Is placing your baby in sunlight enough to treat jaundice?

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Is putting your baby by the window good enough to treat jaundice? Maybe if they only have slightly elevated levels of bilirubin. Let us examine the evidence behind this ever so famous suggestion. *this is not medical advice, ALWAYS consult with your baby’s pediatrician*

“Putting your baby in sunlight is not recommended as a way of treating jaundice. Exposing your baby to sunlight might help lower the bilirubin level, but this will only work if the baby is completely undressed. This cannot be done safely inside your home because your baby will get cold, and newborns should never be put in direct sunlight outside because they might get sunburned.” Neonatal Jaundice: to sun or not to sun?

“In their original description of phototherapy, Cremer et al demonstrated that exposure of newborns to sunlight would lower the serum bilirubin level. Although sunlight provides sufficient irradiance in the 425 – to 475nm band to provide phototherapy, the practical difficulties involved in safely exposing a naked newborn to the sun either inside or outside (and avoiding sunburn) preclude the use of sunlight as a reliable therapeutic tool, and it therefore is not recommended.” (Cremer RJ, Perryman PW, Richards DH. Influence of light on thehyperbilirubinemia of infants. Lancet. 1958;1(7030):1094–1097)

“The practice of placing jaundiced infants under sunlight to reduce discoloration is a cultural health belief in most communities and appears to be effective in many anecdotal reports. In fact, midwives, nurses, doctors and pediatricians were identified to be the main professional sources of this belief [1]. In an in vitro experiment, it was found that sunlight was 6.5 times more effective than phototherapy in the isomerization of bilirubin compared to a phototherapy unit [2]. However, there are no appropriate controlled trials comparing the efficacy of sunlight to no treatment or artificial light therapy in jaundice [3]. Delayed treatment of severe jaundice in an otherwise healthy baby can result in the development of kernicterus – a complication causing brain damage as result of bilirubin deposition in the central nervous system [4]. Hence, withholding phototherapy would be unethical in controlled trials. We should not recommend sunlight for routine treatment of jaundice as this would encourage parental misconception that home therapy is adequate and result in delayed healthcare seeking behaviour. Moreover, there are concerns of adverse effects of sunlight exposure causing skin tanning, sunburn and hyperthermia.” Neonatal Jaundice: To sun or not to sun?

Anything done in vitro (tests done outside of the body in regulated conditions) is going to be almost always different when trying to replicate the results in vivo (things that happen within the body).

“In the late 1950s, phototherapy emerged as another potential treatment of jaundice. In 1956 at Rochford General Hospital in Essex, England, Sister J. Ward noted that sunshine decreased neonatal jaundice. Meanwhile, hospital biochemists noted erroneously low bilirubin levels in samples sitting in sunlight before processing.” A Tale of Two Hospitals: The Evolution of Phototherapy Treatment for Neonatal Jaundice

Listed below are 2 valuable resources for informing yourself about the management of jaundice.
ABM Clinical Protocol #22: Guidelines for Management of Jaundice in the Breastfeeding Infant Equal to or Greater Than 35 Weeks’ Gestation
Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation
Also be aware that there are several types of jaundice, all with their own style of treatments.

What should you do if your baby is jaundiced? Talk to your pediatrician and link up with an IBCLC. Some moms don’t like hearing that their baby needs to be supplemented, and that is totally normal. Supplementation doesn’t always mean formula, consider hand expression or pumping to provide your baby’s supplementation. Colostrum and breast milk clears excess bilirubin much more effectively and also doesn’t disrupt the very sensitive and immature microbiome in your baby’s stomach. Also ask your doctor about donor milk if you are not able to express enough milk to adequately supplement your baby.

Supplementation doesn’t equal “bottle” … there are many different ways of delivering supplement to your baby. You can tube feed at the breast, cup feed, finger feed, or use a dropper.
There are many ways to cope with a jaundice diagnosis. One of the best ways is arming yourself prenatally with information on how to deal with it so you know all of the options.

 
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One comment on “Is placing your baby in sunlight enough to treat jaundice?

  1. reshmishetty says:

    This blog is very informative, neonatal jaundice is one of the main problems with infants. It can occur when the baby is having higher levels of bilirubin (yellowish substance) in the blood. So the phototherapy treatment can be done to eradicate jaundice and to lower bilirubin levels. Phototherapy treatment is one of the main and more effective treatments with the best result. Ibis Medical is one of the major manufacturers of the neonatal products which have a worldwide distribution network.

    Like

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