A multicentre randomised clinical trial study in Sweden investigated if home phototherapy could be a safe alternative to inpatient phototherapy for otherwise healthy newborn infants with hyperbilirubinemia.
Phototherapy in the hospital in infants with neonatal jaundice is a safe and effective treatment without major side effects. The development of fibre optic equipment has made the choice of home phototherapy possible. In a first randomised controlled trial in Sweden comparing home phototherapy with hospital phototherapy, 147 patients were recruited to assess whether home phototherapy was feasible and safe in a cohort of otherwise healthy term-born infants who fulfilled the criteria for in-hospital phototherapy. 69 patients were randomised to conventional phototherapy and 78 to home phototherapy. The results showed that no patients needed blood exchange and only 4% of the patients allocated to home phototherapy were admitted to the hospital. The duration of phototherapy, length of stay, amount of blood tests and weight change showed no statistically significant differences.
Using fibre optic devices means that the mother can care for, and feed, her baby while minimising the risk of interrupting the phototherapy. In addition, it is also possible that home treatment is more convenient and cost-effective for families than conventional hospital treatment since it avoids parents being separated from their infant when it needs jaundice treatment in hospital. Allowing patients to have phototherapy at home means handing over part of the responsibility for performing the treatment to the parents; this is only possible if the parents are willing to participate. Parents should not be forced to perform the treatment.
Home phototherapy could be a safe alternative to inpatient phototherapy for otherwise healthy newborns with hyperbilirubinemia if daily check-ups and 24/7 telephone support can be provided. The parents should be informed to contact the hospital immediately if they fail to perform the treatment at home.
Paper available at: European Journal of Pediatrics
Full list of authors: Pettersson, Miriam; Eriksson, Mats; Albinsson, Emil; Ohlin, Andreas