Sophie Backus was able to take her son Kodi home while he was being treated for jaundice. Photo: Claire Fenwicke.
Sophie Backus’ experiences when two of her children were diagnosed with jaundice are chalk and cheese.
Her middle son developed severe jaundice a week after he was born. Mum and baby needed to stay in the special care nursery (SCN) for three days while he received treatment.
“It was a bit daunting because being in hospital you’re in a chair, watching the baby in the blue light,” Ms Backus said.
“It was hard to breastfeed and be there for my family as well.”
But when her third child, Kodi, developed jaundice, a donation from the Newborn Intensive Care Foundation (NICF) meant he could receive his treatment at home – thanks to a portable device known as a BiliCocoon.
The sleeping bag design allows the baby to continuously be swaddled in phototherapy light.
Ms Backus described this experience as “amazing”.
“We came in, everyone explained what we had to do, went home and it was easy to set up,” she said.
“I could be there for my other two children and my husband, and that experience was far better, far better.”
Jaundice is a condition where a baby’s levels of bilirubin (which comes from the breakdown of red blood cells) are high and results in a yellow colouration of the skin and sometimes the eyes.
About 60 per cent of babies, and 80 per cent of premature babies, will contract jaundice.
CHS staff specialist neonatologist Dr Nadia Schmidt said the condition occurred because the baby’s liver and metabolism weren’t mature enough to process the bilirubin.
“The usual progress is that the bilirubin goes up and then, in the first two weeks of life, the system and the feeding will help that elimination of extra bilirubin,” she said.
“[But] there is a level considered high or risky because the bilirubin can produce neurological consequences … so that’s what we want to avoid.”
It’s diagnosed through a heel prick test.
Phototherapy light creates a photochemical reaction which makes the bilirubin water soluble, meaning it can be eliminated through bodily waste.
Kodi accessed the therapy as part of Canberra Health Service’s Home Phototherapy Program.
Dr Schmidt said the BiliCocoon process used the same intensity of light as the overhead lights in the neonatal intensive care unit (NICU) or SCN, but she felt it was even more effective.
“If the baby is unsettled [under the lights], the parents will take the baby to have a cuddle … and babies need a feed every two or three hours, for half an hour or 20 minutes, so that [interrupts] the treatment,” she said.
“The BiliCocoon is very friendly from the breastfeeding point of view and the baby is inside this sleeping bag, so the treatment is not interrupted, it’s continuous.”
Five-week-old Kodi (now too large for the BiliCocoon) demonstrates how the portable phototherapy sleeping bag is used. Photo: Claire Fenwicke.
BiliCocoons aren’t used in NICU or SCN wards because those babies usually need more intensive care. An exclusion checklist ensures it’s appropriate for a baby to be sent home with the treatment rather than be admitted.
But SCN clinical nurse manager Elyse Honeybone said it allowed for more babies to be looked after in the hospital.
“We’ve got babies that do need a bit of treatment but don’t need admission, so it’s a game changer,” she said.
“They’re babies that would generally need to be admitted either to special care, post-natal or sometimes pediatrics, and they’re all busy areas with a significant patient flow.
“It’s been wonderful to be able to have those babies at home and not have to come into the hospital system.”
It also means a baby needing jaundice treatment while the mother is recovering in the postnatal ward doesn’t necessarily have to be separated.
Home Visiting Program midwife Carol Peden, who helps administer the program, said midwives visited the mother’s home each day she had the BiliCocoon to track the baby’s bilirubin levels and make sure everything was working smoothly.
“I think overall it’s a very positive experience for the mum because it’s a simple setup. It’s a simple machine to use, there’s an on-off button and that’s really it,” she said.
“Babies tend to be also more settled because when they’re under overhead lights, they’ve usually got no clothes on and eye masks and nappies just lying there, whereas these little cocoons are more snuggly.”
Canberra Hospital has three BiliCocoons, including one to be used to transport babies needing treatment from other jurisdictions including Wagga Wagga and the South Coast.
NICF founder Peter Cursley said it was the next step in supporting the important unit as the foundation prepared to mark 30 years.
“We’ve approved the funding of Angel Eye, which is the little cameras above the cots … and we’re also funding Sam, which is a baby mannequin that allows doctors to practise ultrasound,” he said.
“I actually lose track of how much things are and how many we’ve supplied, but we’ve been really lucky in that the community has got right behind us.”
