use of diapers during phototherapy

[al.ghada68]

we are not allowed to use diapers in our unit when the baby is under phototherapy, to expose larger surface area. we only cover the male genitalia with a folded gauze and place a urine plastic bag underneath.

a new nurse came from another hospital and she was saying that they use diapers with no problems. i was wondering that diapers will almost cover half the tiny baby's body.

what is the preferable practice during phototherapy? should we put diaper or not? i work in a third world country so i'm not sure if our policy is valid regarding this.

[Kidrn911]

Always used diapers with no problem

[boardchic]

We always use diapers and still get good results. I fold the top of the diaper under (in front and back) to expose more skin.

[GrowingBabies]

I use the diaper on larger babies and fold it down to expose more skin. We also have snugglys that are made to use with phototherapy, very nice developmental tool! For a micro preemie that doesn't move much, or a sedated baby, I will often leave the diaper just underneath the baby, not close the front, and drape genitalia with a 2x2.

[Nurse Connie]

We always use diapers too.

[prmenrs, RN]

W/term babies, sometimes babies being treated w/phototherapy lights have copious, loose stools. If you leave the diaper completely off, you'll be cleaning that incubator for a really long time. I'd suggest using a diaper, folded down so only the 'messy' parts are contained. Below the umbi in front, around the sacrum in back, fastened tightly.

Expose the skin, but don't make more work for yourself. jmho

[katierobin23]

Even on the worst kid I've seen under bili lights, we use diapers. I have seen a term baby in a tiny preemie XS diaper to expose the most skin possible, but never naked. That kid was the exception (came very close to needing an exchange transfusion, was on a bili blanket and under 4 bili lights), most babies are in an appropriately sized diaper, just folded down...their levels come down just fine :)

[laynaER]

We use diapers as well. I always fold the diaper down when the baby is prone to expose more skin! Voila! The levels drop everyday. Does anyone have a protocol for irradiance and what the target is for single, double, and triple?

[Bortaz, MSN, RN]

We use diapers. I've also been known to make a thong for a baby, made out of a mask. Covers the bits but leaves a lot of skin exposed.

My problem is trying to get nimrods to understand that the reason their pt's bili went UP while on a bili bed is that they had the bed covered with a frigging pillow case.

"But Bortaz! I don't like laying the bebe on the bare mat!"

[SteveNNP, MSN, NP]

Everywhere I've worked we leave the diaper on, just pull it down so as much skin is exposed as possible. IMHO if bilis are meant to come down they will, with or without diapers on. Those kids who get exchanged have so much ongoing hemolysis no amount of lights would've save them I think.

[NICURN29]

We also use diapers. We use the Pampers preemie-sized diapers on term babies, and on our preemies, we use the tiny micropreemie diapers and fold and sometimes trim them to allow for maximum skin exposure. We have good success with doing it this way.

[kerussll]

We always use diapers too. Just try to fold the extra cloth down, and plenty of skin is exposed.