PHOTORX

Lamola recommends the changes we need if we want to provide effective PT and improve outcomes [14]. They are as follows: ‘(i) Use photons as a drug when prescribing phototherapy (ii) use a narrow-spectrum blue light (450 nm) (iii) measure irradiance for specific wavelength and (iv) use the least irradiance dose to achieve an efficient decrease in bilirubin load’. I would add one other recommendation to these ‘best practices’ and that is to use phototherapy for the shortest possible time. However we plan to use it, and we should apply the same therapeutic rigour to the use of phototherapy as we do to the use of a pharmacologic agent in the newborn which simply means using the lowest effective dose for as shorter time as possible. Finally, as noted by Stevenson [9], we should consider a ‘nonphototherapy’ option for the treatment of hyperbilirubinaemia in ELBW infants [22].

Ancil