Context: Phototherapy treatment for hyperbilirubinemia in neonates may result in development of hypocalcaemia. The study is done to assess role of calcium prophylaxis and head cap in the prevention of phototherapy induced hypocalcemia. Aims: To compare the efficacy of head cap versus calcium supplementation in preventing phototherapy induced hypocalcemia. Settings and Design: Prospective study undertaken in NICU at JSS Hospital, Mysuru from January 2013 to June 2014. Methods and Material: This study was conducted on 150 full term neonates (50 in each group: Group A - only phototherapy, Group B - phototherapy receiving oral calcium prophylaxis, Group C - phototherapy with head cap). Serum ionized calcium levels were measured before and after phototherapy. Statistical analysis used: Statistical analysis done by SPSS software 19.0 version. Results: In control group (Group A), 28 (58.3%) neonates showed decrease in serum ionized calcium levels following phototherapy out of which, 11 (22.9%) developed hypocalcemia. Mean serum ionized calcium levels before phototherapy was 1.193 mmol/L and after phototherapy 1.06 mmol/L. In group Group B, 27 (56.3%) showed a decrease in serum ionized calcium levels following phototherapy of which, three (6.3%) developed hypocalcemia. The mean serum ionized calcium levels before phototherapy was 1.219 mmol/L and after phototherapy 1.172 mmol/L. In Group C, 30 (62.5%) neonates showed a decrease in serum ionized calcium levels following phototherapy of which, nine (18.8%) developed hypocalcemia. Mean serum ionized calcium levels before phototherapy was 1.25 mmol/L and after phototherapy, it was 1.14 mmol/L. None of the neonates in all group who showed a drop in serum ionized calcium levels below one mmol/L developed any signs of hypocalcemia. Conclusions: Neonates under phototherapy can develop hypocalcemia as a complication. Oral calcium supplementation to neonates under phototherapy would be beneficial in preventing phototherapy induced hypocalcemia.

Keywords: Hyperbilirubinemia; Phototherapy; Ionized Calcium; Hypocalcemia; Head Cap.