Influence of Biliblanket Treatment on Admission for Overhead Phototherapy in Term Infants Approaching the Treatment Line - A Randomised Controlled Trial

Purpose: To evaluate if biliblankets prevents the need for overhead phototherapy in neonates with physiological jaundice approaching the treatment line. Methods: Single-centre randomised trial carried out in a tertiary maternity unit. Infants ≥35 weeks gestation and >24 hours of age with suspected physiological jaundice were eligible if serum bilirubin level was within 35µmol/l of the treatment line. Infants admitted to the neonatal unit or with a positive pre-randomisation direct Coombs test were excluded. Infants were randomised to intervention arm (treatment with Biliblanket) or control arm (routine care). Primary outcome was need for overhead phototherapy. Results: Ninety-seven infants were included in an intention-to-treat analysis, 51 in intervention arm and 46 in control arm with no baseline imbalances. Sixteen percent in the intervention group and 15% in the control group required overhead phototherapy (p>0.99) and no difference in length of stay (p=0.6) was observed. More infants in the intervention arm were discharged receiving formula feeds exclusively (p=0.04) despite no difference in feeding intentions. Conclusion: Use of a biliblanket for physiological jaundice approaching the treatment line in well term infants does not decrease need for overhead phototherapy with no difference in length of stay, but a potential for disruption of breastfeeding establishment. Trial Registration: The trial was retrospectively registered (ISRCTN29045982 - https://www.isrctn.com/) on 08/01/2022.