Jaundice is a build-up of yellow pigment, called bilirubin, in the blood. Normally, the liver processes red blood cells to remove bilirubin. When it builds up, it causes skin and the whites of the eyes to appear yellow. In adults, the underlying cause (such as cirrhosis) must be treated. Newborns, by contrast, have an immature liver that causes jaundice, but resolves itself in about two weeks. Light therapy helps to break down the excess bilirubin and bring the baby's colour back to normal.
Traditional Phototherapy (Light Therapy)
If your baby is treated at the hospital, he will be placed by a nurse in an incubator that has attached to the top of it a set of special fluorescent white or blue lights, called bililights. The lights emit a limited range of ultraviolet light waves that is safe for the newborn's skin.
If you are allowed to take your baby home to do the phototherapy, the device you use will look like a partially open suitcase, with the lights on the upper part and a place for the baby to lie on the lower part. Place the device inside the baby's crib or on top of a sturdy table. Line the bottom of the bed with a receiving blanket, and lay him in it, but do not cover him. Your baby should be unclothed except for a diaper.
Some units have a "face shield" that hangs down from the unit and blocks the light from the baby's face. If not, put a lightweight covering over his eyes to protect them. Change your baby's position every few hours for greater exposure. If you can remove the diaper for brief periods of time, do so.
The lights should be used throughout a 24-hour period for two to three days, depending on what your doctor has prescribed. Some may recommend turning it off for a few hours at night. The length of treatment also depends upon the progress of bilirubin removal.
About every three hours, turn off the bililights, and feed your baby. Frequent feedings are important, to help clear out the bilirubin. You may also use this break to bathe him, play with him and care for him as you usually would. Be aware that as the bilirubin is excreted, the baby's stools may look green, black and tarry. This is normal.
Check the baby's temperature every few hours while he is under the lights, to make sure he is not getting too warm. A normal rectal temperature for baby is 36.6 to 38.0 degrees C. If your baby's temperature gets up to 38.3 degrees C or higher, contact your paediatrician. (See References 1)
Biliblankets and Pads
The biliblanket contains fibre-optic lights used for phototherapy in treating infant jaundice. It uses the same light spectrum as bililights, but the blanket allows the light to get closer to the baby's skin, and the baby can be fed and held while wrapped in the blanket.
You may safely put the blanket right up against your baby's skin. Be sure to shield her eyes, as with the bililights.
The bilipad is similar to the blanket, but it is a pad on which the baby lies that emits light.
Although they are more mobile than the bililights, both the blanket and the pad are connected to a box that powers the fibre-optics.
For home treatment, you may be provided with the bed, blanket or pad by the hospital. If not, a doctor's prescription may be necessary for you to be able to rent or purchase the appropriate equipment.
Do not use lotion, cream, baby oil, baby powder or any other product on your baby's skin while they under the bililights or in the biliblanket, unless your paediatrician orders it.
Although bililights are safe, it is possible for your baby to develop a rash during treatment. It will go away on its own, but mention it to your paediatrician.
Your baby will need to have blood drawn daily, to check bilirubin levels. The hospital may arrange for a nurse to visit your home to do this.