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The behavior of jaundiced infants undergoing phototherapy
Insights
Jaundiced infants show altered behavior, particularly visual orienting, even before phototherapy. These behavioral changes worsen during treatment and separation, suggesting hyperbilirubinemia impacts infant development.
Area of Science:
- Neonatal Development
- Pediatric Neurology
- Infant Behavior
Background:
- Hyperbilirubinemia is common in newborns.
- Jaundice may affect infant behavior and development.
- Phototherapy is a standard treatment for neonatal jaundice.
Purpose of the Study:
- To assess the behavioral impact of hyperbilirubinemia and phototherapy on jaundiced infants.
- To compare the behavior of jaundiced infants undergoing phototherapy with non-jaundiced controls.
Main Methods:
- Utilized the Brazelton Neonatal Behavioral Assessment Scale (NBAS) for behavioral evaluations.
- Compared 10 full-term jaundiced infants with 10 non-jaundiced controls.
- Conducted assessments before, during, and after phototherapy.
Main Results:
- Jaundiced infants exhibited lower scores on orienting items, particularly visual, prior to phototherapy.
- Behavioral differences were most pronounced during phototherapy and maternal separation.
- Infants receiving phototherapy showed deficits in muscle tonus, pull-to-sit, cuddliness, and self-quieting post-treatment.
Conclusions:
- Hyperbilirubinemia appears to cause behavioral changes in infants independent of phototherapy or separation.
- Phototherapy and separation may exacerbate these behavioral alterations.
- Further research is needed to understand long-term effects and potential confounding factors.
Abstract:
Ten full-term jaundiced infants were examined with the Brazelton Scale before, during and following phototherapy. They were compared with 10 non-jaundiced control infants examined at the same post-partum ages. All infants were appropriate for gestational age and free of perinatal complications other than hyperbilirubinemia. Differences on the orienting items of the Brazelton examinations (primarily visual orienting) were found prior to the onset of phototherapy or separation, and persisted for the length of the study. The greatest over-all differences were noted during phototherapy and separation from the mother, at which times the treatment group had lower scores on four of the six orienting items. They also had lower scores on muscle tonus, pull-to-sit and cuddliness while undergoing phototherapy, and poorer scores on orienting items, self-quieting and tremulousness were also evident three days following treatment. It is suggested that the differences found in mother-infant interaction following separation for the management of minor medical problems may be related to changes in infant behaviour which are already evident prior to separation. In the cases of jaundiced infants requiring phototherapy, these changes appear to be related primarily to hyperbilirubinemia. The possibility of these effects being prolonged or confounded by phototherapy or separation cannot be discounted.