Jaundice in babies: implications for community screening for biliary atresia.

Although prompt referral of babies with biliary atresia ensures early surgery and improves outcome,(1) late referral persists in the United Kingdom, leading to calls for systematic screening of babies with neonatal jaundice persisting beyond 14 days.(2) This would entail reviewing the baby, establishing whether the stool is pigmented, testing urine for bilirubin, and measuring blood concentrations of conjugated and unconjugated bilirubin.(2)(3) To evaluate the feasibility of systematic screening, we ascertained the prevalence of (a) jaundice in babies aged 2, 4, and 6 weeks, and (b) dark urine or pale stools as reported by the parents or a health visitor. We also established how often stools or urine of jaundiced babies were noted by health visitors at their first visit to gauge the effect on workload. …