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