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Shining light on jaundice in the developing world

Family lore has it that when I was born, I had to spend a couple of extra days in the hospital for jaundice, the distinctive yellow tint to the skin that shows that a baby’s liver isn’t fully up and running yet. For me—and most of the newborns that develop jaundice every year in the developed world—the treatment was simple: spending some time lying under bright blue lights (aka phototherapy). Note that I said “developed world.” The story in the developing world is quite different. Sometimes the nearest hospital with phototherapy equipment is hours’ or days’ travel away. Even though it’s simple, phototherapy is power intensive; no power, no treatment.

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 In countries lacking electricity, filtered sunlight could save thousands of newborns

A new low-tech, low-cost cure for jaundice could save thousands of newborns in impoverished countries. Just look to the sky for the answer. Researchers from Stanford University, the University of Minnesota, and the Massey Street Children’s Hospital in Lagos, Nigeria, have developed sunlight-filtering canopies to treat the condition in newborns. This new affordable option relies on sheets of plastic film and the sun because traditional phototherapy, which requires neonatal incubators and ultraviolet bulbs, isn’t always possible in developing countries.

Articles of Interest

Neonatal jaundice: phototherapy

Neonatal jaundice is a common condition in newborn babies, affecting about 50% of term and 80% of preterm babies. Phototherapy is often used to reduce levels of unconjugated bilirubin that may result in acute or chronic encephalopathy. However, exchange transfusion is still the gold standard of treatment for severe hyperbilirubinaemia.

Portable jaundice therapy could save infants' lives

The problem is that the tried-and-true cure for jaundice – bathing an affected infant in blue light – isn’t possible in many hospitals in developing countries, where there is no steady supply of electricity.

Portable kit to treat babies with jaundice goes on trial in Peru

Health workers in a remote province high in the Peruvian Andes are trialling a revolutionary method to treat babies with jaundice – with nothing more than a colour-coded ruler, blood reader and carrycots. Their goal is to screen, diagnose and treat jaundice in 12,000 newborns over the next two years in a country where 90% of the public health facilities lack the capability to adequately diagnose or treat it in newborns.

ASU graduates create medical device to cure jaundice

Jaundice is a common condition that occurs in approximately 60 percent of newborn babies. If left untreated, it can be life-threatening, especially in underdeveloped countries where health care and technology are limited. NeoLight, an Arizona State University student startup, aims to solve that problem with a portable and cost-effective medical incubator.

Challenges of phototherapy for neonatal hyperbilirubinemia (Review)

Phototherapy is universally recognized as the first option for treating neonatal jaundice due to its unparalleled efficiency and safety in reducing the high serum free bilirubin levels and limiting its neurotoxic effects. However, several studies have suggested that phototherapy may elicit a series of short- and long-term adverse reactions associated with pediatric diseases, including hemolysis, allergic diseases, DNA damage or even cancer.

Efficacy of phototherapy of neonatal jaundice – light wavelength matters

Since its discovery in 50´s of the last century,1 phototherapy of neonatal jaundice has become the golden standard in the treatment of severe neonatal jaundice.2 Exposure of the newborn to the light of a specific wavelength (blue or blue-green light) leads to photisomerization and photooxidation of unconjugated bilirubin (UCB), the products of which are more polar and excretable through the kidneys into the urine and the liver into the bile. In the last seven decades, phototherapy has become a modern, evidence-based therapeutic tool, with the development of treatment protocols to maximize its efficacy.

Five Questions with Dr. Donna Brezinski, Delivering Portable Jaundice Treatment in the USA and the World

Phototherapy devices have a large patient pool. Three in five newborns develop neonatal jaundice in their first few weeks of life, and in the United States, one in 10 suffer severe jaundice. Bili-hut, named for the clinical term for jaundice, hyperbilirubinemia, treats the condition with blue LEDs arranged in a canopy above a bassinet. Traditional devices use older technologies that draw more electricity. With its low-powered LEDs, bili-hut operates on 20 watts, or about four times the wattage required by a phone charger or 1/45th the wattage of a mid-sized window air conditioner.

For Neonatal Jaundice, a New Option in Resource-Poor Nations

So scientists and designers at D-Rev, a nonprofit design firm in Palo Alto, Calif., created a phototherapy device, called Brilliance, that uses light-emitting diodes instead of compact fluorescents. The LED bulbs require half the wattage and cost one-tenth as much as fluorescent bulbs, and they last up to five years. If the power goes out, Brilliance can be operated for up to eight hours on a car battery.

