be fussy or irritable during the treatment. Sing or talk softly to your newborn. Give him or her a gentle massage. Try offering a pacifier.
  • Take your newborn's temperature every 3 to 4 hours. Place the thermometer in your newborn's armpit while the phototherapy lights are on. His or her temperature should be between 97°F and 100°F (36.1°C and 37.8°C). If your newborn is too warm, remove the curtains or cover from around the light set. Decrease the room temperature. Check your newborn's temperature every 15 minutes until it decreases. If your newborn is too cold, wrap him or her in blankets and hold him or her close to you. Feed him or her warm breast milk or formula. Check your newborn's temperature every 15 minutes until it increases.
  • Your newborn should feed in his or her usual way during the phototherapy. He or she may need to feed more often. This will help get rid of the bilirubin through his or her urine and bowel movements. You may need to feed him or her with the phototherapy lights on.
  • Record feeding times and amounts. Record your newborn's temperature and how many wet or soiled diapers he or she has. Your newborn should have at least 6 wet diapers and 1 soiled diaper each day. The urine may be darker as the bilirubin leaves your newborn's body. His or her bowel movements may change from yellow to green.

Risks of phototherapy:

Your newborn could become too cold or too warm during the treatment. He or she may be irritable or tired, or spit up more. He or she may become dehydrated. He or she may get a skin burn or rash from the lights. Your newborn could have eye damage if his or her eyes are not protected by an eye mask.

Seek care immediately if:

  • Your newborn has a fever higher than 100.4°F (38°C) for more than 30 minutes.
  • You cannot raise your newborn's temperature above 96°F (35.6°C) after 30 minutes.
  • Your newborn has trouble feeding, or he or she will not feed at all.
  • Your newborn begins to vomit forcefully, or his or her vomit is yellow.
  • Your newborn is hard to wake up.

Contact your newborn's pediatrician if:

  • Your newborn's jaundice gets worse.
  • Your newborn's jaundice is not gone by the time he or she is 14 days old.
  • You think your newborn is not drinking enough breast milk, or he or she is losing weight.
  • Your newborn does not want to breastfeed or drink formula.
  • Your newborn has pale, chalky bowel movements.
  • You have questions or concerns about your newborn's condition or care.

Follow up with your newborn's pediatrician as directed:

Write down your questions so you remember to ask them during your newborn's visits.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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