Jaundice is common in babies in the first few days after they are born. Now a team from the University of Washington is developing a smartphone app that should make it easier for doctors and parents to monitor newborns and decide if they need to have a blood test to confirm they have jaundice.

Often the sign that a baby might have jaundice is when the skin has a yellow tinge. But this is not always easy to spot, and if left untreated, jaundice can make an infant very sick.

Jaundice is the result of build-up in the blood and tissues of the body of a substance called bilirubin – a natural byproduct of the breakdown of red blood cells. Normally, the liver metabolizes excess bilirubin, but in newborns this process can be slow because the liver is not yet functioning optimally.

If untreated, jaundice causes brain damage and a potentially fatal condition called kernicterus.

The definitive test for jaundice is a blood test, but what is needed is an effective screening tool, better than the naked eye, to help decide if a blood test should be done.

Some hospitals have a non-invasive screening tool for jaundice, but it is expensive and not suitable for home use.

The tool that the University of Washington (UW) team has developed combines a smartphone app with a color calibration card and algorithms in a cloud and gives a result in minutes, as UW professor of pediatrics James Taylor explains:

Virtually every baby gets jaundiced, and we’re sending them home from the hospital even before bilirubin levels reach their peak. This smartphone test is really for babies in the first few days after they go home. A parent or health care provider can get an accurate picture of bilirubin to bridge the gap after leaving the hospital.”

To use the app, called BiliCam, the parent or health care provider places the calibration card – which is about the size of a business card – on the naked torso of the baby and takes a flash-assisted photo of the baby and card using the smartphone.

The app sends key data from the photo – which with the help of the calibration card accounts for differences in lighting conditions and skin tones – to the cloud using a data connection provided through the smartphone.

Algorithms in the cloud analyze the data and within minutes the smartphone receives a report on the likely levels of bilirubin in the baby.

The team has so far tested the app in a clinical study involving 100 newborns and their families in the newborn nursery at UW Medical Center, of which Prof. Taylor is the medical director.

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Parents or physicians can monitor a newborn baby’s jaundice with their smartphones through BiliCam.
Image credit: University of Washington

All the babies underwent a blood test and screening with BiliCam when they were between two and five days old. The results showed BiliCam performed as well as or better than the current screening tool.

The idea is not for BiliCam to replace the blood test, but to help parents know if they should take the next step.

The advantage of siting the algorithms in the cloud rather than in the smartphone is that they can be improved over time, says the team, which now plans to test BiliCam on up to 1,000 newborns with a range of skin pigments, so the algorithms will be robust enough to use with babies of all ethnicities and skin colors.

The team expects that within a year, doctors will be using BiliCam as an alternative to the current screening tool for bilirubin. Patents are already pending, and the team is also hopeful the device will gain Federal Drug Administration approval so parents can use it at home within the next two years.

Prof. Taylor says they hope their app will also be useful in developing countries where jaundice accounts for many newborn deaths:

“We’re really excited about the potential of this in resource-poor areas, something that can make a difference in places where there aren’t tools to measure bilirubin, but there’s good infrastructure for mobile phones,” he explains.

He and his colleagues will be presenting their work at the Association for Computing Machinery’s International Joint Conference on Pervasive and Ubiquitous Computing, which takes place in Seattle in September.

The Coulter Foundation and a National Science Foundation Graduate Research Fellowship helped fund the research behind the app.

In September 2013, Medical News Today reported how another team is developing smartphone photography to help diagnose eye diseases by capturing high-quality photos of retinas.