The newborn liver carries out the same function that it does in adults -- breaking down medicine, toxins and bilirubin, forming the proteins of blood, and storing energy. However, the newborn liver is prone to additional stresses that are less commonly seen in adults. In addition, the liver can be prone to a number of diseases due to inheritance or birth defects. The treatment of liver diseases vary from watchful waiting to surgery.
Neonatal Jaundice
Jaundice is a yellowish discoloration of the skin. Neonatal jaundice, or physiologic jaundice of the newborn, is a benign cause of this discoloration. According to "Nelson Textbook of Pediatrics," this kind of jaundice is seen in 60 percent of babies born at term and 80 percent of preterm babies. One of the important functions of the liver is to create bilirubin from waste products of red blood cells. The neonatal liver is often too immature to break down this product. As a result, the bilirubin accumulates, leading to this yellow discoloration of skin. The jaundice usually disappears after the first week of life with no treatment.
Breast-Feeding Jaundice
Two kinds of jaundice are associated with breast-feeding. Breast-feeding jaundice occurs within the first week of life. This may be due to infant dehydration during the first week of life or insufficient feeding. The other form, breast-milk jaundice, occurs around the seventh day of life and can peak in the second or third week before subsiding. The treatment for this condition is temporary cessation of nursing, which allows the bilirubin levels to fall. A common treatment of these kinds of jaundice is known as phototherapy. Placing the infant under a blue light allows the conversion of bilirubin to a harmless product that can be excreted in the urine, correcting the problem.
Metabolic Disorders
The infant liver is susceptible to a number of metabolic diseases in which an enzyme necessary for life is missing. The causes of these diseases are genetic. Unfortunately, many of these conditions create many complications and may even result in death. Two examples are galactosemia and Criggler-Najar syndrome. Galactosemia is an inability to break down the sugar galactose. These infants should not breast-feed. Criggler-Najar syndrome is a disease of the liver due to the inability to break down bilirubin, leading to dangerous levels of jaundice.
Neonatal Hepatitis
Bilirubin which is formed by the liver is excreted in the feces by the gallbladder and biliary tract. Congenital conditions which interfere with the biliary tract can cause severe disease in infants. These conditions are known as neonatal hepatitis or as cholestatic liver disease. Doctors can determine if this condition is present by a blood test. Infants who are suspected to have this condition should undergo an ultrasound to determine what part of the biliary tract has failed to develop. Some cases can be treated with a surgical procedure; unfortunately, there is no treatment for the remainder of these infants, who usually die.
References
- Medscape: Neonatal Jaundice
- "Nelson Textbook of Pediatrics"; Dr. Robert M. Kliegman, et al.; 2008
- MedLine Plus: Newborn Jaundice
