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Evaluating bilicocoon phototherapy for neonatal hyperbilirubinemia

Pediatric Research (2025)Cite this article

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We read with considerable interest the article by Donneborg et al. 1 on “Comparison of BiliCocoon phototherapy with overhead phototherapy in hyperbilirubinemic neonates. A randomized clinical trial”. While this multicenter randomized controlled trial provides valuable empirical evidence regarding an innovative phototherapy modality, several methodological and clinical considerations warrant further discourse.

The investigators employed exemplary methodological rigor through standardized irradiance measurements across three centers and robust statistical modeling using mixed-effect regression. However, the unblinded design, while pragmatically necessary, potentially introduces systematic bias in subjective outcome assessments. The CONSORT guidelines2 emphasize the importance of blinding assessors when feasible. Additionally, the sample size calculation targeting a 6% difference in bilirubin reduction may have been underpowered to detect clinically meaningful differences in secondary outcomes, particularly thermoregulation complications.

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References

  1. Donneborg, M. L. et al. Comparison of BiliCocoon phototherapy with overhead phototherapy in hyperbilirubinemic neonates. A randomized clinical trial. Pediatr. Res. 97, 1951–1957 (2025).

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  2. Schulz, K. F., Altman, D. G. & Moher, D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. J. Pharm. Pharmacother. 1, 100–107 (2010).

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  3. Bhutani, V. K. et al. Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation: technical report. Pediatrics 154, e2024068026 (2024).

  4. Aydemir, O. et al. Body temperature changes of newborns under fluorescent versus LED phototherapy. Indian J. Pediatr. 81, 751–754 (2014).

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  5. 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. 111, 760–766 (2022).

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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  1. School of medicine, Wuhan University of Science and Technology, Wuhan, China

    Xin Li & Feifei Hu

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  1. Xin Li
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  2. Feifei Hu
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Correspondence to Feifei Hu.

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Li, X., Hu, F. Evaluating bilicocoon phototherapy for neonatal hyperbilirubinemia. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04457-4

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  • DOI: https://doi.org/10.1038/s41390-025-04457-4

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