Phototherapy using filtered sunlight.

Abstract

Most severe neonatal hyperbilirubinaemia occurs in poor countries where access to phototherapy is limited by cost or electricity supply. A US research group has previously shown that sunlight filtered through films like those used to tint car windows is safe and effective at reducing serum bilirubin levels.1 The same group performed a randomised controlled trial in a single maternity centre in Nigeria, which compared filtered sunlight with conventional phototherapy in 447 term and late per-term infants.2 Filtered sunlight had a significantly higher mean level of irradiance (40 vs 17 μW/cm2/nanometre, P < 0.001) and was as effective as conventional phototherapy in reducing bilirubin. Filtered sunlight was associated with fever >38 °C (5% vs 1%, P < 0.001) but no infant needed withdrawal from the study for safety reasons. No infants needed exchange transfusion. The proportion of jaundice due to haemolysis was unknown and no babies had severe bilirubinaemia (serum bilirubin >15 mmol/dL or 256 µmol/L), so future studies will need to address whether or not filtered sunlight is effective in infants with severe bilirubinaemia. Reviewers: David Isaacs, david.isaacs@health.nsw.gov.au, Children's Hospital at Westmead, Sydney