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. 2021 Jul 6;2021(7):CD013277. doi: 10.1002/14651858.CD013277.pub2

Xiao 2009.

Study characteristics
Methods Randomized controlled trial conducted at Schenzen Maternity and Child Healthcare Hospital from March 2004 through September 2007.
Participants Term infants born in Schenzen, China to healthy mothers with no history of hepatitis B or liver dysfunction, infants weighing ≥ 2 kg with Apgar 7–10 with no obvious abnormalities. Monitored from day 3 to 6–7 of life.
Interventions Randomized to 1 of 4 groups: sunlight, bath, sunlight + bath, or neither sunlight nor bath (control)
Sunlight
  • Twice daily, for 30 minutes to 1 hour each time, naked, totally exposed, room temperature 28–30 °C in winter, under "direct sunlight." Eye mask, covered male genitals.


Bath
  • Boil 5000 mL water with traditional Chinese herbs, wait until water warm, bathe infant. 1 to 2 times per day for 15–20 minutes for 3–5 days.

Outcomes
  • Incidence of jaundice

  • Duration of jaundice

  • Hospitalization rate

  • Forehead and chest TCB measured and averaged to give "serum bilirubin" – used to determine presence of jaundice

Notes Jaundice definitions and management criteria: serum bilirubin level 257–291 µmol/L indicated diagnosis of jaundice. Value > 291 µmol/L required hospital admission. Normal serum bilirubin 205–257 µmol/L. Funding source not provided.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Information not reported in study.
Allocation concealment (selection bias) Unclear risk Information not reported in study.
Blinding of participants and personnel (performance bias)
All outcomes High risk Study did not comment on blinding.
Blinding of outcome assessment (detection bias)
All outcomes High risk Study did not comment on blinding.
Incomplete outcome data (attrition bias)
All outcomes Unclear risk Authors did not comment on data completion/loss to follow‐up.
Selective reporting (reporting bias) Unclear risk Trial registration not identified.
Other bias Unclear risk None identified.

AAP: American Academy of Pediatrics; BW: birthweight; CPT: conventional phototherapy; FSPT: filtered‐sunlight phototherapy; GA: gestational age; IEPT: intensive electric phototherapy; PT: phototherapy; TCB: transcutaneous bilirubin; TSB: total serum bilirubin.