The purpose of our study was to compare the effects of narrow-spectrum blue light and broad-spectrum white light on the production of bilirubin photo-isomers in human infants with jaundice. Twelve preterm infants were studied under both white and blue light. Irradiance at 450 nm was controlled at 12 microW/cm2/nm for both light sources. Each light condition (white or blue) was administered for 12 hours. Bilirubin isomers (4Z,15E-bilirubin and lumirubin) were measured before therapy and after 12 hours of each sequential light condition. The percentage of 4Z,15E-bilirubin was greater under blue light than under white light (P less than 0.01) phototherapy. There was no significant difference in percentage lumirubin under white or blue light therapy. Our data indicate that blue light is more effective than white light in producing 4Z,15E-bilirubin in vivo. Our study demonstrates that when irradiance in the bilirubin absorbance spectrum is constant, the color of light (spectral distribution) will determine the relative concentrations of photo-isomers produced.