Abstract
Background:Neonatal cholestasis (NC) is one of the commonest presentations in early infancy diseases. The nutritional status of infants may be affected by many factors. Impaired bile flow may further lead to the nutritional compromise of infants. Timely nutritional assessment and adequate nutritional support in the form of adequate breastfeeding and if required appropriate formulae feeding according to age and weight is crucial for better outcomes in improving morbidity and decreasing mortality of infants with NC. Methods:Consecutive 143 patients of NC up to 12 months enrolled from the HIS data (hospital information system). Anthropometric examination, mode, and type of feeding and serum markers like LFT (liver function test) and Hb (hemoglobin) were recorded. Data were analyzed by IAP growth parameters and SPSS 21. Results:The mean age of NC presentation was 3.6 months. 74(51.7%) were on mixed feeding, 61(42.6%) were exclusively breastfed (EBF) and only 8(5.6%) infants were on only top feeding by formula feeding or bovine milk feed. 39.16% were undernourished and around 19.5% were stunted.40% infants were anemic. The median value of serum albumin in top-fed and EBF (exclusive breastfed) was low. Conclusions:Malnutrition is common in infants with NC. There area different feeding pattern and type observed in infants with NC. EHBA (extrahepatic biliary atresia) is the most common diagnosis in infants with NC presented to the tertiary care center. Early nutritional assessment and timely nutritional supplementation having a crucial role in the outcome of patients with various diagnoses in NC.
Highlights
MethodsMalnutrition affects nearly two-thirds of children with chronic liver disease [1]
Physiological jaundice in the neonate is a common condition, which rarely extends beyond two weeks of life.When jaundice extends beyond two weeks of life,it's known as pathological jaundice,and the majority of times it is due to neonatal cholestasis (NC).If jaundice persists beyond two weeks in term infant and three weeks in preterm,conjugated and unconjugated both serum bilirubin levels should be done to exclude the diagnosis of NC
Consists of 19%-33% of all chronic liver disease(CLD) in children reaching tertiary care hospital.NC is being more and more recognized in Indiadue to multiple factors.One of the most important campaigns to recognize a case of neonatal cholestasis was “Yellow alert” drive started by former Prof and Head, Dr S
Summary
Neonatal cholestasis (NC) is one of the commonest presentations in early infancy diseases. The nutritional status of infants may be affected by many factors. Nutritional assessment and adequate nutritional support in the form of adequate breastfeeding and if required appropriate formulae feeding according to age and weight is crucial for better outcomes in improving morbidity and decreasing mortality of infants with NC. 74(51.7%) were on mixed feeding, 61(42.6%) were exclusively breastfed (EBF) and only 8(5.6%) infants were on only top feeding by formula feeding or bovine milk feed. EHBA (extrahepatic biliary atresia) is the most common diagnosis in infants with NC presented to the tertiary care center. Nutritional assessment and timely nutritional supplementation having a crucial role in the outcome of patients with various diagnoses in NC. Nutritional status characteristics of infants presenting with neonatal cholestasis.
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