Home phototherapy for neonatal jaundice in the UK: a single-centre retrospective service evaluation and parental survey

• Published in: BMJ paediatrics open 2021-05, Vol.5 (1), p.e001027-e001027
• Main Authors: Noureldein, Mona, Mupanemunda, Grace, McDermott, Helen, Pettit, Katy, Mupanemunda, Richard
• Format: Article
• Language: English
• Subjects: Babies; Birth weight; Breastfeeding & lactation; COVID-19; Feedback; Gestational age; Hospitals; Humans; Infant; Infant, Newborn; jaundice; Jaundice, Neonatal - therapy; Light therapy; Mann-Whitney U test; Neonatology; Newborn babies; Parents; Patient safety; Patient satisfaction; Pediatrics; Phototherapy; Retrospective Studies; United Kingdom
• ISSN: 2399-9772; 2399-9772
• DOI: 10.1136/bmjpo-2021-001027

BackgroundIn the UK setting, where neonatal jaundice treatment is required, it is largely carried out in hospitals. However, it is possible to safely administer home phototherapy (HPT).ObjectiveTo report on our centre’s experience of HPT and its potential benefits.DesignRetrospective observational study performed as a service evaluation.PatientsInfants ≥35 weeks corrected gestational age with a weight of 2 kg and serum bilirubin ≤50 µmol/L above treatment thresholds. Controls were a matched group of infants who received inpatient phototherapy (IPT).SettingThe catchment area of two neonatal intensive care units, one special care unit and a birth centre at four different hospitals that is covered by a single neonatal community outreach nursing team in Birmingham, UK.InterventionHPT was started either in the community or as a continuation of IPT. Controls received IPT.Main outcome measuresThe rate of bilirubin reduction, hospital readmission rates and parental satisfaction.Results100 infants received HPT while 50 received IPT. No infant showed a progressive rise of serum bilirubin level while receiving HPT. The rate of bilirubin reduction was similar in both HPT and IPT groups (2.4±1.9 and 2.5±1.6 µmol/L/hour, respectively, MD=−0.1, 95% CI −0.74 to 0.53, p=0.74). Readmission rate was 3% in the HPT group. 97% of parents stated that the overall experience was good and 98% would choose HPT if they had their time all over again.ConclusionOur programme suggests that HPT for neonatal jaundice can be carried out in a select group of infants. It helps in providing holistic family-centred care and is viewed positively by families.