Jaundice in newborns is common. It occurs when a baby’s liver can’t clear bilirubin from the blood as efficiently as an adult’s. When bilirubin accumulates, the skin and eyes turn yellow. In most cases, mild newborn jaundice resolves on its own. In others, treatment is required to prevent complications.

What Causes Newborn Jaundice

• Physiological jaundice: The most common form. Seen in over 50% of newborns. The liver is still maturing. It usually appears at 2-3 days old and resolves within 1-2 weeks.
• Breastfeeding jaundice: Happens when the baby doesn’t take enough breast milk. Happens in about 5–10% of newborns.
• Breast-milk jaundice: Affects about 1–2% of breastfed babies. A substance in the mother’s milk slows bilirubin elimination. This type appears a bit later (days 4-7), and may last several weeks.
• Blood-group incompatibility (Rh or ABO): When the mother’s antibodies attack the baby’s red blood cells, bilirubin rises quickly, often within the first 24 hours. This type needs careful monitoring.
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Diagnosing Jaundice

Doctors look for yellowing of the skin and whites of the eyes. To confirm, they measure bilirubin levels with:

• A transcutaneous bilirubin meter (non-invasive device)
• Blood tests, if levels are high or risk factors present
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How Light Therapy (Phototherapy) Works

Light therapy uses blue light, typically wavelengths around 420–470 nm, to convert bilirubin in the skin into forms the body can excrete more easily. Key points:

• The baby usually wears just a diaper, with protective eye patches.
• Light is directed at as much skin as possible. Some equipment shines from above, others use fiber-optic pads or “bili blankets.”
• The light changes bilirubin’s structure so it becomes water-soluble, allowing it to be passed via urine and feces.

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Recent Clinical Insights

Recent studies refine how we deliver phototherapy and how safe and effective it is:

• A large mixed‐methods meta-analysis comparing home phototherapy versus in-hospital phototherapy found similar declines in bilirubin levels and no increase in serious adverse events for low-risk infants (≥ 35 weeks gestation, ≥ 24 hours old) when done according to protocol. It was also less expensive.
• A randomized trial comparing continuous phototherapy (CPT) versus intermittent phototherapy (IPT) showed that IPT had similar effectiveness in lowering bilirubin, fewer side effects, shorter hospital stays, and lower incidence of issues like overheating or skin irritation.
• Pilot studies using prototype low-cost LED phototherapy devices have shown substantial bilirubin reduction (≈ 16-30% over 24-48 hours) with minimal complications.
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Treatment Practices & Safety

• Eye protection is essential; infants must not be exposed directly without shielded eyes.
• Infants should be undressed except for diapers to maximize skin exposure.
• Rotate or reposition to ensure even exposure and avoid burns.
• Hydration, monitoring temperature and feeding well are part of safe practice.
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Home Phototherapy: An Emerging Option

Home phototherapy is becoming more accepted for certain low-risk newborns. Recent evidence shows:

• Similar effectiveness to hospital phototherapy when protocols are followed.
• Lower costs and less stress (less separation, more comfort for family)
• But requires careful selection of infant gestational age, health status, and bilirubin levels must be appropriate.

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Best Practices for Light Therapy Devices

For parents or providers evaluating phototherapy devices, look for:

• Wavelength specification in the blue light range (about 420-470 nm)
• Certified medical-grade LEDs or bulbs
• Even light distribution and sufficient irradiance
• Eye safety features
• Clear usage guidance (hours per day, when to stop)

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References

• IJP Online. (2024). Efficacy of home phototherapy versus inpatient phototherapy for newborn hyperbilirubinemia: a systematic review and meta-analysis. Retrieved from https://ijponline.biomedcentral.com/articles/10.1186/s13052-024-01613-0 BioMed Central
• Spaan, J., Westenberg, L. E. H., Ista, E., van der Geest, B. A. M., Reiss, I. K. M., Willemsen, S. P., Hulzebos, C. V., & Been, J. V. (2025). Home phototherapy for neonatal hyperbilirubinemia: a mixed-methods systematic review and meta-analysis. Pediatric Research. https://doi.org/10.1038/s41390-025-04313-5 Nature
• Frontiers in Pediatrics. (2023). Efficacy of kangaroo mother care combined with neonatal phototherapy in newborns with non-pathological jaundice: a meta-analysis. Frontiers in Pediatrics, 11. https://doi.org/10.3389/fped.2023.1098143Frontiers
• Calabia, V. M. V., Perez, M. L. M., Tangonan, G. L., Cabacungan, P. M., Culaba, I. B., & De Guzman, J. E. (2020). Bilirubin lowering effect and safety of a prototype low-cost blue light emitting diode phototherapy device in the treatment of indirect hyperbilirubinemia among healthy term infants. ArXiv. https://arxiv.org/abs/2008.08875

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