Everything you need to know about Neonatal Cholestasis

What is Neonatal Cholestasis? 

Neonatal cholestasis occurs in a newborn baby or within 3 months of birth. This disease is defined as conjugated hyperbilirubinemia. It occurs due to reduced excretion or bile formation. Both situations can lead to many disorders in the baby. One such disorder is known as biliary atresia.

In this article, we will discuss the symptoms of this disease, along with the major causes and treatments. Keep reading to uncover every detail about neonatal Cholestasis.

Symptoms of Neonatal Cholestasis

The initial symptoms of cholestasis are yellow skin and eyes, which means jaundice. Liver diseases are not the primary cause of newborn jaundice, but in this case, liver disease is the underlying cause of jaundice.

Following that, you will be able to notice symptoms like:

  • Fatigue
  • poor feeding
  • difficulty gaining weight
  • Itchiness

Here's a list of things that you need to keep an eye on for a newborn baby

  • Along with having jaundice, your baby might have pale stools and dark-coloured urine.
  • In addition to having jaundice, your baby might have other abnormal conditions in the body. Abnormalities can be spotted in the skeleton, the heart, the eyes, the skin, and the spleen.

Causes of Neonatal Cholestasis

There are two types of causes for neonatal cholestasis: extrahepatic causes and intrahepatic causes.

Extrahepatic causes 

Biliary atresia is the most common extrahepatic disorder. In most cases, biliary atresia is visible in babies many weeks after birth. The reason for that could be the inflammation of extrahepatic and intrahepatic bile ducts. 

Infants with cystic fibrosis are more likely to experience inspissated bile duct syndrome, which is also a potential contributor to extrahepatic newborn cholestasis.

Intrahepatic causes

Intrahepatic causes are mostly metabolic/genetic, toxic, infectious, or alloimmune.

Viral, bacterial, or parasitic infections in newborn babies under parenteral nutrition can lead to cholestasis.

Transplacental transit of maternal IgG causes a complement-mediated membrane assault complex, which damages the foetal liver, resulting in gestational alloimmune liver disease.

Metabolic causes of neonatal cholestasis include a lot of inborn metabolic errors, which include:

  • galactosemia, tyrosinemia
  • alpha-1 antitrypsin deficiency
  • disorders of lipid metabolism
  • bile acid defects
  • mitochondrial disorders
  • fatty acid oxidation defects.

In addition to that, there are also genetic defects, which include:

  • Alagille syndrome
  • cystic fibrosis
  • arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome

The major source of toxic causes is prolonged parenteral feeding given to newborns with small bowel syndrome or extremely premature neonates.

When to see a doctor

Neonatal cholestasis is a medical emergency. Hence, rapid diagnosis is essential. Before 4-6 weeks of age, biliary atresia must be detected and diagnosed, and a Kasai portoenterostomy should be provided. Many of the illnesses, except for biliary atresia, are curable and need a thorough evaluation.

Treatment for Neonatal Cholestasis

Here is a list of treatments that will be undertaken if your child is suffering from Neonatal Cholestasis:

First and most importantly, your child will be given special formulas, specific medications, or vitamin supplements, depending particularly on the problem.

Doctors generally suggest low-fat foods for newborn babies with cholestasis because these types of foods cause less diarrhoea. 

Babies with cholestasis have difficulty absorbing certain vitamins. Thus, high dosages of vitamins  A, D, E, and K, sometimes known as fat-soluble vitamins, are suggested by doctors.

Infants may develop itchiness due to cholestasis. Thus, a lot of different medications to control itchiness are suggested by doctors.


In conclusion, Neonatal Cholestasis is a complex and potentially serious medical condition. It can be effectively treated with medications and dietary changes. However, it is important to seek medical help right away if you suspect that your baby may have the disease.

Request an appointment at Apollo Cradle, Hyderabad - Kondapur. Call 1860-500-1066 to book an appointment.

1. What is the main cause of cholestasis?

Primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC) are two of the most frequent forms of cholestatic liver disease (PSC).

2. What is the difference between cholestasis and jaundice?

Biochemically, cholestasis is characterized by an increase in serum alkaline phosphatase. Jaundice is a clinical manifestation of bilirubinostasis, which is caused histologically by the retention of bilirubin in the hepatocytes, bile canaliculi, or bile ducts.

3. Can neonatal cholestasis go away?

Usually, two weeks after birth, it goes away. However, newborn cholestasis (NC), which is indicated by conjugated hyperbilirubinemia, is never innocuous and always points to a serious underlying disease.

4. Can a baby have cholestasis?

An uncommon disorder called cholestasis affects roughly 1 in every 2,500 newborn babies. Cholestasis in babies may be a hereditary disorder. Any child may be affected by this illness, irrespective of his/her age.

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