Recognizing liver disease in jaundiced infants

Abstract

Serious liver disease in infancy often presents as jaundice in an otherwise healthy baby. Recognition of these babies is made more difficult by the occurrence of physiological jaundice of the newborn. It is important for midwives to be aware that in most infants, including those who are breast fed, physiological jaundice has cleared by 14 days of age. Therefore any infant who remains jaundiced beyond 14 days should have a special split bilirubin blood test. If the conjugated bilirubin is greater than 20% of the total bilirubin, the infant should be referred immediately to a paediatrician for investigation and treatment of liver disease. Early management significantly improves the long term prognosis and avoids unnecessary complications