What is Phototherapy?
Phototherapy is a treatment commonly used in pediatrics to manage neonatal jaundice. It involves exposing the baby's skin to special blue spectrum light, which helps to break down excess bilirubin in the blood. Neonatal jaundice is a common condition that occurs in newborns due to the immaturity of the liver, leading to an accumulation of bilirubin.
How Does Phototherapy Work?
The blue light used in phototherapy converts bilirubin into a more water-soluble form through a process called photo-oxidation. This form can then be easily excreted by the baby's body through urine and stool. Phototherapy lights typically emit wavelengths between 430-490 nm, which are most effective for breaking down bilirubin.
Types of Phototherapy Lights
There are several types of phototherapy lights used in pediatrics: Fluorescent Lamps: These are the most traditional form of phototherapy lights and are effective but can generate heat, requiring careful monitoring.
LED Phototherapy: LED lights are newer and more energy-efficient. They emit a narrow spectrum of light, making them highly effective at breaking down bilirubin without producing much heat.
Fiberoptic Phototherapy: This method uses a pad that contains fiberoptic cables to deliver light directly to the baby's skin. It is often used in conjunction with other forms of phototherapy for more severe cases.
When is Phototherapy Indicated?
Phototherapy is indicated when the levels of bilirubin in a newborn's blood are higher than what is considered safe. The decision to initiate phototherapy depends on the baby's age in hours, the level of bilirubin, and the presence of any risk factors such as prematurity or hemolytic disease. Pediatricians use a
bilirubin nomogram to determine when phototherapy is necessary.
What are the Benefits of Phototherapy?
Phototherapy is a non-invasive and effective method for reducing bilirubin levels. It significantly lowers the risk of
kernicterus, a form of brain damage that can occur if severe jaundice is left untreated. Moreover, it allows for treatment without the need for more invasive procedures like exchange transfusions.
Dehydration: Increased water loss through the skin can occur, so ensuring adequate hydration is important.
Temperature Instability: Especially with older fluorescent lights, there can be issues with maintaining the baby's body temperature.
Skin Rash: Some babies may develop a temporary rash during phototherapy.
Eye Damage: The baby's eyes must be protected during treatment to prevent damage from the intense light.
How Long Does Phototherapy Last?
The duration of phototherapy varies depending on the severity of jaundice and the baby's response to treatment. In many cases, treatment lasts between 1 to 2 days, but it can be longer if bilirubin levels are high or if the baby has underlying conditions that affect bilirubin metabolism.
Monitoring and Follow-Up
While undergoing phototherapy, the baby’s bilirubin levels are regularly monitored through blood tests. Pediatricians also keep an eye on the baby's hydration status, feeding patterns, and overall health. After phototherapy, follow-up visits are essential to ensure that bilirubin levels remain normal and to monitor for any late-onset complications.Conclusion
Phototherapy is a cornerstone in the management of neonatal jaundice in pediatrics. Its effectiveness and relative safety make it an invaluable tool for pediatricians. However, as with any medical treatment, careful monitoring and appropriate usage are key to optimizing outcomes and minimizing risks. 
