My granddaughter is 2 months old with persistent jaundice. Please review her reports.

Hi,

Welcome to icliniq.com.

Persistence of direct bilirubin at two months of age needs to be evaluated properly. Most importantly, what is the color of her stool? Is your doctor told you anything about the liver whether it is big or normal?

There are so many causes, but most important and serious and need timely intervention is extrahepatic biliary atresia which as per information has been ruled out.

Other common causes can be neonatal hepatitis or some metabolic disorder. The list of causes is long so better if you can share all the reports (blood, urine, sonography, Torch titer, TFT, enzymes, alpha 1 anti-trypsin, etc), I can advise you on how to proceed further and whether it needs further investigations.

Hi,

Welcome back to icliniq.com.

As per these blood reports (attachment removed to protect patient identity) and as the color of stool is normal, biliary atresia is unlikely. These reports include liver enzymes and thyroid tests which are normal. It is more probably defect in the clearing of bilirubin from the liver. Thus giving Cardinal needs to be continued but as your baby is not gaining weight, also, in spite of accepting feeds well, then better to rule out other possibilities.

Sonography, Torch titer, alpha 1 anti-trypsin reports are not there. She will require bilirubin uptake and clearance studies if problem persists.

I suggest you check for this test, I expect they must have done it. And if all these are normal, wait and watch for weight gain. Monitor total milk intake, if breastfeeding just weighs the baby once before and after feeding to confirm how much baby is getting (just once only). Monitor regular weight gain, and continue Cardinal.