How long does it take to treat neonatal jaundice with light?

The article was professionally consulted by Doctor Nguyen Hung Tien - Department of Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital.

Jaundice phototherapy is one of the most popular and effective measures today to treat jaundice with increased indirect bilirubin in young children at a very economical cost. How long the yellow light treatment lasts depends on the jaundice level of the child to consider hospitalization and conduct light, so when there are abnormal signs, parents need to take the child to a medical facility. medical for the earliest examination.

Neonatal jaundice is a phenomenon in which blood bilirubin levels rise too much, allowing bilirubin to permeate through the skin and connective tissues, leading to yellowing of the mucous membranes and skin.
Usually in the first week after birth, the baby will appear physiological jaundice is very mild jaundice and does not need treatment. On the contrary, there are cases of more severe jaundice that will become pathological jaundice and need to be treated as soon as possible.
If not promptly treated, pathologically elevated bilirubin can lead to dangerous complications, one of which is the phenomenon of indirect bilirubin infiltrating the brain causing neurotoxic syndrome leading to death. or lifelong cerebral palsy.
Babies who are subject to neonatal jaundice include:
Premature babies. Babies are not breastfed, formula milk. The baby has a blood type that is incompatible with the mother's blood. Methods used to treat neonatal jaundice today include:
Provide the baby with enough water and energy through breastfeeding or infusion, especially infusion of Albumin and some drugs to speed up the metabolism of Bilirubin Indirect. Phototherapy is considered one of the most effective, safe, simple, and easy to perform and cost effective treatment for neonatal jaundice. Newborn blood transfusion occurs when there are dangerous complications such as neurotoxicity or high blood bilirubin levels when other treatments are not effective. These methods can be used alone or in combination for maximum effectiveness.

Phototherapy for jaundice for newborns is considered a modern method of treating jaundice, the most economical and easiest to implement up to now.
Yellow light treatment uses blue or white light to convert free Bilirubin into water-soluble Photobilirubin, so it will be excreted in the urine, resulting in a reduction in jaundice in newborns. This method uses light with a wavelength in the range of 400-500 nm, with a peak of 450-460 nm which is comparable to the absorption peak of Bilirubin. The mechanism of action of the phototherapy method is that the light energy emitted from the lamp will pass through the skin layer, acting on the bilirubin molecules in the subcutaneous adipose tissue layer, turning it into photooxygen products with properties. The substance is water soluble, non-toxic and is eliminated by the liver and kidneys. The amount of Bilirubin that must be irradiated depends on the Bilirubin concentration exceeding the prescribed level according to the age, weight and level of jaundice of each child, on risk factors (infection, premature birth, illness, etc.) accompanying reason...).

The yellowing process includes the following steps:
Prepare a clean, well-functioning incubator with proper parameters, a qualified illuminator, a blue or bright light with a wavelength of 400 -480nm with height from lamp to child about 30-50cm. Because the operating time of the tube lamp is < 2000 hours, it is necessary to mark the time when the child has just started using the lamp to promptly change the bulb. Need to prepare eye mask, protective glasses. Explain to the child's family members about the preparation method applied to the child. Assess the child's general condition. Assess the clinical level of jaundice of the child before irradiation. Leave the child naked, swaddle around to expose the baby's skin to blue/white light as much as possible, Dark cloth eye patch. Close the diaper or cover the baby's genitals to prevent testicular atrophy in the baby. Turn on the light switch and adjust the incubator temperature to the patient's body temperature. Change the baby's position about every 2-4 hours to ensure the skin is exposed as much as possible to the light from the lamp. Provide enough water when the child is in the light, encourage breast-feeding. Make sure your baby has constant light except during breastfeeding or procedures. Use double-sided phototherapy in cases of severe hyperbilirubinemia in the child or increased jaundice in the child. Conduct blood Bilirubin test every 12-24 hours, from indirect Bilirubin and Total Bilirubin results to determine how long phototherapy will treat jaundice. In addition, how long the baby has jaundice depends on the clinical jaundice as well as the blood bilirubin test results. If jaundice decreases and blood bilirubin returns to normal values, then there is an indication to stop irradiation. If this method is not effective, showing by irradiation is still jaundiced and Bilirubin is higher, there will be indications for a blood transfusion for the baby. It is necessary to monitor the baby's jaundice level, blood Bilirubin index, mental health, muscle tone, suckling reflex during and even after irradiation to promptly detect neurotoxicity, if any. . If you see an increased level of jaundice, you can combine 2 or 3 lights at the same time. Side effects of yellow light exposure are usually increased body temperature, dehydration, green stools, body temperature disturbances, increased irritation, skin redness, bronzed skin, eyeball damage, burns... and has no side effects on the brain of the child. Children with jaundice due to direct elevation of bilirubin are contraindicated with phototherapy for jaundice.
For children suffering from indirect hyperbilirubinemia, the indication for how long to use the lamp to treat jaundice depends on the degree of jaundice and the Bilirubin test index, it is best to be treated at a hospital under the observation and monitoring of doctors and medical staff. Because the effectiveness of this method depends on the light intensity, the distance from the lamp to the child, the wavelength of the light, etc., parents should take the child to a medical center for examination and treatment. Do not light your own lights at home.
As a key area of ​​Vinmec Health system, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of top doctors and nurses in Pediatrics : consists of leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All doctors are well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. from birth to adulthood Specialized techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation. blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to have fun and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment. If you have a need for consultation and examination at Vinmec Hospitals of the national health system, please book an appointment on the website for service.

Reference source: Portal of Maternal and Child Health Department - Ministry of Health
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