{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T05:01:08Z","timestamp":1791090068625,"version":"4.1.0"},"reference-count":40,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,2,1]]},"abstract":"<jats:p>Cholestatic jaundice is a common presenting feature of neonatal hepatobiliary and metabolic dysfunction. Any infant who remains jaundiced beyond age 2 to 3 weeks should have the serum bilirubin level fractionated into a conjugated (direct) and unconjugated (indirect) portion. Conjugated hyperbilirubinemia is never physiologic or normal. The differential diagnosis of cholestasis is extensive, and a step-wise approach based on the initial history and physical examination is useful to rapidly identify the underlying etiology. Early recognition of neonatal cholestasis is essential to ensure timely treatment and optimal prognosis. Even when specific treatment is not available, infants who have cholestasis benefit from early medical management and optimization of nutrition. Future studies are necessary to determine the most reliable and cost-effective method of universal screening for neonatal cholestasis.<\/jats:p>","DOI":"10.1542\/neo.14-2-e63","type":"journal-article","created":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T18:34:49Z","timestamp":1359743689000},"page":"e63-e73","source":"Crossref","is-referenced-by-count":113,"title":["Neonatal Cholestasis"],"prefix":"10.1542","volume":"14","author":[{"given":"Amy G.","family":"Feldman","sequence":"first","affiliation":[{"name":"Fellow in Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Colorado School of Medicine, and Digestive Health Institute, Children\u2019s Hospital Colorado, CO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald J.","family":"Sokol","sequence":"additional","affiliation":[{"name":"Professor and Vice Chair of Pediatrics, Chief of Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, and Director of Colorado Clinical and Translational Sciences Institute, University of Colorado Denver, and Digestive Health Institute, Children\u2019s Hospital Colorado, CO."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2013,2,1]]},"reference":[{"issue":"6988","key":"2021121000462829800_B1","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1136\/bmj.310.6988.1172","article-title":"Jaundice in babies: implications for community screening for biliary atresia","volume":"310","author":"Kelly","year":"1995","journal-title":"BMJ"},{"issue":"5","key":"2021121000462829800_B2","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1542\/peds.2008-1949","article-title":"Impact of age at Kasai operation on its results in late childhood and adolescence: a rational basis for biliary atresia screening","volume":"123","author":"Serinet","year":"2009","journal-title":"Pediatrics"},{"issue":"10","key":"2021121000462829800_B3","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1136\/adc.66.10.1177","article-title":"Jaundice at 14 days of age: exclude biliary atresia","volume":"66","author":"Hussein","year":"1991","journal-title":"Arch Dis Child"},{"issue":"8635","key":"2021121000462829800_B4","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/S0140-6736(89)90012-3","article-title":"Late referral for biliary atresia\u2014missed opportunities for effective surgery","volume":"1","author":"Mieli-Vergani","year":"1989","journal-title":"Lancet"},{"issue":"1\u20132","key":"2021121000462829800_B5","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1440-1754.2007.01170.x","article-title":"Pre-admission consultation and late referral in infants with neonatal cholestasis","volume":"44","author":"Lee","year":"2008","journal-title":"J Paediatr Child Health"},{"issue":"2","key":"2021121000462829800_B6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0022-3476(85)80282-1","article-title":"Neonatal cholestasis","volume":"106","author":"Balistreri","year":"1985","journal-title":"J Pediatr"},{"issue":"11","key":"2021121000462829800_B7","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1542\/pir.25-11-388","article-title":"Neonatal cholestasis","volume":"25","author":"Suchy","year":"2004","journal-title":"Pediatr Rev"},{"issue":"1","key":"2021121000462829800_B8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.cld.2005.10.008","article-title":"Whatever happened to \u201cneonatal hepatitis\u201d?","volume":"10","author":"Balistreri","year":"2006","journal-title":"Clin Liver Dis"},{"issue":"6","key":"2021121000462829800_B9","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1136\/adc.60.6.512","article-title":"Hepatitis syndrome in infancy\u2014an epidemiological survey with 10 year follow up","volume":"60","author":"Dick","year":"1985","journal-title":"Arch Dis Child"},{"issue":"6","key":"2021121000462829800_B10","doi-asserted-by":"crossref","first-page":"e1428","DOI":"10.1542\/peds.2011-1869","article-title":"Patients with biliary atresia have elevated direct\/conjugated bilirubin levels shortly after birth","volume":"128","author":"Harpavat","year":"2011","journal-title":"Pediatrics"},{"issue":"4","key":"2021121000462829800_B11","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.jpeds.2010.09.061","article-title":"Interpreting conjugated