Biliary Atresia: A Simple Check Could Catch a Serious Liver Disease Early

Biliary atresia is a rare but serious liver disease that affects babies in the first weeks of life. It blocks or damages the bile ducts, which carry bile out of the liver. If it’s not treated early, it can lead to liver damage and need for liver transplant.

Doctors at Texas Children’s Hospital are working hard to catch this condition earlier — to treat the disease quickly before it causes too much liver damage. A new strategy gives pediatricians and family doctors better tools to spot the warning signs during a baby’s checkup around 1 month of age.

“We want to help primary care providers identify infants who may have biliary atresia earlier, so that they can be referred and evaluated quickly,” said Sanjiv Harpavat, MD, PhD, a pediatric liver specialist at Texas Children’s, who helped develop this new strategy.

Why early detection matters for biliary atresia

Biliary atresia affects about 1 in every 8,000 to 18,000 babies. The signs can be hard to notice at first. Many babies look a little yellow (jaundiced) in the first days of life, which is usually normal. But for babies with biliary atresia, that yellow color doesn’t go away — and it’s a sign of something more serious.

Because the symptoms can look like normal newborn changes, the diagnosis is often delayed. However, the treatment, a surgery called the Kasai procedure, is more likely to work if it is performed earlier.

A simple strategy for the well-child visit at 2-4 weeks of life

To help doctors catch the condition earlier, experts now recommend a simple screening at the baby’s 1-month checkup. The idea is to look at three things:

1. Eye color: Are the whites of the eyes still yellow?
2. Stool color: Are the baby’s stools a normal brown or green color, or are they pale or gray?
3. Previous blood tests: Did any early tests show high levels of a substance called bilirubin?

If anything seems off, doctors can order a blood test to check for a type of jaundice that could point to a liver disease.

What parents can do to prevent this liver disease

Parents play a big role, too. If your baby still looks yellow at 3 or 4 weeks old, or if their poop looks light gray, beige or white, tell your doctor right away. Keep a photo of your baby’s dirty diaper to show the doctor if you’re unsure about the color. These small clues can make a big difference.

“To help catch babies earlier, we all can work together – parents, pediatricians, and specialists,” said Dr. Harpavat.

Looking ahead

In the future, doctors hope to create even better ways to screen all newborns for biliary atresia. But for now, the visit in the first 2-4 weeks of life is an important opportunity to find biliary atresia early — and act.

At Texas Children’s, the goal is simple: give every baby the best possible chance for a healthy future. Early detection can help make that happen.