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Home Phototherapy for Neonatal Jaundice: Should the UK Adopt It?

A new study suggests that home phototherapy (HPT) could be an effective alternative to inpatient phototherapy (IPT) for a select group of infants with neonatal jaundice in the UK. It has good acceptance and is viewed positively by parents.

Neonatal jaundice is routinely treated in a hospital setting. Evidence suggests that HPT prevents prolonged hospitalisation and re-admission in addition to promoting mother-infant bonding. Several high-income countries including the US have widely adopted the practice, but its use in the UK remains rare.

Researchers at the Birmingham Heartlands Hospital, Birmingham, conducted a retrospective observational study involving 100 infants received HPT and 50 control infants who received IPT. HPT was commenced in the community or as continuation of IPT. 

No progressive elevation in serum bilirubin level was seen in any infant receiving HPT. The rate of bilirubin reduction was comparable in the HPT and IPT groups (2.4±1.9 and 2.5±1.6 µmol/L/hour, respectively; mean deviation, −0.1; 95% CI, −0.74 to 0.53; P=.74). The total duration of intervention was longer in HPT compared with controls (mean, 43±28 vs 26±9 hours).

Ninety-seven per cent of parents rated their overall experience of HPT as good. Ninety-eight per cent said they would choose HPT again if they had to and would recommend the service to other families. 

"HPT enables mothers and their infants to remain at home receiving family support and could reduce occupancy of acute beds. We would, however, recommend larger prospective studies before adopting the practice across the UK," the authors wrote in BMJ Paediatrics Open.

Noureldein M, Mupanemunda G, McDermott H, Pettit K, Mupanemunda R. Home phototherapy for neonatal jaundice in the UK: a single-centre retrospective service evaluation and parental survey. BMJ Paediatr Open. 2021 May 18 [Epub ahead of pritn]. doi: 10.1136/bmjpo-2021-001027. PMID: 34079916

This article originally appeared on Univadis, part of the Medscape Professional Network.

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