New Westmead Hospital research finds newborn babies with jaundice can be safely treated with at-home service

Westmead Hospital in Western Sydney Local Health District (WSLHD) has conducted research which finds newborn babies with jaundice can be safely and effectively treated at home.

This allows babies to remain with their mothers and family instead of being readmitted to hospital.

Associate Professor Terry McGee, Senior Staff Specialist in Obstetrics and Gynaecology at Westmead Hospital, and one of the key researchers involved in the study, explained the significance of the findings saying, “Our study describes a uniquely holistic model of care, where the surveillance and management of jaundice is part of the overall midwifery-led home care for women and newborn babies in the early weeks after birth.

The model not only ensures the safety of infants but usually also allows those with jaundice to remain at home with their mothers.”

Jaundice is a common condition among newborns, characterised by the yellowing of the skin and eyes due to elevated bilirubin levels.

While mild jaundice often resolves on its own, high levels of bilirubin can lead to severe complications, including lifelong brain damage.

Therefore, it is crucial to closely monitor newborns in their first week of life, with a small percentage requiring phototherapy treatment to reduce bilirubin levels to safe levels.

Traditionally, hospitals have delayed discharge for several days to observe for jaundice.

In addition, infants developing significant jaundice at home were almost always readmitted for treatment, resulting in separation from their mothers during the critical early weeks of life.

Delayed discharge and/or readmission are still routine in many hospitals at Westmead Hospital however, safe early discharge is possible with midwives undertaking jaundice surveillance and treatment at home as part of a routine early postnatal care for mothers and babies.

The research, which involved over 4300 mother and baby pairs born in 2019, demonstrated that the midwifery-at-home model was both safe and cost-effective for jaundice care.

“Our findings were that no baby suffered any jaundice harm, most babies needing phototherapy were able to have it at home, and both home phototherapy and the entire midwifery at home model of care were highly cost-effective,” A/Prof McGee revealed.

Providing up to two weeks’ midwifery-at-home care and jaundice surveillance over one year for about 4300 mothers and baby pairs was approximately two million dollars cheaper than keeping them in hospital for two additional days ($6.6million AUD compared to $8.6million AUD).

For newborns needing phototherapy, home phototherapy cost $640 a day, compared to $2100 a day for readmission phototherapy. 

The advantages of home jaundice surveillance and treatment are multifaceted.

It not only ensures the well-being of newborns but also allows them to remain in the care of their mothers, promoting successful breastfeeding, bonding and emotional support.

Moreover, this model positively impacts fathers, other family members, and the community as a whole.

“We hope our study will encourage the adoption of this model by other maternity services globally,” expressed A/Prof McGee.

Westmead Hospital has been providing routine midwifery-at-home care for up to 2 weeks after discharge for about three decades.

Home phototherapy has been offered as part of this model since 2006.

Based on the lack of similar studies, it would appear that the Westmead Hospital midwifery-at-home service, with its large size and comprehensive range of services, including home phototherapy, is currently unique.

However, the researchers believe that the success of their study will inspire other healthcare providers to implement similar programs, benefiting countless newborns and their families worldwide.

Read the published paper here