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Phototherapy

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Phototherapy is used in the management of jaundice to prevent the concentration of unconjugated bilirubin in the blood from reaching levels where neurotoxity may occur. The neonate's skin is exposed to high-intensity light, which photochemically converts fat-soluble unconjugated bilirubin into water-soluble bilirubin that can be excreted in bile and urine. Treatment may be intermittent or continuous and interrupted only for essential care.

Side effects of treatment include hyperthermia, dehydration, damage to the retina, rashes and skin burns, decreased calcium levels, low platelet counts and increased red cell osmotic fragility. In addition, the baby may experience alterations in infant state and neurobehavioural organisation, as well as isolation and lack of usual sensory experiences including visual deprivation.

The Practising Midwife featured articles

Use of technology in childbirth: 6. Phototherapy 2012; 15(3): 36-39 Helen Baston

Further reading

Mary Anne Kelly (2014). Neonatal jaundice and phototherapy. Great Ormond Street Hospital for Children guideline. http://www.gosh.nhs.uk/health-professionals/clinical-guidelines/neonatal-jaundice-and-phototherapy

NICE (2010). Jaundice in newborn babies under 28 days. Clinical guideline 98. https://www.nice.org.uk/guidance/cg98

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