bilirubin levels in newborns","volume":"158","author":"Davis","year":"2011","journal-title":"J Pediatr"},{"issue":"11","key":"2021121000462829800_B12","first-page":"745","article-title":"Exome sequencing as a tool for Mendelian disease gene discovery","volume":"12","author":"Bamshad","year":"2011","journal-title":"Genetics"},{"issue":"2","key":"2021121000462829800_B13","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1097\/00005176-200408000-00001","article-title":"Guideline for the evaluation of cholestatic jaundice in infants: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition","volume":"39","author":"Moyer","year":"2004","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"1","key":"2021121000462829800_B14","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s00247-010-1858-5","article-title":"Hepatobiliary and pancreatic imaging in children\u2014techniques and an overview of non-neoplastic disease entities","volume":"41","author":"Nievelstein","year":"2011","journal-title":"Pediatr Radiol"},{"issue":"8","key":"2021121000462829800_B15","first-page":"1279","article-title":"Outcome of hepatobiliary scanning in neonatal hepatitis syndrome","volume":"38","author":"Gilmour","year":"1997","journal-title":"J Nucl Med"},{"issue":"2","key":"2021121000462829800_B16","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00261-006-9049-4","article-title":"Biliary atresia in infants with prolonged cholestatic jaundice: diagnostic accuracy of hepatobiliary scintigraphy","volume":"32","author":"Esmaili","year":"2007","journal-title":"Abdom Imaging"},{"issue":"8","key":"2021121000462829800_B17","first-page":"793","article-title":"Liver biopsy in neonatal cholestasis: a review on statistical grounds","volume":"10","author":"Zerbini","year":"1997","journal-title":"Mod Pathol"},{"issue":"4","key":"2021121000462829800_B18","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.cgh.2011.01.003","article-title":"Design and validation of the biliary atresia research consortium histologic assessment system for cholestasis in infancy","volume":"9","author":"Russo","year":"2011","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"6","key":"2021121000462829800_B19","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.jpeds.2007.05.051","article-title":"Biliary atresia: the Canadian experience","volume":"151","author":"Schreiber","year":"2007","journal-title":"J Pediatr"},{"issue":"7","key":"2021121000462829800_B20","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/S0022-3468(03)00178-7","article-title":"Five- and 10-year survival rates after surgery for biliary atresia: a report from the Japanese Biliary Atresia Registry","volume":"38","author":"Nio","year":"2003","journal-title":"J Pediatr Surg"},{"issue":"2","key":"2021121000462829800_B21","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1002\/hep.20547","article-title":"Outcome in adulthood of biliary atresia: a study of 63 patients who survived for over 20 years with their native liver","volume":"41","author":"Lykavieris","year":"2005","journal-title":"Hepatology"},{"issue":"24","key":"2021121000462829800_B22","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1056\/NEJM197606102942404","article-title":"Liver disease in alpha1-antitrypsin deficiency detected by screening of 200,000 infants","volume":"294","author":"Sveger","year":"1976","journal-title":"N Engl J Med"},{"issue":"3","key":"2021121000462829800_B23","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1002\/hep.510290331","article-title":"Features of Alagille syndrome in 92 patients: frequency and relation to prognosis","volume":"29","author":"Emerick","year":"1999","journal-title":"Hepatology"},{"issue":"2","key":"2021121000462829800_B24","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/S0022-3476(95)70298-9","article-title":"Outcome of syndromic paucity of interlobular bile ducts (Alagille syndrome) with onset of cholestasis in infancy","volume":"127","author":"Hoffenberg","year":"1995","journal-title":"J Pediatr"},{"issue":"10","key":"2021121000462829800_B25","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1016\/j.jpedsurg.2011.06.002","article-title":"A contemporary analysis of parenteral nutrition-associated liver disease in surgical infants","volume":"46","author":"Javid","year":"2011","journal-title":"J Pediatr Surg"},{"issue":"5","key":"2021121000462829800_B26","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1038\/sj.jp.7211686","article-title":"Identifying patients, on the first day of life, at high-risk of developing parenteral nutrition-associated liver disease","volume":"27","author":"Christensen","year":"2007","journal-title":"J Perinatol"},{"issue":"5","key":"2021121000462829800_B27","doi-asserted-by":"crossref","first-page":"e1152","DOI":"10.1542\/peds.2007-1962","article-title":"Percutaneously inserted central catheter for total parenteral nutrition in neonates: complications rates related to upper versus lower extremity insertion","volume":"121","author":"Hoang","year":"2008","journal-title":"Pediatrics"},{"issue":"3","key":"2021121000462829800_B28","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1097\/01.sla.0000179647.24046.03","article-title":"Pediatric