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Baby has low weight, elevated liver enzymes. What does this mean? Usual solutions?

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Pediatrician, Pulmonology
Practicing since : 2003
Answered : 1802 Questions
My wife just called me and told me that she had a message on the answering machine from our Pediatrician. Our baby is in a very low percentile in terms of weight and we have been seeing doctors for a month or so in an effort to correct this. The message said that her Iron levels (previously low) are now above average and so we should stop the iron suppliments but it also said that the follow-up lab results showed "elevated liver enzymes" and that we should call them back and schedule some follow-up labs. The office is closed right now so we can't get additional information immediately so I'm "freaking out" a bit.

I am wondering if you can tell me what "elevated liver enzymes" typically mean in this kind of case and what the usual solutions are? Baby is female, 4 months old, mainly breastfed (with about 60ml of iron fortified formula supplimented daily).
Posted Mon, 10 Sep 2012 in Child Health
Answered by Dr. Arun 8 hours later

Thanks for the query.

I apologize for the delayed response. I have gone through the details submitted with diligence and I shall provide you with useful information to allay your fears.

Your baby had low iron levels previously and the levels have picked up to more than average with treatment. In this circumstance the iron therapy is probably the cause of elevated liver enzymes.

Elevated liver enzymes can occur with iron therapy, especially in small babies. Do not panic it just means that your baby's liver is just not able to handle the excess iron in the formula. But this is only a transient condition and should settle by itself once you stop the fortification.

So the elevated liver enzymes just means baby's liver is filled up with more than needed iron and DOES NOT mean that liver is failing or bad. This happens with many drugs as temporary completely reversible side effect.

As suggested, please follow up with your pediatrician. He/she might perform some follow up labs to include iron levels. Only if the iron levels are very high, then some treatment with chelation is needed. In your baby it’s just above average. So need for any treatment.

I expect the liver enzymes to come down in a few months once the iron supplements are stopped.

Hope I cleared your doubts. I will be glad to answer any other doubts or follow up enquiries that you might have.

Dr Arun
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