Seminars in perinatology
September 26, 2026 · via Europe PMC
Identifying best practices for global standardization of home phototherapy for neonatal hyperbilirubinemia: An international comparative study.
Spaan J, Hulzebos CV, Been JV, Ohlin A, Cummings E, Pettersson M, Thomas M.
AI summary — for doctors, generated from the abstract only
Home phototherapy protocols across Australia, the Netherlands and Sweden agreed on daily bilirubin monitoring and structured parental education but varied widely in eligibility, care models and escalation criteria.
What was studied
A cross-country comparative study of 20 national and local home phototherapy protocols (6 Australian, 6 Dutch, 8 Swedish) collected through public resources and professional networks, with data extracted on patient selection, parental education, logistics and care delivery models, and safety.
Key findings
- 20 protocols included from three countries
- Eligible neonates were generally required to be 36 weeks' gestation or more, 48 hours postnatal age or more, clinically well, with total serum bilirubin well below exchange transfusion thresholds and no evidence of haemolysis
- Care delivery models varied across midwifery-led, nurse-led and hospital-led approaches
- Escalation criteria were present in only 5 (25%) protocols and inconsistently defined
- All protocols emphasised structured parental education by qualified nurses and recommended daily bilirubin monitoring
Clinical relevance
This offers a practical reference for units developing home phototherapy pathways, with the notable gap that three-quarters of existing protocols lack defined escalation criteria, which is arguably the most safety-critical element of home treatment.
Who should care
Limitations
Document review limited to three high-income countries with protocols obtained opportunistically through public resources and professional networks, with no outcome or safety data from actual home phototherapy practice.
The consensus on home phototherapy is daily bilirubin checks and parent education, while most protocols alarmingly fail to specify when to escalate.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To identify insights from home phototherapy protocols for neonatal hyperbilirubinemia in Australia, the Netherlands, and Sweden, and to inform future efforts toward standardizing a curriculum and implementation framework.
Methods
We performed a cross-country comparative study of national and local guidelines and protocols on home phototherapy. Documents were collected through publicly available resources and professional networks. Data were extracted on four domains: patient selection and eligibility criteria, parental education, logistics and care delivery models, and safety aspects.
Results
Twenty protocols were included: six from Australia, six from the Netherland, and eight from Sweden. While variation in eligibility criteria for home phototherapy was observed across protocols. Eligible neonates were generally required to be ≥36 weeks' gestation, ≥48 h postnatal age, clinically well, with total serum bilirubin (TSB) well below exchange transfusion thresholds, and without evidence of hemolysis. Care delivery models varied, across midwifery-led, nurse-led, and hospital-led approaches. Escalation criteria were present in five (25%) protocols and inconsistently defined. All protocols emphasized structured parental education delivered by qualified nurses and recommended daily TSB monitoring.
Conclusion
Home phototherapy protocols demonstrate consistent emphasis on TSB monitoring and parental education, with more variation in eligibility, care delivery models and escalation criteria. A Delphi consensus study is recommended to address observed variability and to inform the development of a globally applicable framework for different healthcare systems.
DOI
10.1016/j.semperi.2026.152305
PMID
42800788
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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