Neonatus supplies a hand-held Jaundice Meter that uses dual-wavelength 450 nm and 550 nm reflectance photometry to measure the yellow colouration of the subcutaneous tissue, correlating it with serum bilirubin concentration. The device is applied to the infant’s sternum the recommended site for all ethnicities with a gentle press-to-measure button; a reading in µmol/L or mg/dL is displayed within 2 seconds. The meter’s algorithm corrects for melanin content and haemoglobin level, validated to provide a TcB within plus or minus 25 µmol/L of the serum total bilirubin at levels up to 300 µmol/L.

Every infant in the well-baby nursery receives a TcB measurement at 24 and 48 hours of age, timed with the routine newborn examination. The reading is automatically transferred via Bluetooth to the nursery’s electronic health record, where it is plotted on an hour-specific nomogram Bhutani or equivalent. The nomogram demarcates three zones: low risk below the 40th percentile, intermediate-low 40th-75th, intermediate-high 75th-95th, and high risk greater than 95th. Any infant with a TcB in the high-risk zone triggers an immediate order for serum bilirubin confirmation and initiation of phototherapy.

Technical Note: The Jaundice Meter’s calibration must be checked daily using the supplied white reference disc; a reading that deviates by more than 10 µmol/L from the disc’s labelled value requires factory recalibration. TcB should not be measured on a site that is bruised, stained with meconium, or has been exposed to phototherapy light; these factors produce artefactually lower readings.

For infants requiring phototherapy, Neonatus deploys the Blue Light Therapy unit – an overhead LED array emitting narrow-band blue light with a peak wavelength of 458 plus or minus 10 nm and a spectral irradiance of 30 µW/cm²/nm at the mattress surface, measured with a calibrated radiometer. The LED array is mounted on an articulated arm that positions the light source 30 cm above the infant. A flexible fibre-optic blanket biliblanket is available for double-sided phototherapy, delivering an additional 20 µW/cm²/nm from below, doubling the rate of bilirubin photoisomerisation.

As soon as the decision to start phototherapy is made, the nurse places the infant in a diaper only, ensures eye shields are securely fitted checking for skin pressure every 2 hours, and activates the light. The infant’s axillary temperature is monitored every 30 minutes for the first 2 hours, as the LED array can increase skin temperature by up to 1.0 °C. The phototherapy unit logs the cumulative treatment time and outputs a digital dose delivered in J/cm², facilitating documentation. For infants receiving double phototherapy, a separate temperature probe on the fibre-optic blanket ensures the contact surface temperature does not exceed 38 °C.

Technical Note: The LED array’s spectral output must be verified quarterly with a spectroradiometer; individual LED failure is difficult to detect by eye, and a 10% loss of array irradiance lengthens the phototherapy duration by 12 hours. Eye shields must be removed during feeds and the eyes inspected for pressure marks; a correctly fitted shield should allow full eyelid closure.

Neonatus integrates the Jaundice Meter with the phototherapy unit’s software. After 6 hours of phototherapy, a TcB measurement is taken from a shielded skin site a small adhesive patch on the hip that blocks phototherapy light. The system calculates the rate of bilirubin decline in µmol/L per hour and projects whether the current therapy is sufficient to bring the infant below the treatment threshold within the expected timeframe 24-48 hours. If the decline is less than 6 µmol/L/hour, the system suggests checking the eye shields, verifying the light distance, and considering intensification to double phototherapy.

Once the TcB falls below the treatment threshold, the infant enters a weaning period: single phototherapy is continued for a further 12 hours, and a rebound TcB is measured 12 hours after cessation. If the rebound remains below the phototherapy threshold, the infant is cleared for discharge with a follow-up appointment for a serum bilirubin check in 24-48 hours, depending on gestational age and risk factors. If the rebound exceeds the threshold, phototherapy is resumed, and a diagnostic workup for haemolysis is initiated direct Coombs, G6PD, blood film.

Technical Note: The shielded skin patch must be applied before phototherapy starts; a patch applied mid-treatment underestimates TcB by up to 50 µmol/L because the underlying skin has already been partially photobleached. The patch site is rotated every 24 hours to prevent skin maceration.

Neonatus’s jaundice management software generates a structured report for every infant, including the hour-specific TcB values plotted on the nomogram, the time of phototherapy initiation, total phototherapy hours, the dose delivered, the rate of bilirubin decline, and the rebound result. The report is automatically uploaded to the hospital’s electronic medical record and printed as a parent handout explaining the condition and follow-up plan.

The software’s population dashboard tracks the percentage of infants who require phototherapy, the mean age at initiation, the rate of exchange transfusion, and the readmission rate for phototherapy within 72 hours of discharge. These metrics are reviewed at the monthly neonatal quality meeting. Any case of bilirubin-induced neurological dysfunction BIND score greater than 2 or a serum bilirubin that exceeded 425 µmol/L before treatment triggers a root-cause analysis with mandatory case review.

Technical Note: The phototherapy unit logs treatment interruptions for example for feeding, parental holding and deducts this time from the total delivered dose; cumulative interruptions exceeding 60 minutes per 12-hour period significantly reduce treatment efficacy and should be reviewed with the nursing team.

Neonatus embeds the Jaundice Meter into the universal newborn discharge checklist. Every infant, at the time of discharge, receives a final TcB measurement, and the result is plotted on the nomogram together with the gestational age and postnatal age. If the TcB is below the phototherapy threshold, a discharge Jaundice Action Plan is printed: a parent education leaflet covering the signs of worsening jaundice lethargy, poor feeding, high-pitched cry, dark urine, a follow-up serum bilirubin appointment within 48 hours for any infant with risk factors ABO incompatibility, cephalohaematoma, exclusive breastfeeding with greater than 7% weight loss, and a 24-hour telephone hotline number.

The jaundice management software automatically schedules and confirms the follow-up appointment via SMS to the parent’s mobile phone. If the parent fails to attend the appointment, an alert is sent to the community midwifery team for a home visit within 4 hours. Compliance with follow-up is tracked as a key quality indicator.

Technical Note: The parent leaflet must be available in the family’s preferred language, and the visual colour scale showing the progression of jaundice from the face to the trunk and extremities must be printed on high-quality colour-fast paper. Photocopied leaflets with poor colour fidelity may cause parents to miss the onset of advancing jaundice.