It’s very common for newborns to have (or develop) a touch of jaundice before their livers are functioning at full speed. (One of my daughters went through a lovely lemonish phase during her first week on Earth.) This is caused by a build-up of the yellow pigment bilirubin. Usually it’s harmless, but exceptionally high levels of bilirubin (hyperbilirubinemia) can be dangerous for a newborn. This condition can be treated with the use of intense blue light, which acts on bilirubin in the skin, breaking it down to a form which the body can more easily excrete.
Phototherapy is pretty gentle, as treatments go. But if it isn’t necessary, the newborn is probably better off snuggled up with a parent than lying blindfolded in a lightbox. The Northern California Neonatal Consortium recently reviewed the evidence and released revised guidelines on use of phototherapy, which set a higher bound for phototherapy in neonatal jaundice.
Dr. Tom Newman studies phototherapy and neonatal hyperbilirubinemia at UCSF’s Department of Epidemiology and Biostatistics. I worked with Dr. Newman to develop an easy-to-use web-based calculator for demonstration purposes. The user enters a few data points and gets a quick calculation of whether the NCNC guidelines recommend phototherapy for the infant. The older American Academy of Pediatrics (AAP) guidelines – which recommend treatment at a lower level of bilirubin – are also shown, for comparison. The hope is that this calculator will help the NCNC’s guidelines become more widely known, eventually leading to a reduction in unnecessary treatment.