Aluminum Foil as an Adjuvant to Phototherapy for Pathological Unconjugated Hyperbilirubinemia in Full-term Infants: Randomized Controlled Trial

Objective Phototherapy is the standard treatment for neonatal jaundice; however, prolonged exposure may have drawbacks. This study evaluated the efficacy and safety of adding aluminum foil reflectors to conventional phototherapy in full-term neonates with nonhemolytic unconjugated hyperbilirubinemia. Design/Methods A prospective, single-center, randomized, open-label trial was conducted in 234 full-term infants admitted to the neonatal intensive care unit. Participants were randomly assigned to receive either phototherapy with aluminum foil reflectors or standard phototherapy alone. The primary outcome was total serum bilirubin (TSB) at 8, 24, and 48 h. Secondary outcomes included total duration of phototherapy, length of hospital stay, exclusive breastfeeding on discharge, and adverse effects. Results Of 234 infants (117 per group), the aluminum-foil group had significantly lower mean TSB at 24 h (mean difference −0.75 mg/dL; 95% CI −1.41 to −0.09; P = .021) and 48 h (−0.49 mg/dL; 95% CI −0.98 to −0.004; P = .040). Median phototherapy duration was shorter (38 h [interquartile range 32-50] vs. 48 h [36-50]; P = .014), as was hospital stay (3.5 days [3-4] vs. 4 days [3-5]; P = .020). Exclusive breastfeeding on discharge was more frequent (88.0% vs. 69.2%; risk difference 18.8%, 95% CI 4.0-32.4; P < .001). No significant adverse effects were observed. Conclusion The use of aluminum foil reflectors with phototherapy was associated with improvements in bilirubin reduction and clinical outcomes without added risk. These findings suggest a potential role for this simple, low-cost adjunct in similar clinical settings.