Phototherapy for jaundice in newborns

Phototherapy for jaundice in newborns

Reviewed by Joanna J. Parga-Belinkie, MD

Reviewed on

All newborn babies are at risk for having jaundice. Jaundice is a yellow color that appears in the skin and eyes of newborn babies. It is caused by high levels of a substance called bilirubin. When bilirubin levels get too high, they can damage a baby’s brain. 

Bilirubin levels are high in babies for a few different reasons: 

  • They are still learning how to eat and bilirubin is taken out of the body in urine and stool
  • Bilirubin is found in the blood of babies and they have higher blood levels than adults
  • The liver helps process bilirubin found in the blood breakdown products and is still immature in infants. 

Every baby born in a hospital has a bilirubin level or a jaundice screen when they are 24 to 36 hours old to make sure their levels of bilirubin don’t get too high and hurt the brain. 

What is phototherapy? 

Phototherapy is an effective way to bring down bilirubin levels. When a baby receives phototherapy, they are placed under a blue light (or more rarely, green) with their skin exposed. The light therapy is absorbed through the skin and helps babies get rid of bilirubin in their urine and stool faster than they can do on their own.    

When a baby needs phototherapy, it is usually for a few days. It is rare to need phototherapy for more than a week. When a baby does need phototherapy for a long time, they are often being checked for different blood conditions. This means they will need checks of more than just bilirubin levels. Healthcare professionals will want to know things like their blood type and complete blood counts. 

What are the concerns about and risks of using phototherapy in babies?  

Phototherapy has some risks. The eyes of babies can be hurt by the phototherapy light and so all babies must wear special glasses to keep their eyes closed and covered. 

In the past, the lights used to provide phototherapy could get hot with the potential to cause burns. Most lights now are LED so we do not worry about burns with those lights as they stay cool. 

There are times when phototherapy can tan a baby or make them looked bronzed – but this will go away when the therapy is completed. 

There have been studies looking at phototherapy increasing the risk of cancers in babies, but no studies found that they did. 

There are also parents who find it hard to keep the baby under the lights. Their skin has to be exposed to the light and they can’t be swaddled and may startle. It also makes feeding sessions shorter and less intimate given they need to go back under light therapy, and feeding is important for pooping and peeing and getting the bilirubin levels down. However, the benefits of getting the therapy to protect the brain and make sure it does not get damaged far outweigh any risks of the treatment.   

What are we still learning?  

We are still questioning why bilirubin levels are high in all newborn babies and wondering if there is some protective effect or reason for this. Bilirubin has long been thought of as a waste product because it leaves the body in urine and stool, however it also has antioxidative properties. This means it may be helpful for the body at some level that we still need to discover.  

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