Gastroenterology Services

Gastroenterology Services

As an experienced paediatric gastroenterologist, Dr Ong’s clinical expertise is in treating children and adolescents with various gastrointestinal, liver and nutrition conditions. At our clinic, we will provide a comprehensive review of your child’s condition and recommend appropriate treatment and investigations.

Gastroenterology Services

As an experienced paediatric gastroenterologist, Dr Ong’s clinical expertise is in treating children and adolescents with various gastrointestinal, liver and nutrition conditions. At our clinic, we will provide a comprehensive review of your child’s condition and recommend appropriate treatment and investigations.

Abdominal Pain in Children

Abdominal pain is a very common problem in children and adolescents. There are many causes of abdominal pain originating from the various organs in the abdomen- the stomach, the digestive tract, the liver, kidneys, pancreas or spleen. Chronic abdominal pain may be due to organic causes or functional causes.

Organic causes vs benign (functional) causes of abdominal pain in children

Organic causes: Upper abdominal pain in general points towards problems in the stomach such as gastritis, stomach ulcers, liver conditions or pancreas involvement. Lower abdominal pain suggests involvement of the small intestine and colon such as inflammatory bowel disease, allergic gut condition etc.

Functional causes: Frequently, recurrent abdominal pain may be due to functional causes which essentially refer to altered sensation or function of the gut. This means the gut either contract in a different way, or the patient experiences the sensation of normal gut movement as painful. Treatment is targeted towards improving the child’s symptoms.

Assessment

Paediatric gastroenterologists see hundreds of children and adolescents with abdominal pain and are highly experienced in differentiating between organic and functional causes. Depending on the history and physical examination, targeted investigations including blood tests, stool tests, breath tests and scans are ordered. Symptomatic medications may be prescribed depending on your child’s symptoms. Occasionally, an endoscopy (gastroscopy and/or colonoscopy) is performed if organic causes such as gastric problems, ulcers or inflammatory bowel disease are suspected.

What is Helicobacter pylori?

Helicobacter pylori (H pylori) is a bacteria that is found in the stomach. There are many people in Asia including children with H pylori infection. In some patients, H pylori can cause stomach or gastric pain due to the following reasons:

  • The H pylori can cause inflammation of the stomach lining causing gastritis
  • It can also lead to stomach ulcers (or sores) and duodenal ulcers. The duodenum is the first part of the small intestine. Gastritis and ulcers may lead to bleeding and anaemia.
  • In a small minority, it can cause stomach cancer (typically in adult patients)

What are the symptoms of Helicobacter pylori infection?

  • Upper abdominal pain
  • Nausea or vomiting
  • Feeling full easily after eating only small amount
  • Feeling more tired likely from anaemia
  • Stools colour changing to dark or black-colour

Are there any investigations for Helicobacter pylori infection?

Yes, the diagnosis can be confirmed with the following tests:

  • Breath test
  • Stool test
  • Blood test including checking for complications.

Patients with any of the above test positive will need a proper evaluation with upper endoscopy. An upper endoscopy is a procedure that allows the gastroenterologist to look at the inside lining of the oesophagus, stomach, and duodenum to assess for any inflammation or ulcers. The endoscopist will also take biopsies (small piece of tissue) from the lining of the stomach and duodenum to analyse under the microscope.

What are the treatments available for H pylori?

Children will be started on combination of antibiotics and medications to relieve acid in the stomach.

It is important to treat H pylori infection to help the gastric inflammation and ulcers to heal and reduce the risks of bleeding. H pylori may also cause stomach cancer in a small minority of patients although mostly in adult patients.

What is constipation?

Constipation is a common bowel problem in children. It refers to passing hard stools with difficulty, less frequently than normal. A child is considered to have constipation if they pass motion less than four times per week. Constipation affects up to 30% of children and is particularly common among toddlers and pre-school children.

How do I recognise if my child has constipation?

Signs indicating a child is constipated include:

  • Avoiding emptying the bowels.
    • A child may exhibit stool withholding behaviour such as standing on tiptoes and rocking on the heels of the feet, crossing legs, hiding in a corner or being fidgety
  • Crying when passing stools.
  • Passing liquid stools in the pants known as soiling.

How do you diagnose constipation and does my child need any test?

The diagnosis of constipation is made from the history and careful physical examination. Blood tests and scans may be ordered to rule out certain treatable causes. In rare situation, a rectal biopsy (tissue sampling from rectum) is required to diagnose Hirschspung’s disease, a rare condition affecting the nerves of the bowel.

Treatment of constipation

In most cases, constipation can be successfully treated. However, the treatment may be prolonged in resistant cases. The mainstay of treatment will be a healthy diet consisting of adequate fluids and fibre. Laxatives may be prescribed if necessary.

What services for constipation are offered in our clinic?

Our doctor will perform a comprehensive review and treatment for your child including:

  • Detailed history and physical examination
  • Dietary assessment
  • Toilet training advice
  • Blood tests and scans only if indicated
  • Prescription of appropriate medications
  • Monitoring of treatment course

Diarrhoea in Children

When a child’s bowel habits changes suddenly to become loose and watery, he or she has diarrhoea. Diarrhoea can be acute (duration less than a week) or chronic (lasting more than 2 weeks).

