Medical Writer

October 8, 2009

Neonatal Jaundice: To Sun or Not to Sun?

Filed under: Uncategorized — drcharity @ 1:12 am
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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.

 

Resources:

1. SL Harrison, PG Buettner, R M Aclennan (1999). Why do mothers still sun their infants?  Journal of Paediatrics and Child Health 35 (3), 296-299. doi:10.1046/j.1440-1754.1999.00362.x

2. Fadhil M Salih (2001). Can sunlight replace phototherapy units in the treatment of neonatal jaundice? An in vitro study. Photodermatology, Photoimmunology & Photomedicine 17 (6), 272-277.

3. RV Johnston, JN Anderson, C Prentice. Is sunlight an effective treatment for infants with jaundice? Medical Journal of Australia. 2003 April 21;178(8):403.

4. Kernicterus in Full-Term Infants – United States, 1994-1998. JAMA 2001 286: 299-300.

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