Home phototherapy; an alternative method for treatment of jaundice in healthy-term newborns

Objective: Hyperbilirubinemia in the healthy, term neonate. is the most common cause of rehospitalization. Expense, risk of nosocomial infections, separation from mother's nursing, A imparting a sense of illness to the infant, and disrupting of parents' and family relationship with neonate are all unhappy drawbacks to in-hospital phototherapy. Because home phototherapy is being used in different regions of Iran, evaluation of effectiveness, benefits and complications of this method can help the physicians and parents to use home phototherapy for management of neonatal icterus. Material & Methods: This prospective study has been done from April 2005 to February 2006 on 108 healthy full-term newborns with jaundice that visited the emergency room of the Children's Medical Center in Tehran. These newborns that had full criteria of home phototherapy are treated by standard four lamp home phototherapy after parents' acceptance. Findings: All 108 patients 48 (44%) male and 60 (56%) female with an average age of 7.1 days and average weight of 3170 gram were treated with horae phototherapy in average for 33 hours. Average serum bilirubin value on entry into home phototherapy was 16.4 (14.2-18) mg/dl and 10.1 mg/dl when discontinued. The average daily decrement in bilirubin was 3.2 mg/dl/day. Parental satisfaction has been nearly 94 percent. Phototherapy-related complications Were noted only in one patient hospitalized due to hyperthermia, Poor compliance was identified in five families (4.6%) who could not continue home phototherapy due to their anxiety. Hyperbilirubinemia in 2 (1.9%) patients did not respond to phototherapy due to G6PD deficiency and hypothyroidism. Conclusion: Home phototherapy is an effective alternative to in-hospital phototherapy for healthy full-term jaundiced newborns if performed by an expert medical team. Benefits such as low expense, continuation of mother's nursing and not imparting a sense of illness to the infant were major causes for parents' content.