In some cases, phototherapy will only be needed for 24 hours or less, in some cases, it may be required for 5 to 7 days. The AAP Guidelines suggest that an infant readmitted for hyperbilirubinemia, with a level of 18 mg/dL or more, should have a level of 13 – 14 mg/dL in order to discontinue phototherapy.

How long can a baby stay under phototherapy?

Babies usually need to be under phototherapy lights for around 48 hours and often longer. How long will the jaundice last? Physiological jaundice normally clears by the time your baby is two weeks old. However, sometimes it lasts longer and further investigations may be needed to rule out other causes of jaundice.

When do you start phototherapy in premature babies?

A commonly used rule of thumb in the NICU is to start phototherapy when the total serum bilirubin level is greater than 5 times the birth weight. Thus, in a 1-kg infant, phototherapy is started at a bilirubin level of 5 mg/dL; in a 2-kg infant, phototherapy is started at a bilirubin level of 10mg/dL and so on.

Can bilirubin levels go up after phototherapy?

It is not unusual for babies to still appear jaundiced for a period of time after phototherapy is completed. Bilirubin levels may rise again 18 to 24 hours after stopping phototherapy. Although rare, this requires follow-up for those who may need more treatment.

Can phototherapy cause blindness in newborns?

Retinal damage has been observed in some animal models during intense phototherapy. In an NICU environment, infants exposed to higher levels of ambient light were found to have an increased risk of retinopathy. Therefore, covering the eyes of infants undergoing phototherapy with eye patches is routine.

What is a good bilirubin level for a newborn?

In a newborn, higher bilirubin is normal due to the stress of birth. Normal indirect bilirubin would be under 5.2 mg/dL within the first 24 hours of birth. But many newborns have some kind of jaundice and bilirubin levels that rise above 5 mg/dL within the first few days after birth.

How fast can bilirubin levels drop with phototherapy?

The overall rate of decrease in the bilirubin concentration for the duration of exposure to phototherapy was as follows: group 1, 0.8%+/-0.3% per hour; group 2, 0.6%+/-0.3% per hour; and group 3, 0.8%+/-0.3% per hour.

How long should a baby with jaundice be in the sun?

Make sure the room is warm and take off the baby’s clothes except the diaper. Sunbathe the baby like this for 20-30 minutes twice a day.

What are the guidelines for phototherapy in newborns?

Guidelines for Phototherapy. Use total bilirubin. Do not subtract direct (conjugated) bilirubin. For well infants 35 – 37 6/7 wk, can adjust TSB levels for intervention around the medium risk line. It is an option to intervene at lower TSB levels for infants closer to 35 wks and at higher TSB levels for those closer to 37 6/7 wks.

Is phototherapy effective in the management of hyperbilirubinemia in preterm infants?

An approach to the management of hyperbilirubinemia in the preterm infant less than 35 weeks of gestation We provide an approach to the use of phototherapy and exchange transfusion in the management of hyperbilirubinemia in preterm infants of <35 weeks of gestation.

What are the guidelines for phototherapy in children with G6PD deficiency?

Guidelines for Phototherapy 1 Use total bilirubin. 2 Risk factors = isoimmune hemolytic disease, G6PD deficiency, asphyxia, significant lethargy, temperature instability, sepsis, acidosis, or albumin <3g/dL 3 For well infants 35 – 37 6/7 wk, can adjust TSB levels for intervention around the medium risk line.

What are the guidelines for phototherapy in children with hemolytic disease?

Guidelines for Phototherapy Use total bilirubin. Do not subtract direct (conjugated) bilirubin. Risk factors = isoimmune hemolytic disease, G6PD deficiency, asphyxia, significant lethargy, temperature instability, sepsis, acidosis, or albumin <3g/dL For well infants 35 – 37 6/7 wk, can adjust TSB levels for intervention around the medium risk line.