Osteopathic Manipulative Treatment Plus Phototherapy in the Management of Neonatal Hyperbilirubinemia: A Case Report

Abstract Neonatal hyperbilirubinemia (NH) is costly and has the potential for complications. Standard of care for mild-moderate NH is phototherapy. Osteopathic manipulative treatment (OMT) is safe and effective in other pediatric conditions, but there is little literature on the safety and efficacy of OMT in NH. We present a case of an otherwise healthy 4-day-old term female readmitted for NH and placed on phototherapy. Osteopathic structural exam showed dysfunctions in the following regions: head, cervical, sacral, pelvic, upper extremity, and abdomen, which were treated with osteopathic cranial manipulative medicine, myofascial release, and visceral manipulation. Patient’s bilirubin level dropped 3.5mg/dL following OMT, and she was discharged sooner than anticipated than if her NH had been managed with phototherapy alone. According to literature, the median length of stay (LOS) for NH in the United States is 48.00 hours. Her LOS was 24.90 hours. No adverse events were noted. Compared to phototherapy alone, phototherapy plus OMT may lead to improved NH patient outcomes, such as shorter LOS, while still being safe. However, this is a case report of one patient, so no causality can be determined, and more research is needed.