No needles: new jaundice screening for preemies promises a smoother start in life | Science| In-depth reporting on science and technology | DW | 26.11.2013
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No needles: new jaundice screening for preemies promises a smoother start in life

At medica - the world's largest medical trade fair, held in Dusseldorf - a new device has been unveiled that could help the smallest of babies make it through their first weeks.

Some newborns weigh just 1.5 to 2.5 pounds (800 to 1,000 grams): premature babies, or preemies, that have arrived to the world far too early. Some are so tiny that they fit into the palm of an adult hand.

A preterm birth is defined as one that takes place within the first 37 weeks of pregnancy, when most babies weigh less than 5.5 pounds (2,500 grams).

Baby Frieda from Fulda, Germany - the youngest premature baby in Europe - made headlines in November 2010 when she tipped the scales at just over 1 pound (460 grams).

Jaundice more common among preemies

Within the first few hours after birth, about 60 percent of all babies develop jaundice, a yellow coloration of the skin or eyes caused by bilirubin. Bilirubin is a by-product created when the baby's body replaces old blood cells with new ones.

If there's too much bilirubin in the blood, the baby turns a yellowish color and is diagnosed with jaundice.

Healthy newborns typically overcome jaundice on their own, and within a few days, as their livers break down the excess bilirubin, and excrete it in stool.

A mother holds her newborn baby who's eyes are covered to prevent damage from ultraviolet rays while the baby recieves treatment for jaundice (Photo: Graeme Robertson/Getty Images)

Ultraviolet light therapy is required in extreme cases of hyperbilirubinemia

But when the underdeveloped livers of preemies aren't able to handle this natural process, excessive bilirubin can build in the blood. The condition is known as hyperbilirubinemia. And if the bilirubin-rich blood crosses the blood-brain barrier, it can cause real damage.

"It can lead to limited mobility, or to reduced sight or hearing," explains Welsh neonatal doctor Arun Ramachandran, "and in the worst cases to kernicterus, a form of severe damage to the central nervous system."

Since around 80 percent of preemies get jaundice, they are at greater risk of this condition and require extra monitoring, in addition to other special care.

Typically, the baby's blood is tested through a heel prick - but such draws should be avoided, as even small injuries can affect a preemie's development.

Now, an alternative may become widely available.

Avoiding the prick

The alternative involves a transcutaneous method - one that measures the yellowness of the blood without breaking the skin.

Although such a device has been on the market for some time now, a more sophisticated model has been developed especially for preemies - the JM-105.

Inken Schröter, a product manager at Dräger - the company that developed the device - says its advantages include reduced pain for the newborn and less work for the hospital.

"The device quickly and easily determines bilirubin levels, reducing unnecessary blood draws," Schröter says.

Woman using JM-105 on baby doll in incubator at medica 2013 (Photo: Messe Duesseldorf / ctillmann)

The JM-105 was unveiled at medica 2013

The device itself resembles an oversized digital thermometer.

It's placed against the forehead or breastbone of the little patient, providing an instant measurement that bypasses the blood labs. It can also be connected to a computer, which allows the values to be uploaded to a database.

Ramachandran has run a pilot project, outfitting midwives in certain areas of Wales with the JM-105.

They have tested it to measure the bilirubin values of normal-weight babies, using its needle-free method.

Those babies, whose values were thought to be too high, were sent for further care.

In other cases, babies were assessed for jaundice visually, based on the yellowness of their skin.

The result was that 60 percent of all the babies sent to hospital for possible newborn jaundice had negative blood tests.

"Digital measurement means less stress for parents and babies," Ramachandran says, adding that keeping newborns out of clinics also reduces their exposure to potentially dangerous germs.

So, welcome to the world, preemies - the digital world, that is.

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