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Baby having constipation, jaundice. Total bilirubin at 2.3 and direct bilirubin at 0.47. Indications?

Hi Doctor My Baby (Boy) is 2m & 20days old. He has prolong joundice problem. His Bilirubin Total of 6 tests are like below respectively; 12.1 Day 5 11.2 Day 7 3.8 Day 18 5.3 Day 44 3.1 Day 2m &10d 2.3 TODAY + Bilirubin direct 0.47 CBC, TSH , Osmotic fragility, G6pd are done last week which are normal. Today doctor did also (ALTSGPT : 53.5) and (AST SGOT : 38.7). Doctor didn t explain us and we re confused. He told us repeat the test after 2 weeks. Baby physically looks perfect fine and active with no sign of joundice or any other thing. His weight today 5.7KG. He s facing constipation problem also from last 2 weeks so we re giving him Lactolose sirup 3 time a day. Looking for your advice and to clarify the baby s health conditions. Thanks Adeel
Asked On : Mon, 3 Dec 2012
Answers:  1 Views:  87
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Pediatrician 's  Response
Hello Adeel,

Your baby had persistent jaundice which is now decreasing and he is gaining weight adequately. You have mentioned the direct bilirubin only in the latest report which is normal. His SGPT and SGOT levels are also almost normal for his age. There are many causes of persistent jaundice and your doctor has ruled out the common causes (hypothyroidism, G6PD deficiency, hemolytic anemia). I would like to know if your child is passing clay coloured stools? If your child has history of passing clay coloured stools you should immediately get an ultrasound abdomen done and consult a paediatric surgeon.

If he is passing normal green/yellow/brown coloured stools then I agree with your doctor's decision to repeat the tests after 2 weeks. If the bilirubin is

You are giving your child lactulose since the last 2 weeks for constipation. Has your doctor discussed the cause for constipation in your baby? Lactulose can be given for a few days for constipation but not continuously and that too not three times a day. Please discuss this with your doctor and adjust the dose and duration accordingly. But more importantly what is the cause for his constipation. If your baby is breast fed then such severe constipation needs to be worked up for a cause. On the other hand formula feeding is known to cause constipation - please ensure you are using correct dilution and you can try changing the brand of formula which you are using.

Hope that helps.
Wishing you good luck.

Dr. Preeti
Answered: Fri, 15 Nov 2013
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