Thanks for that information Lois, My understanding was that we needed 620
NM of light waves for effectiveness. Johnson says " exposing the baby's
skin to sunlight".. does this mean direct through the glass or indirect
through the glass or direct sunshine or indirect near the window? As you
say, it is very difficult to quantify the number of nanometers in the various
seasons in Australia. I also wonder if we haven't been seduced into
being a bit paranoid about jaundice? What is the range of nanometers of
the bililights that are currently used for treatment? When I was
researching it for my research proposal, the research seemed to be going away
from the causes of jaundice and the simple solutions, into the area of drug
control of SBRs. That area doesn't seem to have taken off and I
wonder what the latest research says? MM
----- Original Message -----
Sent: Saturday, July 12, 2003 12:56
PM
Subject: Re: [ozmidwifery] Sun
baths
Hi again - interesting to get info related to the
northern hemisphere.. (thanks Debbie and Marilyn), compared to
Australia.
I revisited my text books before
posting my bit on ozmid about natural light for treating physiological
jaundice - just to check my facts. The use of natural light this way
is mentioned in PGB. Johnston's book "The Newborn Child" (my text from
my mid studies) pp181,and 187. Johnson states "exposing the baby's
skin to sunlight effectively reduces the bilirubin level but is
impractical for treatment in the UK."
Regarding the specific lighting requirement -
"exposing the skin to blue light of wavelength 400-500 nm and in an
intensity of 4-10 microwatts/cm2 converts the bilirubin in the
superficial capillaries to harmless water soluble metabolites which are
then excreted in the urine and bowel". I don't know how to
quantify/measure the nm's of natural daylight in various states or seasons
in Australia, however I don't think it's necessary. The value of
exposure to INDIRECT 'white' daylight in a well lit room
to convert unconjugated bilirubin into conjugated water soluble
bilirubin for excretion is well documented. Exposure of the head and
shoulders, maybe chest in a temperature-controlled environment is
usually sufficient to stimulate the process, in combination with frequent
feeding.
Home and hospital rooms vary in how much light they
get, but often it's only a matter of rearranging where the baby is located
in the room which makes the difference. I'm sure there are hospital
midwives out there who encourage women to put their baby's cot on the
opposite side of the bed just to take advantage of the natural light in the
room to minimise or treat physiological jaundice the natural way, just as I
did when I worked in the hospitals. Attention to this type
of early treatment will save many babies from the
heel pricks for SBR collections ('just to check'), and possibly from
separation and Mothers' associated anxiety, interuptions to feedings and so
on related to artificial phototherapy. Just my two
bob's worth! Cheers, Lois
----- Original Message -----
Sent: Saturday, July 12, 2003 2:37
PM
Subject: [ozmidwifery] Sun
baths
Lois wrote:
Hi Tina, my understanding is
that normal bright 'white' daylight in a well lit room is adequate to
facilitate the conversion of bilirubin in it's fat soluble form stored in
the tissue, to the water soluble form, which is then returned to the
bloodstream for processing through the GI system for
excretion.
I was always told just to put babies in a well-lit
room (and this was in the lukewarm sunlight of the northern hemisphere -
London to be exact).
This is just from a mother's
perspective.
Debbie
Slater
