Liver Disease

Jaundice

Yellow urine or yellow color of sclera of eyes is an important sign of jaundice. Jaundice in babies can be due to various reasons, but liver disease is an important cause which needs urgent attention.

Prolonged jaundice is defined as jaundice persisting beyond two weeks of age in term babies and three weeks in pre-term babies.

Urine and stool colour

One should be aware of the importance of urine and stool colour:

• Normally a baby’s urine is colourless
• Persistently yellow urine which stains the nappy can be a sign of liver disease
• Normally a baby’s stools are green or yellow
• Persistently pale coloured stools may indicate liver disease.

A jaundiced baby with pale stools and yellow urine can appear completely healthy. The baby may have a potentially lethal liver disease.

Jaundiced babies who need urgent referral and investigations :

• A baby who is unwell and/or not progressing normally.
• A baby with abnormal colour of stools and/or urine at any age.
• A baby where the conjugated bilirubin is greater than 20% of the total bilirubin.
• Any infant with prolonged jaundice that has not been investigated.

Breast-fed babies may also have liver disease; be extra careful to check stools and urine.

Tests should include:

• Total and Direct Bilirubin
• Liver Function Tests

These include the following:

• Albumin
• Aspartate and Alanine Transaminases (AST, ALT)
• Alkaline Phosphatase (ALP)
• Gamma Glutamyltransferase (GGT)
• Prothrombin Time (PT)
• Ultransound liver

If any of the investigative tests are abnormal or liver disease is suspected, the infant may need referral to a specialist unit for further diagnosis or management.