Liver damage in infants can occur from a number of causes. Liver damage can be related to chronic disease, such as biliary atresia, or may develop acutely, occurring suddenly and severely from genetic diseases or infection. Symptoms of liver disease in infants are quite similar to those seen in adults with liver damage.
Jaundice
Infants with liver damage, especially those who have blocked bile ducts so that bilirubin can't be excreted, are likely to be jaundiced. The jaundice of liver damage is not the same as the transient jaundice often seen in newborns. Neonatal jaundice is usually associated with a breakdown of red blood cells and a temporary inability of the body to eliminate them quickly. Jaundice found with liver damage lasts longer than a few days; the whites of the eyes, in addition to the skin, will be yellow. Urine will be tea colored or darker because it contains a large amount of bilirubin.
Gastrointestinal Symptoms
The lack of bile in the intestine leads to the inability to absorb fat and fat-soluble vitamins, the Merck Manual explains. This leads to decreased appetite, weight loss, poor growth and nausea. Stools may be very foul smelling and may float because fats aren't absorbed by the body. Stools may be clay colored because the intestines aren't absorbing any bile into the stools; bile gives stools their color.
Bleeding from varices, dilated blood vessels, may occur if portal hypertension develops. Portal hypertension is the result of high blood pressure in the vein that takes blood to the liver from the GI tract. Portal hypertension develops when the blood vessels into the liver are blocked or scarred and blood flow into the liver is slowed, Merck explains.
Ascites is fluid retention in the abdomen and lower extremities. Ascites occurs in infants with liver damage as a result of portal hypertension. Fluid is forced out of the bloodstream into the tissues when the blood vessels into the liver are damaged; a decrease in albumin, a protein manufactured in the liver, also contributes to ascites.
Other Symptoms
Fever is common in infants with liver failure. Infants are often irritable, especially as bilirubin levels rise. High levels of bilirubin cause confusion. Easy bruising and bleeding may occur as platelets, which help blood clot, are trapped in the enlarged spleen; the liver's inability to manufacture vitamin K, which aids in blood clotting, also contributes. The skin may be itchy as bilirubin builds up in the tissues. The spleen and liver may both be enlarged.