Illuminating Progress: A Comprehensive Review of the Evolution of Phototherapy for Neonatal Hyperbilirubinemia

The mechanism underlying phototherapy for neonatal hyperbilirubinemia is rooted in the interaction between light and bilirubin. When an infant's skin is exposed to light, the non-polar unconjugated bilirubin present in the skin undergoes a process known as photoisomerization. This transformation results in the conversion of bilirubin into water-soluble isomers that can be readily excreted from the body through bile or urine, consequently reducing serum bilirubin levels

Nanomeds can cure jaundice faster: Indian scientists

The age-old home remedy for jaundice – nimbu paani or lemon juice – has now got a 21st century spin, thanks to Indian scientists.

Newborn Care Startup NeoLight Scores $2.5 Million From NFL Quarterback Ben Roethlisberger

NeoLight’s FDA-approved technology is a two-pronged effort to make diagnosing and treating jaundice among infants more convenient. The diagnostic device, Bilicount, can yield results in less than two minutes and eliminates the need for sending out blood samples. Once the results confirm that a newborn’s bilirubin is too high, a portable device called Skylife can treat the condition with “high efficiency, high intensity” phototherapy.

Newborn Jaundice Treatment May Increase Risk of Childhood Seizures

New research suggests that phototherapy – a treatment for newborns with jaundice – could increase children’s risk of developing epilepsy. The finding raises concerns about babies being given the treatment when it’s not absolutely necessary, as the potential risks could outweigh the benefits.

Phototherapy for Neonatal Jaundice

The goal of therapy is to lower the concentration of circulating bilirubin or keep it from increasing. Phototherapy achieves this by using light energy to change the shape and structure of bilirubin, converting it to molecules that can be excreted even when normal conjugation is deficient.

The Birth Of Phototherapy

The effect of light on jaundice in newborns was first discovered in the 1950s at Rochford General Hospital, Essex, with a little bit of science and a lot of luck! Sister J Ward was in charge of the Premature Baby Unit at the hospital and believed in the benefits of fresh air and warm sunshine over the confines of a stuffy incubator. She would take babies outside on warm summer days, bringing them in quickly before the consultants were doing their ward round.

These Light-Emitting Pajamas Could Help Treat Newborns With Jaundice

The method has an advantage over traditional phototherapy in that it allows babies to receive treatment in the comfort of their parents’ arms

These Plastic Canopies Could Save Thousands of Babies

Researchers have developed sunlight-filtering canopies as a low-tech treatment for jaundice in newborns.

“Light” on Phototherapy—Complications and Strategies for Shortening Its Duration, A Review of the Literature

Phototherapy has been the preferred treatment for neonatal jaundice for many years. From the time it was first introduced as a treatment for neonatal jaundice, phototherapy has proven to be a very effective and accessible therapy that has prevented many cases of kernicterus and saved millions of children from severe brain damage and even death, thus contributing more than most treatments in neonatology to saving lives and maintaining a good quality of life. Although considered as safe, it is not free from possible immediate and future mild and severe side effects, but most complications of phototherapy are relatively mild or rare compared to other procedures. However, since the possible complications from prolonged exposure to phototherapy lamps are known today, it is recommended to invest efforts into finding new ways to treat hyperbilirubinemia. In the future, it might be possible that phototherapy will be replaced by a new treatment that has not yet been found. Until new technologies come into use and prove themselves to be at least as effective and less harmful, phototherapy will continue to be used as the main treatment for NHB, while strictly following the indications for treatment, avoiding unnecessary overexposure and being aware of the possible consequences.

Resources

Bili-Hut

Phototherapy treatment for the baby, made easy by the mother's bedside. Each year more than 6 million newborns in low resource areas around the globe do not receive adequate phototherapy to treat jaundice. Timely delivery of blue light phototherapy cures nearly 100% of babies, but failure to treat leaves newborns at risk for seizures, deafness, vision impairment, cerebral palsy, or even death. The Bili-Hut™ is a novel solution to provide the recommended high intensity light treatment to newborns without access to care.

Skylife™ Neonatal Phototherapy System

The Skylife Neonatal Phototherapy System was engineered with Spectral Power Treatment™ which provides a narrow bandwidth of light between 430-475nm to most closely match the bilirubin absorption spectrum for effective jaundice treatment.

NeoLight

Forget bulky blankets and tangled wires. Skylife's 3D Light Array, powered by its revolutionary Spectral Power Treatment™, bathes your patients in gentle, effective light. This precise, targeted treatment exceeds AAP guidelines and achieves optimal results with unparalleled precision, minimizing discomfort and maximizing comfort for both babies and caregivers.