short bowel syndrome: redefining predictors of success","volume":"242","author":"Spencer","year":"2005","journal-title":"Ann Surg"},{"issue":"3","key":"2021121000462829800_B29","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.jpeds.2011.08.047","article-title":"Intravenous fat emulsions reduction for patients with parenteral nutrition-associated liver disease","volume":"160","author":"Cober","year":"2012","journal-title":"J Pediatr"},{"issue":"1","key":"2021121000462829800_B30","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jpedsurg.2011.10.007","article-title":"Parenteral nutrition-associated cholestasis: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review","volume":"47","author":"Rangel","year":"2012","journal-title":"J Pediatr Surg"},{"issue":"5","key":"2021121000462829800_B31","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1177\/0148607109332773","article-title":"Fish oil-based lipid emulsions prevent and reverse parenteral nutrition-associated liver disease: the Boston experience","volume":"33","author":"de Meijer","year":"2009","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"2","key":"2021121000462829800_B32","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.jpeds.2009.08.033","article-title":"Failure of resolution of portal fibrosis during omega-3 fatty acid lipid emulsion therapy in two patients with irreversible intestinal failure","volume":"156","author":"Soden","year":"2010","journal-title":"J Pediatr"},{"issue":"5","key":"2021121000462829800_B33","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1177\/0148607110363614","article-title":"A new intravenous fat emulsion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil: a single-center, double-blind randomized study on efficacy and safety in pediatric patients receiving home parenteral nutrition","volume":"34","author":"Goulet","year":"2010","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"5","key":"2021121000462829800_B34","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1053\/j.gastro.2007.03.043","article-title":"High-dose oral erythromycin decreased the incidence of parenteral nutrition-associated cholestasis in preterm infants","volume":"132","author":"Ng","year":"2007","journal-title":"Gastroenterology"},{"issue":"4","key":"2021121000462829800_B35","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1016\/S0016-5085(03)01199-5","article-title":"Biliary diversion for progressive familial intrahepatic cholestasis: improved liver morphology and bile acid profile","volume":"125","author":"Kurbegov","year":"2003","journal-title":"Gastroenterology"},{"issue":"1","key":"2021121000462829800_B36","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/0016-5085(88)90301-0","article-title":"Partial external diversion of bile for the treatment of intractable pruritus associated with intrahepatic cholestasis","volume":"95","author":"Whitington","year":"1988","journal-title":"Gastroenterology"},{"issue":"2","key":"2021121000462829800_B37","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/00005176-199402000-00001","article-title":"Differential diagnosis of extrahepatic biliary atresia from neonatal hepatitis: a prospective study","volume":"18","author":"Lai","year":"1994","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"1","key":"2021121000462829800_B38","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1002\/hep.24023","article-title":"Effects of the infant stool color card screening program on 5-year outcome of biliary atresia in Taiwan","volume":"53","author":"Lien","year":"2011","journal-title":"Hepatology"},{"issue":"1","key":"2021121000462829800_B39","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1542\/peds.114.1.297","article-title":"Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation","volume":"114","author":"American Academy of Pediatrics Subcommittee on Hyperbilirubinemia","year":"2004","journal-title":"Pediatrics"},{"issue":"4","key":"2021121000462829800_B40","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1542\/peds.2009-0128","article-title":"Screening of infants for hyperbilirubinemia to prevent chronic bilirubin encephalopathy: US Preventive Services Task Force recommendation statement","volume":"124","author":"US Preventive Services Task Force","year":"2009","journal-title":"Pediatrics"}],"container-title":["NeoReviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/neoreviews\/article-pdf\/14\/2\/e63\/817131\/neoreviews_201302.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/neoreviews\/article-pdf\/14\/2\/e63\/817131\/neoreviews_201302.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,5]],"date-time":"2024-05-05T10:57:39Z","timestamp":1714906659000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/neoreviews\/article\/14\/2\/e63\/87273\/Neonatal-Cholestasis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2,1]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2013,2,1]]},"published-print":{"date-parts":[[2013,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/neo.14-2-e63","relation":{},"ISSN":["1526-9906"],"issn-type":[{"value":"1526-9906","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,2,1]]}}}