4th January 2017
Children’s Liver Disease Foundation (CLDF) has developed the Yellow Alert app which is designed to promote the early diagnosis and referral of babies with liver disease.
While newborn jaundice is very common, if it persists beyond 14 days (21 days in a pre-term baby) it can be a sign of liver disease. Prolonged jaundice (yellowing of the skin and the whites of the eyes) can be a sign of liver disease. A another key indicator is stool and urine colour; persistently pale stools and yellow urine.
If the baby’s symptoms do indicate a cause for concern, a special blood test called a split bilirubin blood test should be carried out to rule out potentially life threatening liver disease..
One of the most common forms of childhood liver disease is biliary atresia in which inflammation develops within the bile ducts around the time of birth. The resulting bile duct damage reduces the flow of bile leading to cirrhosis. If it is diagnosed early the corrective Kasai procedure can be performed to establish bile flow. In order to give the Kasai the best chance of success, however, it should ideally take place before the baby is eight weeks old.
The role of health visitors in spotting the signs of liver disease and arranging specialist referral is a vital one, and the Yellow Alert app has been designed to give health professionals the information they need in the quickest, most accessible way possible.
In addition to a stool chart, the app incorporates information on when to refer, and a basic overview of the tests which will be done, as well as details of other resources available from CLDF and the facility to order a full Yellow Alert pack from CLDF.
- If the infant is jaundiced, however mildly, their stools and urine should be checked. An infant’s urine should be colourless and stools should be clearly pigmented with a yellow or green colour. If the stools are pale or clay-coloured this may be a sign of liver disease.
- It is recommended that all babies with prolonged jaundice be given a split bilirubin test.
- If a split bilirubin test highlights that the conjugated fraction of bilirubin is greater than 20% a referral to a specialist unit is necessary for further investigation.