Three years ago, I had the privilege of holding the most precious and fragile gift I ever held, my newborn daughter whom we now dearly call ‘Anu’. Being the engineers we are, Bharath and I had made a custom hammock for her. The first 2 days were straight from a happy movie. Everything seemed just perfect. Within the next couple of days though, Anu started to become weak. By the 7th day, she looked very sluggish and very very yellow. It was not something that we had no idea of; My family is full of doctors and we knew that neo-natal jaundice is a very common occurrence. What we did not know was the slope of the precipice. Between the 6th and 7th day, Anu deteriorated to the point of not waking up for feeds. Neo-natal jaundice can at times set up a vicious cycle of low feeding and hence further worsening of the jaundice. The result was a 3 day hospitalization that was the lowest point in our lives. From the comforts of the custom-hammock that we had built with so much love, Anu was now shifted to a bed made of a glass bottom and a single layer of bubble wrap. Her blue-light treatment had begun.
I am not going to talk much about neo-natal jaundice itself. There are a zillion articles on the web already. I am going to talk about preventing it and my personal experience of fighting it with my second child.
The first mistake is to listen to the grandmas. Don’t get me wrong here. Grandmas are great! They are right 99% percent of the time. But, times have changed. For whatever reason, neo-natal jaundice is a bigger problem now than it was. Neo-natal jaundice is supposed to naturally disappear through the passing of stools. More milk means more stools and hence better recovery. But not everything is straight forward; The gut bacteria ecosystem (gut biome) that helps in this process of cleanup may not form efficiently. No one knows what exactly causes this issue, but our modern lifestyle may have something do with it. When our grandmas say that mother’s milk should be the only milk given to the baby, they may be wrong. They are remembering their experiences from a time when things were probably better. Breast milk consumption is not easily measured. The baby may not feeding well. Even if it is feeding well, the rate of removal of bile may not be sufficient. Top feeding for the first 10-15 days significantly improves the removal rate of bile. But top-feeding has it’s own risks. One careless feed, and your baby is going to have a terrible tummy. One cannot be paranoid enough about maintaining hygiene.
Neo-natal jaundice is measured using the bilirubin count. The total count is a sum of two counts – Direct and Indirect. Neo-natal jaundice is a physiological jaundice and this results into a higher indirect bilirubin count. The direct count usually remains within safe limits. If the direct count is higher, the issue may be a different one and the details of other types of neo-natal jaundice are not covered here. If the indirect count goes beyond 15, it is a sign of concern. A value beyond 20 usually means hospitalization with blue-light treatment. The serendipitous discovery of this treatment is its quite remarkable.
There are several logistical issues with blue-light treatment. The first one is that it involves hospitalization. Specially, in a CSec, a re-hospitalization when the mother is barely recovering is extremely painful. Moreover, making sure that the baby’s eyes are not exposed is a big task that requires someone to watch-over 24×7. Many hospitals do not allow any help other than the mother and the father to accompany the baby. The already over-stressed parents are further pushed.
Fortunately, their are some options for home treatment available these days (Not common in India though). The Biliblanket is one such comfortable option –
Given the dreaded experience with our first child’s treatment, I was not going to take any chances with the second (there is a family history of all neonates suffering from jaundice). Due to the non-availability of easy home treatment options in India, I decided to make one in advance. Turns out that making one is quite simple, but making sure of the safety requires a reasonable knowledge of electronics, optics and a lot of common-sense.
The first step was to study the irradiance limits. I found some online publications and also read specs of existing medical products. This one gives a good comparative study. I got some Phillips blue LEDs from the Phillips Lighting Store, but it was important to make sure that they do not emit UV. The LEDs claimed they did not emit UV, but we did not want to take chances. We have many kids toys that are phosphorescent when exposed to UV, so the verification was pretty straightforward.
As per the specs and irradiance calculations, 5 LED modules were needed to get to about half the dosage of a standard medical device used in the hospitals. The 5 modules were connected in series to make sure the same current flows through all of them. The next step was to get a suitable power source. I bought an adjustible boost converter from here and wired it to a regular USB power bank. For making sure the power is monitored and within limits, I used a USB power meter that is readily available here. The boost converter’s voltage was adjusted till the USB power meter read 2A@5V.
Since we had made a cradle for our baby (which also happens to be our start-up), rigging up everything to the cradle was easy.
Blue light is particularly harmful to neonates’ eyes and genitals. Adequate safety precautions were an absolute must. Diapers are sufficient for protecting genitals. We got an eye protection band meant for the purpose from a local medical store.
We still lacked one critical thing! We did not have a way of measuring bilirubin. We got the permission of a doctor to monitor bilirubin levels on a daily basis using a non-invasive transcutaneous bilirubinometer that was available at the hospital we used to consult with.
The ends results were great! With about 5 days of moderate treatment as per our conveniences, Samyak was out of Jaundice while sleeping cozily in a hammock with music and swinging to sooth him. About 10 hrs of advanced preparation saved us 72 hrs of agony we would otherwise have had to go through.
This is how the baby would see the lights from the cradle (if he were allowed to).