A new study by researchers at the Stanford University School of Medicine published recently in The New England Journal of Medicine reveals that newborn jaundice can be treated with filtered sunlight. This finding has global impact as it can be instrumental in providing a safe, inexpensive, low-tech solution to a health problem that now causes permanent brain damage or death in more than 150,000 babies in developing countries each year.
In the study which was conducted in Nigeria, some mothers and babies sat under outdoor canopies that filtered out harmful wavelengths from sunlight, and allowed jaundice-treating blue wavelengths to reach the babies’ skin. The filtered-sunlight treatment was as safe and effective as the blue-light lamps traditionally used to treat infant jaundice.
David Stevenson, MD, the Harold K. Faber Professor in Pediatrics and senior associate dean for maternal and child health at Stanford and study’s senior author said that all babies can get jaundice. In such circumstances where there is no access to modern devices, this study shows that there is something that can be used all around the planetsunlightto treat this dangerous condition.
Jaundice is quite common in newborns it is due to a compound called bilirubin which is released during the normal breakdown of red blood cells. Baby's body needs a few days after birth to develop the enzymes that enable excretion of bilirubin. In case too much bilirubin builds up in the blood, the skin and eyes acquire the typical yellow tinge of jaundice. If high bilirubin levels are left untreated for long, it can cause lasting brain damage or infant death.
Since the 1960s, the most common treatment for newborn jaundice has been phototherapy with lamps that emit blue wavelengths. However, in developing countries many hospitals and health clinics do not have the funds, expertise and reliable electricity needed to operate the equipment.
Commercially available plastic films were used by the researchers to build the outdoor canopies. These canopies could filter out sunburn-causing ultraviolet rays and infrared rays that could make infants overheat. But, it would let the blue wavelengths that treat jaundice to pass through filters. Different types of canopies were built for sunny days and for overcast days.
Hendrik Vreman, PhD, a senior research scientist in pediatrics at Stanford and a study author who developed and tested the canopies opined that even on an overcast sky, good light transmission and phototherapy is possible. The clinical trial was carried out in a large inner-city hospital in Lagos, Nigeria where the scientists enrolled 447 infants with jaundice. 224 of the infants were randomly assigned to treatment with filtered sunlight and 223 were treated with conventional phototherapy.
The infants were given at least five hours per day of their assigned treatment, and were evaluated hourly during the span of the treatment for signs of hypothermia, overheating, dehydration and sunburn. The infants who were treated with filtered sunlight were rested in their mother's lap under the canopies. Breastfeeding was allowed while receiving the treatment.
The study revealed that both therapies worked equally well and were equally safe. Filtered sunlight was effective on 93 percent of treatment days, and conventional phototherapy on 90 percent of treatment days. To further their study, the team is now studying greenhouse-like structures that incorporate the filters. Such structures could be used in places which are rainy, windy or colder than Nigeria.
Stevenson, who is a member of the Stanford Child Health Research Institute, said that they were happy and excited about the fact that they could use their understanding of the biology of jaundice and adapt treatment to the local context of a developing country and with the resources available there.