Treating Newborn Jaundice Without an Overnight Stay: What a New Study Found

A plain-language look at a 2026 clinical trial (Ong and colleagues, European Journal of Pediatrics) testing a shorter, daytime-only light treatment for jaundiced babies

A new study suggests that some newborns with mild jaundice may not need to stay in the hospital overnight under the lights. Researchers found that a shorter, 10-hour daytime course of light therapy worked about as well as the usual round-the-clock treatment for carefully chosen low-risk babies, with no baby needing extra treatment, a blood transfusion, or readmission. If confirmed by larger studies, this "daycare" approach could let more mothers and babies stay together while jaundice is treated.

Why Jaundice Matters, and What Families Have Faced

Jaundice — a yellow tint to a newborn's skin and eyes — is one of the most common things doctors watch for in the first days of life. It happens when a natural substance called bilirubin, made as the body recycles old red blood cells, builds up faster than a newborn's still-immature liver can clear it. Most jaundice is harmless and fades on its own. But if bilirubin climbs very high, it can cross into the brain and cause lasting harm, a rare but serious condition doctors work hard to prevent [1]. That risk is the reason jaundice is taken seriously even when a baby looks well.

For more than fifty years, the main treatment has been phototherapy: placing the baby under special blue lights. The light changes the shape of the bilirubin in the skin so the body can wash it out easily, without waiting for the liver to catch up [2]. It is safe and effective, and it has made the older, riskier treatment — exchanging the baby's blood — very rare. Doctors decide when to start phototherapy using well-established charts that account for the baby's age in hours and other risk factors [3].

Here is the catch that families know all too well. Traditionally, the lights stay on continuously, and the baby stays in the hospital until the bilirubin drops to a safe level. That often means an overnight admission, a mother and baby separated at the very moment breastfeeding is being established, and the stress and cost that come with a hospital stay. For decades, doctors have wondered whether the lights really need to be on non-stop. The question goes back a long way — researchers were already comparing "on-and-off" schedules with continuous treatment in 1973 [4]. Since then, reviews that pooled many studies together have generally found that giving the light in breaks works about as well as giving it continuously [5] [6]. What no one had tested was a specific schedule short enough to fit into a single day — the kind of schedule that could let a baby go home to sleep.

What the Researchers Did

A team in Malaysia set out to test exactly that idea. At a single teaching hospital in the northeast of the country, between July 2024 and March 2025, they ran what is called a randomized controlled trial — the gold standard for comparing treatments, in which a computer, not the doctor or family, decides which treatment each baby receives, so the comparison is fair [7]. They registered their plan publicly before starting, which is a mark of a well-run study.

They were careful about which babies could join. Only full-term, healthy-weight newborns (born after 38 weeks and weighing more than 2.5 kg), between one day and two weeks old, with jaundice that was only modestly above the treatment line, were included. Babies with conditions that make jaundice more dangerous or more likely to bounce back — such as blood-type incompatibility between mother and baby, a common enzyme deficiency called G6PD deficiency, infection, or certain syndromes — were deliberately left out. This matters: the study was testing the idea only in babies at low risk.

Seventy-four babies took part. Half (37) received the new schedule: 10 hours of light, then a 14-hour break. As a safety step, the team drew a small blood sample six hours after the lights were switched off to make sure the bilirubin was not climbing; any baby whose level rose too high would be taken out of the study and given standard care. The other half (37) received the usual 24 hours of continuous light. Both groups used the same lights and the same feeding and nursing routine, and everyone's bilirubin was measured at the start and again at 24 hours.

What They Found

The two approaches came out remarkably close. Bilirubin fell at nearly the same speed in both groups, and the small difference was well within the range you would expect by chance [7]. At the 24-hour mark, babies in the short-treatment group had a slightly higher average bilirubin level than those treated continuously. On paper that difference was "statistically significant," but the doctors judged it unimportant in practice — and the reason is the part that matters most to parents: not a single baby in either group needed the lights turned back on, needed a blood transfusion, or had to come back to the hospital. A few babies in the short-treatment group had small rises in bilirubin afterward, a well-known and usually harmless "rebound" that can happen when the lights come off while a newborn's liver is still maturing [8]. None of them needed more treatment.

In short: for these carefully chosen, low-risk babies, 10 hours of daytime light did the job as reliably as a full day and night of it.

What This Could Mean for Families

The appeal of a "daycare" approach is easy to see. It could mean treating jaundice during the day and letting the family go home together at night, protecting the early days of bonding and breastfeeding that a hospital stay so often interrupts. That benefit is not just a hunch — a separate trial of home phototherapy found that treating babies at home improved parents' bonding with their baby and lowered their stress compared with staying in hospital [9].

It is important to be clear-eyed, though. The safety of a shorter or out-of-hospital approach depends far more on careful follow-up than on the lights themselves. A major review of home versus hospital phototherapy found the approach workable for the right babies, but stressed that it only stays safe with reliable monitoring and a plan to check back in [10], and studies of home treatment have reached the same conclusion when families are chosen carefully [11]. In this trial, the protection came from the scheduled blood check after the lights went off and from clear rules about when to restart treatment. Any real-world daycare program would need to keep both. And parents should know that if a baby's bilirubin does climb, the answer is simple and safe: the treatment is just started again.

How Sure Can We Be, and What Comes Next

This was a small, first-of-its-kind study at a single hospital, so it should be read as a promising start rather than the final word. The authors themselves point out a wrinkle: even after fair, computer-based assignment, the short-treatment group happened to be a little older and a little more jaundiced at the outset, which makes the comparison less than perfect. The good news is that the finding fits comfortably with a large body of earlier research showing that giving phototherapy in breaks works about as well as giving it continuously [12] [13].

What researchers are working on next is the bigger, more definitive study this one calls for: a trial across many hospitals, with enough babies to be confident, and with follow-up long enough to catch any late rebound or return visits. They will also want to measure the things a daycare model is really meant to improve — cost, breastfeeding success, and how families actually experience it. There is even room to make the daytime session shorter still, since brighter or double-sided light setups clear bilirubin faster [14]. For now, families of low-risk jaundiced newborns can take encouragement from this study, and can reasonably ask their care team whether a shorter, more family-friendly schedule might be an option — always alongside the follow-up checks that keep it safe.

References

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  3. Bhutani VK, Wong RJ, Turkewitz D, Rauch DA, Mowitz ME, Barfield WD. Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation: technical report. Pediatrics. 2024;154(3):e2024068026. doi:10.1542/peds.2024-068026 ↩
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  9. Pettersson M, Eriksson M, Odlind A, Ohlin A. Home phototherapy of term neonates improves parental bonding and stress: findings from a randomised controlled trial. Acta Paediatr. 2022;111(4):760–766. doi:10.1111/apa.16231 ↩
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