Neonatal Phototherapy - Care and Risks | A Practical Guide

Pregnancy treatments are diverse and incisive, they allow to analyze the baby's situation and optimize its health condition. One of these treatments is neonatal phototherapy. If you are interested in learning more about this treatment, its characteristics and care, we invite you to read our guide to start phototherapy in neonates.

First, some important background details

Phototherapy is a medical treatment regularly used in newborns to treat neonatal jaundice, a condition in which the baby's skin and eyes turn yellow due to an excess of bilirubin in the blood. This procedure involves exposing the baby to a special light, usually blue or green light, which helps break down the bilirubin into forms that the body can more easily eliminate. Phototherapy is a safe and effective treatment given in neonatal care units to prevent complications associated with elevated bilirubin levels in newborns.

Phototherapy for neonatal jaundice

Phototherapy for neonatal jaundice begins when the infant is placed naked or swaddled under special lights, which can be positioned above or around the incubator. During treatment, the infant's eyes are protected in order to avoid direct exposure to light. Phototherapy is administered over a series of hours per day until bilirubin levels decrease to a safe level.

Criteria for the indication of phototherapy in neonatal jaundice

When is phototherapy indicated in neonatal jaundice? Criteria for the indication of phototherapy include:

1. Indirect bilirubin levels in the infant's blood higher than those established in risk charts.
2. Gestational age
3. Other risk factors.

The infant's age, rate of bilirubin increase, birth weight and the presence of additional risk factors such as blood group incompatibility or the presence of hematomas are taken into account. Pediatricians and neonatologists evaluate these factors and decide whether phototherapy is needed to prevent conditions associated with high bilirubin levels, such as brain damage.

Risks and care in neonatal phototherapy

Neonatal phototherapy is generally safe, however, there are risks involved ranging from dehydration, increased body temperature, eye damage and excessive weight loss. To mitigate these risks it is important to keep the baby well hydrated through regular feeding and body temperature control, avoiding overheating. In addition, the baby's eyes are protected during exposure to light to prevent damage to the baby's eyes. Healthcare professionals continuously monitor the baby during phototherapy to detect any signs of complications and adjust treatment as needed.

Neonatal hyperbilirubinemia: Phototherapy and exchange transfusion

Neonatal hyperbilirubinemia, also known as neonatal jaundice, is a condition in which bilirubin levels in the newborn's blood are elevated, the first line of treatment is phototherapy. However, in severe cases or when phototherapy is not effective, exchange transfusion may be necessary. This is a more invasive procedure that involves replacing the infant's blood with elevated bilirubin levels with fresh, clean blood, usually from a donor. Exchange transfusion is reserved for severe cases of neonatal jaundice that pose a risk to the baby's health.

Phototherapy charts in neonatal jaundice: How to interpret them?

The neonatal jaundice phototherapy charts provide a guide for determining when to initiate phototherapy treatment, based on the newborn's bilirubin levels and other risk factors. These tables usually consider the infant's gestational age, birth weight, and the presence of additional medical conditions. Thresholds for initiating phototherapy vary according to the chart used and may differ among medical institutions. In general, physicians interpret these tables by comparing the infant's bilirubin levels with established thresholds, and recommend treatment with phototherapy if certain values are exceeded.

Essential nursing care in neonatal phototherapy

Among the main nursing care in neonatal phototherapy are:

1. Continuous monitoring of vital signs and bilirubin levels.
2. Protection of the infant's eyes by blindfolds or bandages during light exposure.
3. Maintenance of hydration by frequent feedings and administration of intravenous fluids if necessary.
4. Monitoring the infant's body temperature to prevent hyperthermia.
5. Rotating the infant to ensure even exposure to light.
6. Monitoring the baby's skin for signs of irritation or burns and protecting sensitive areas with sunscreen.

Finally, regular follow-up appointments should be scheduled with the physician to monitor bilirubin levels and evaluate the effectiveness of home treatment. If you have any questions, schedule an appointment with our specialists.