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.
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Phototherapy is remarkably safe, and reports of significant toxicity are exceptionally rare.
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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)."
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