Effect of phototherapy on behaviour of jaundiced neonates

Abstract

Thirty full term newborns appropriate for gestational age with icterus neonatorum were divided into two groups of 15 each. Group I (study group) newborns had serum bilirubin in the range of 12.1 to 15.0 mg/dl. Group II (control group) included neonates with serum bilirubin in the range of 8 to 12.0 mg/dl. Only the study group was given phototherapy. The comparative study of neonatal behaviour in both these groups was done using BNBAS (Brazelton's neonatal behaviour assessment scale), 24 to 48 hrs, both after initiation and cessation of phototherapy in the study group and at corresponding postnatal ages in control group. Many newborns in the study group were on top feeds and had more crying episodes. The study group scores were significantly poorer in orientation response to visual inanimate, visual animate and visual and auditory animates in the cluster interactive processes. Followup assessment showed similar results in the same items. Other items in the same cluster and all items in the other clusters showed no significant difference in the two groups in the initial as well as followup assessments. As maternal separation during phototherapy also possibly affects neonatal behaviour, the effect of this factor can be minimized by keeping the phototherapy unit with the mother of the jaundiced baby. The mother should be encouraged to breast feed her baby regularly and have more mother-baby interaction.

Newborn Pain and Skin Reaction according to the Method of Removing the Eyepatch Used for Phototherapy

“…The mother's presence during phototherapy is a beneficial factor that minimizes the effects on the infant's behavior, allowing for the establishment of the mother-infant bond during the process and encouraging continuing breastfeeding and all the mother-child interactions (8) .…”

The side effects of phototherapy for neonatal jaundice: what do we know? What should we do?

“…Interference with maternal-infant interaction [1,88] Cohort study 2b [45] RCT 1b Imbalance of thermal environment and water loss [60] Before-after study 2c [24,55,66] RCT 1b Electrolyte disturbance-hypocalcemia [38,48] Before-after study 2c [43] Cohort study 4 Disorder of circadian rhythms [28] RCT 1b…”

“…For infants, NNPT affects neonatal behavior, including visual and auditory orientation and alertness [1,45]. For parents, NNPT causes parental anxiety, excessive medical concerns, and increased outpatient visits in the first year [88].…”

Evaluation of incidence of phototherapy induced hypocalcaemia in term newborns with neonatal hyperbilirubinemia and its clinical significance: a cross sectional study with controls

“…1 Jaundice usually becomes apparent in a cephalocaudal progression, starting on the face and progressing to the abdomen and then the feet, as serum levels increase Hyperbilirubinemia in infants ≥ 35 weeks gestation is defined as total bilirubin >95 th percentile on the hourspecific Bhutani normo gram. 2,3 describe neurological clinical manifestations of bilirubin induced neurological dysfunction. 4 Appropriate intervention is important to consider in every infant with severe hyperbilirubinemia.…”