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Updated: Jul 17, 2026
An In Vitro Approach to Photodynamic Therapy
Published on: August 17, 2018
Effect of feeding type on the efficacy of phototherapy
Hande Gulcan1, Filiz Tiker, Hasan Kilicdag
1Department of Pediatrics, Baskent University, Adana Teaching and Research Center, Adana/Turkey. handeglcn@yahoo.com
Insights
Phototherapy effectively treats hyperbilirubinemia in newborns. However, breast-fed infants show a slower response to phototherapy compared to mixed-fed infants, though rebound bilirubin levels are similar.
Area of Science:
- Neonatal Medicine
- Pediatrics
- Phototherapy Research
Background:
- Nonhemolytic hyperbilirubinemia is common in newborns.
- Feeding type may influence the efficacy of phototherapy.
Purpose of the Study:
- To compare phototherapy efficacy for nonhemolytic hyperbilirubinemia in breast-fed versus mixed-fed newborns.
- To assess rebound bilirubin levels based on feeding type.
Main Methods:
- Prospective study involving 53 healthy, full-term newborns with nonhemolytic hyperbilirubinemia.
- Group 1: 28 breast-fed newborns. Group 2: 25 mixed-fed newborns.
- Phototherapy response and rebound bilirubin levels were measured.
Main Results:
- Breast-fed newborns experienced greater weight loss and required longer phototherapy duration.
- Mixed-fed newborns demonstrated a significantly higher rate of bilirubin decrease.
- No significant difference in rebound bilirubin levels was observed between groups.
Conclusions:
- Phototherapy is effective in reducing bilirubin levels for breast-fed newborns.
- Breast-fed infants respond more slowly to phototherapy than mixed-fed infants.
- Feeding type impacts phototherapy response rate but not rebound levels.
Objective:
The objective of this study was to assess the efficacy of phototherapy for nonhemolytic hyperbilirubinemia and rebound bilirubin levels in breast-fed newborns as compared with mixed-fed (breast milk and formula) newborns.
Study Design/Setting:
Prospective study of effects of feeding type on response to phototherapy in newborns.
Methods:
The subjects were 53 full-term healthy newborns with nonhemolytic hyperbilirubinemia [defined as total serum bilirubin 12 mg/dL (205.2 micromol/L) in the first 48 hours of life or 15 mg/dl (256.5 micromol/L), on subsequent days]. Groups were formed according to type of feeding. Group 1 consisted of 28 breast-fed newborns and group 2 consisted of 25 mixed-fed newborns. Phototherapy was terminated when total serum bilirubin concentration fell to 14 mg/dL (< 239.4 micromol/L). Rebound bilirubin measurements were obtained 24 hours after phototherapy ended.
Results:
The groups were comparable with respect to age at the start of phototherapy. The amount of weight loss (relative to birth weight) recorded at the start of phototherapy was significantly greater in group 1 than in group 2 (8.1+/- 3.9% vs. 5.4+/- 2.6% p = 0.004). The duration of phototherapy was significantly longer in group 1 than in group 2 (38.6+/- 12.6 h vs. 26.8+/- 9.4 h; P < 0.001). The 24-hour rate of decrease in bilirubin concentration in group 2 was significantly higher than that in group 1 [5.4+/- 2.2 mg/dL/d (92.3+/-37.6 micromol/L/d) vs. 4+/- 1.3 mg/dL/d (68.4+/- 22.2 micromol/L/d); p = 0.01]. The overall rate of decrease in bilirubin concentration in group 1 was significantly lower than that in group 2 [0.16+/- 0.05 mg/dL/h (2.73+/- 0.85 micromol/L/h) vs. 0.22+/- 0.09 mg/dL/h (3.76+/- 1.53 micromol/L/h); p = 0.01]. There was no significant difference between the two groups with respect to rebound bilirubin concentration (P = 0.184).
Conclusion:
Phototherapy effectively reduced bilirubin levels in breastfed newborns with hyperbilirubinemia, but these patients show significantly slower response to this treatment than mixed-fed newborns.
