Screening for liver disease in newborns
Blog Author: Joanne JablkowskiPosted: Monday, May 12, 2014 - 15:57
Biliary atresia is a rare but fatal liver disease resulting from a blockage of the bile duct. The blockage prevents bile from leaving the liver, resulting in damage and scarring that can lead to death by 2 years of age if not treated.
Biliary atresia begins to affect newborns in the first month of life. Prolonged jaundice (i.e., lasting longer than 2 weeks) as well as pale yellow, chalk white, or clay-colored stools may be an indication that very little or no bile is reaching the intestine.
There is no single blood test for biliary atresia, so stool color is the main tool for early detection. As part of the screening program, new parents are given a stool color card before they leave the hospital. The card shows photos of normal and abnormal infant stool colors. Mothers who have a home birth are given the card by their midwives. Parents are asked to check their newborn’s stool color every day for the first month after birth.
The preferred treatment for biliary atresia is the Kasai procedure, a surgical method where the diseased bile duct is removed and a small segment of the small intestine is attached to the liver at the spot where bile is expected to drain. If the Kasai procedure is performed in the first 2 months of life, it has an 80% chance of success; after 3 months the success rate drops to 20%. If the procedure is unsuccessful, a liver transplant is required.
Parents who see an abnormal stool color are asked to call or e-mail the Biliary Atresia Home Screening Program. Parents can also sign up to receive weekly text or e-mail reminders to check their newborn’s stool (in English and 11 other languages) at www.perinatalservicesbc.ca/infantstoolcolourcard.
This posting has not been peer reviewed by the BCMJ Editorial Board.