Written by Hannah Harp
Spoon Feed
Pediatricians, midwives, and maternity care assistants in the Netherlands identified benefits of at-home phototherapy, though both knowledge and logistical concerns remain.
Cue the lights!
Neonatal hyperbilirubinemia is common, affecting up to 80% of term babies. 4-8% of term neonates require phototherapy, which prolongs hospital stay, reduces skin-to-skin time, and interrupts breastfeeding. Home phototherapy is available from some hospitals and clinics, allowing term neonates with uncomplicated physiologic jaundice to be discharged along with their mother. This study investigated healthcare professionals’ (HCPs) perspectives on implementing home phototherapy (PT) for neonatal hyperbilirubinemia. Using a cross-sectional survey, responses were collected from 106 HCPs (16 pediatricians, 90 midwives), and 514 community maternity care assistants (MCAs). Key findings included high satisfaction with PT at home, citing benefits from HCPs and MCAs including reduced parental stress (81, 87%) and travel (94, 72%), ability to return home (88, 90%), and increased breastfeeding success (81% MCAs) and bonding (84% MCAs). Challenges with home PT included parental anxiety (52, 46%), adherence with appointments (43, 45%), and compensation concerns (44% HCPs). These insights underscore the importance of guidelines, collaboration, and funding for broader adoption of home PT. The major limitation of this study is that it was performed in the Netherlands, a country with a robust model of in-home postpartum care. In other countries (like the U.S.), home phototherapy is applied by parents, unavailable from many outpatient practices, and is not covered by all insurance.
How will this change my practice?
Hyperbilirubinemia is the most common cause of readmission for my newborn patients. Home phototherapy seems implementable, beneficial to parents and babies, and marketable to administrators and insurance companies, as it reduces hospital days.
Source
Home phototherapy for neonatal hyperbilirubinemia: current practices and attitudes. Pediatr Res. 2024 Dec 13. doi: 10.1038/s41390-024-03754-8. Epub ahead of print. PMID: 39672825
