White cover and massage as adjunct interventions during phototherapy in newborns: a randomized controlled trial

OBJECTIVE: This study examined the effects of white cover and massage on bilirubin levels and phototherapy duration in newborns. METHODS: Sixty term newborns with hyperbilirubinemia were randomly assigned to intervention (n = 30) or control (n = 30) groups. The intervention group received a reflective white cover around the phototherapy unit and infant massage twice daily; the control group received routine care. Capillary and transcutaneous bilirubin (TcB) levels, phototherapy duration, and urination/defecation frequency and amount were compared between the groups, as were hospital stay. RESULTS: Baseline characteristics and bilirubin levels were similar between groups (p > 0.05). After the intervention, the intervention group showed a faster decrease in bilirubin, shorter phototherapy, greater weight gain, and more frequent urination and defecation (p < 0.001). CONCLUSION: White cover and massage significantly improved bilirubin elimination, reduced phototherapy duration and hospital stay, and supported weight gain in term newborns. Therefore, the use of white cover and massage may be effective and inexpensive adjunctive interventions for term newborns receiving phototherapy. IMPLICATIONS FOR PRACTICE: The combination of a white cover and massage provides a simple, cost‐effective approach to improving phototherapy outcomes and can be readily incorporated into standard newborn care.