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Phototherapy for Jaundice

How Does This Procedure Help Newborns?

By Lisa A. Goldstein

Jen O'Neal of Orlando, Fla., hadn't heard of phototherapy until her daughter, Molly, had jaundice after her birth. If phototherapy is a term unfamiliar to you, too, here's a primer on the procedure.

Phototherapy has been around for a long time. In fact, the first well-recognized report of its effects on jaundice was in 1958, according to Dr. William Cashore, associate chief of pediatrics at Women & Infants' Hospital of Rhode Island who is well known for his work and knowledge of hyperbilirubinemia, or jaundice. Nurses in their London hospital reported less neonatal jaundice in a newer, brightly lit nursery than an older and darker one in the same building. The report's authors measured bilirubins in the two nurseries to confirm this. A similar discovery was made in a large South American neonatal center at the same time.

U.S. pediatric investigators began reporting on therapeutic use of fluorescent light in the 1960s. Clinical studies were done to confirm its effectiveness.

"When a newborn infant has an elevated bilirubin level (i.e., the infant is jaundiced), there is bilirubin present in the circulation, in the small capillaries in the skin and in the skin and subcutaneous tissues," says Dr. Jeffrey Maisels, chief of pediatrics at Beaumont Hospital in Royal Oak, Mich., and a nationally renowned expert in phototherapy for jaundice. "When you shine light on the skin, it penetrates the skin and also the subcutaneous tissues and converts the bilirubin that is present to other forms of bilirubin called photobilirubin and lumirubin. These are isomers of the bilirubin molecule (i.e., they have the same molecular formula but it has been rearranged)."

We all form bilirubin every day from the breakdown of our red blood cells and this occurs in babies as well, Dr. Maisels says. The difference is that the newborn infant's liver is not capable of conjugating and excreting the bilirubin as well as an adult. Conjugation is required before the bilirubin can be excreted. This is one of the reasons why most newborn infants are jaundiced. When bilirubin is converted to these isomers, they can be removed from the body without requiring conjugation in the liver.

Want to see more?

• Check out our Article Library.
• Get to Know Your Newborn: A Head-to-toe Look at Your Baby
• From Apgar to Vitamin K: Tests and Procedures for Your Newborn Baby
• Why Is My Baby Yellow? Breaking Down Newborn Jaundice
• Talk about it!