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Effect of phototherapy on behaviour of jaundiced neonates
P Abrol1, R Sankarasubramanian
1Department of Pediatrics, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana.
Insights
Phototherapy for neonatal jaundice may negatively impact infant behavior, specifically visual and auditory orientation. Maintaining mother-baby contact during treatment is recommended to mitigate these effects.
Area of Science:
- Neonatology
- Pediatric Behavioral Science
Background:
- Neonatal jaundice (icterus neonatorum) is common in full-term infants.
- Phototherapy is a standard treatment for hyperbilirubinemia.
- Potential effects of phototherapy on neonatal behavior require further investigation.
Purpose of the Study:
- To compare the behavioral development of neonates treated with phototherapy versus those with mild jaundice not requiring treatment.
- To assess the impact of phototherapy on specific interactive behaviors in newborns.
Main Methods:
- A comparative study involving 30 full-term newborns with icterus neonatorum, divided into a phototherapy group (bilirubin 12.1-15.0 mg/dl) and a control group (bilirubin 8-12.0 mg/dl).
- Neonatal behavior was assessed using Brazelton's Neonatal Behavior Assessment Scale (BNBAS) at 24-48 hours post-initiation and post-cessation of phototherapy.
- Behavioral assessments focused on interactive processes, particularly orientation responses.
Main Results:
- Newborns receiving phototherapy exhibited significantly poorer scores in visual and auditory orientation responses within the interactive processes cluster.
- These behavioral deficits persisted at follow-up assessment.
- No significant differences were observed in other behavioral items or clusters between the groups.
Conclusions:
- Phototherapy for neonatal jaundice may be associated with temporary deficits in neonatal interactive behaviors, particularly orientation.
- Minimizing maternal separation during phototherapy by co-locating the unit with the mother and encouraging breastfeeding and interaction is advised.
- Further research should explore strategies to support neonatal behavioral development during jaundice treatment.
Abstract:
Thirty full term newborns appropriate for gestational age with icterus neonatorum were divided into two groups of 15 each. Group I (study group) newborns had serum bilirubin in the range of 12.1 to 15.0 mg/dl. Group II (control group) included neonates with serum bilirubin in the range of 8 to 12.0 mg/dl. Only the study group was given phototherapy. The comparative study of neonatal behaviour in both these groups was done using BNBAS (Brazelton's neonatal behaviour assessment scale), 24 to 48 hrs, both after initiation and cessation of phototherapy in the study group and at corresponding postnatal ages in control group. Many newborns in the study group were on top feeds and had more crying episodes. The study group scores were significantly poorer in orientation response to visual inanimate, visual animate and visual and auditory animates in the cluster interactive processes. Followup assessment showed similar results in the same items. Other items in the same cluster and all items in the other clusters showed no significant difference in the two groups in the initial as well as followup assessments. As maternal separation during phototherapy also possibly affects neonatal behaviour, the effect of this factor can be minimized by keeping the phototherapy unit with the mother of the jaundiced baby. The mother should be encouraged to breast feed her baby regularly and have more mother-baby interaction.