Home phototherapy for neonatal jaundice in the UK: a single-centre retrospective service evaluation and parental survey.

BACKGROUND

In the UK setting, where neonatal jaundice treatment is required, it is largely carried out in hospitals. However, it is possible to safely administer home phototherapy (HPT).

OBJECTIVE

To report on our centre's experience of HPT and its potential benefits.

DESIGN

Retrospective observational study performed as a service evaluation.

PATIENTS

Infants ≥35 weeks corrected gestational age with a weight of 2 kg and serum bilirubin ≤50 µmol/L above treatment thresholds. Controls were a matched group of infants who received inpatient phototherapy (IPT).

SETTING

The catchment area of two neonatal intensive care units, one special care unit and a birth centre at four different hospitals that is covered by a single neonatal community outreach nursing team in Birmingham, UK.

INTERVENTION

HPT was started either in the community or as a continuation of IPT. Controls received IPT.

MAIN OUTCOME MEASURES

The rate of bilirubin reduction, hospital readmission rates and parental satisfaction.

RESULTS

100 infants received HPT while 50 received IPT. No infant showed a progressive rise of serum bilirubin level while receiving HPT. The rate of bilirubin reduction was similar in both HPT and IPT groups (2.4±1.9 and 2.5±1.6 µmol/L/hour, respectively, MD=-0.1, 95% CI -0.74 to 0.53, p=0.74). Readmission rate was 3% in the HPT group. 97% of parents stated that the overall experience was good and 98% would choose HPT if they had their time all over again.

CONCLUSION

Our programme suggests that HPT for neonatal jaundice can be carried out in a select group of infants. It helps in providing holistic family-centred care and is viewed positively by families.