Effect of turning vs. supine position under phototherapy on neonates with hyperbilirubinemia: a systematic review

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Shalin Lee Wan Fei1, Khatijah L Abdullah

  • 1Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia.

Journal of Clinical Nursing
|October 17, 2014
PubMed

Insights

Keeping jaundiced newborns supine during phototherapy is as effective as alternating positions. This finding simplifies nursing care and ensures effective treatment for neonatal jaundice.

Area of Science:

  • Neonatal care
  • Pediatric phototherapy research
  • Evidence-based medicine

Background:

  • Neonatal jaundice is common, requiring phototherapy.
  • Current practice often involves alternating infant positions during treatment.
  • This contrasts with safe infant sleeping guidelines recommending supine positioning.

Purpose of the Study:

  • To determine the optimal position for jaundiced neonates during phototherapy.
  • To evaluate the efficacy of different positioning strategies based on randomized controlled trials.

Main Methods:

  • Systematic review of randomized controlled trials.
  • Searched major databases (CINAHL, ScienceDirect, Embase, Cochrane Library).
  • Included 5 studies evaluating positioning, bilirubin reduction, and phototherapy duration.

Main Results:

  • Four of five studies found no significant difference in bilirubin reduction or treatment duration between supine and alternating positions.
  • One study indicated a significant bilirubin drop and shorter duration in the supine position.
  • All included studies demonstrated external validity.

Conclusions:

  • Maintaining a supine position for jaundiced neonates during phototherapy is as effective as periodic repositioning.
  • Alternating positions is unnecessary for conventional phototherapy, potentially reducing nursing workload.
Abstract

Keywords:
alternatehyperbilirubinemiajaundiceneonatalnewbornphototherapypositiontotal serum bilirubin levelturn

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