Phototherapy for Jaundice

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)."

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