Acute Diarrhoea

Acute diarrhoea is commonly caused by infection with viruses, bacteria or parasites. Some of the associated symptoms are tummy pain, vomiting, frequent loose stools and fever. Dehydration is also common.

In mild cases, treatment involves ensuring that the child takes adequate oral fluids and continues to be active. However, in some cases, profuse diarrhoea and/or vomiting may cause moderate to severe dehydration. It is important to seek medical attention early as appropriate treatment such as giving replacement fluids through the veins may be necessary. Your doctor may also prescribe antidiarrhoeal medications, oral replacement fluids and probiotics depending on the symptoms.

Chronic Diarrhoea

Chronic diarrhoea refers to diarrhoea lasting more than 2 weeks. It is less common than acute diarrhoea. Patients with chronic diarrhoea often have other symptoms such as blood in the stools, loss of weight, lethargy, fever, vomiting etc. If your child has chronic diarrhoea, he or she should be assessed by a paediatric gastroenterologist to determine the causes. Specialist investigations include blood tests, specialised stool tests, breath tests. In some cases, upper endoscopy and colonoscopy are performed to make the diagnosis. Causes of chronic diarrhoea include infections, inflammatory bowel disease such as Crohns disease, ulcerative colitis, food intolerance, celiac disease, irritable bowel syndrome etc. It is important that these patients receive early treatment to control their condition.

Blood in the stools

Seeing blood in the stools or the toilet bowl water turning red can be a frightening experience. There are many possible causes for bloody stools depending on the child’s age, general condition, frequency of the bloody stools and any associated symptoms.

What are the causes of bloody stools?

Bloody stools also known as rectal bleeding occur due to bleeding in the digestive tract. The bleeding may be from the upper digestive tract (stomach and upper small intestine) and/or lower digestive tract (lower small intestine, colon, rectum and anus). The colour of the blood in the stools gives an indication of where the bleeding is coming from. Black tarry stools suggest bleeding from the upper digestive tract. The child may also vomit blood. Possible causes include stomach or duodenal ulcers, gastritis, food allergies, celiac disease, inflammatory bowel disease etc.

Bright red or maroon coloured blood indicates that bleeding is more likely to originate from the lower digestive tract. Causes include anal fissures (tear in the anus), food allergies especially cow’s milk allergy in young infants, polyps (abnormal growth in the intestine), inflammatory bowel disease and Meckel’s Diverticulum.

Assessment and Treatment

Depending on the clinical history, blood tests, stool tests and/or scans are performed to make the diagnosis. In some situation, the paediatric gastroenterologist may perform a colonoscopy and/or upper endoscopy. Treatment will depend on the causes of the rectal bleeding.

Nausea and/or vomiting in children

Nausea is the sensation of wanting to vomit or throw up. Vomiting refers to the actual forceful expulsion of stomach contents through the mouth.

What are the causes of nausea and vomiting?

Some of the more common causes include:

  1. Reflux

Reflux occurs when partially digested food in the stomach is brought back into the food pipe. The contents are usually acidic and lead to sensation of heart burn, nausea, bad or sour taste in the mouth or tummy pain. In young children or babies who are unable to speak, they may cry in distress when reflux occurs. Occasionally, children with reflux may start refusing feeds. In severe cases, vomiting of blood may occur.

  1. Stomach Flu or Gastroenteritis

Another common cause of nausea and vomiting is gastroenteritis. In most cases, gastroenteritis is caused by viruses or bacteria. It is important to ensure that the child does not get dehydrated. If he or she is vomiting frequently and unable to keep down any food or liquids, please seek medical attention. Your doctor may prescribe anti vomiting medications. Occasionally, replacement fluids given through the veins may be necessary for a few days until your child recovers from the illness.

Assessment

There are many other causes for nausea and vomiting from the common to rare conditions. Your doctor may do further investigations depending on the history and physical examination. Possible investigations include blood tests and scans. In some cases, endoscopy (camera test of the digestive tract) is performed to make a diagnosis.

What is gastroesophageal reflux?

Gastroesophageal reflux refers to the bringing up of stomach contents into the food pipe (oesophagus) and/or to the mouth resulting in vomiting. The stomach contents are normally acidic which can result in pain and discomfort for the patient.

What are the symptoms of gastroesophageal reflux in babies?

Gastroesophageal reflux is common in babies. Some of the symptoms might include:

  • Vomiting or spitting up forcefully
  • Crying and arching the back suggestive of pain
  • Refusal to feed
  • Choking during feeding
  • Not able to gain weight well

Should my baby see a doctor?

If your baby has frequent vomiting and/or have any of the symptoms listed above, take him to see a paediatrician or paediatric gastroenterologist. Your doctor will determine if your baby’s symptoms are caused by reflux or some other conditions. Occasionally, blood tests or scans are performed to exclude other causes of vomiting. In severe cases, impedance-pH monitoring (a specialised test for reflux) may be indicated.

Treatment of reflux involves adjusting feeding regimes and postures. Occasionally, medications may be prescribed by your doctor especially in severe cases.

What is celiac diseae?

Celiac disease is a chronic lifelong condition whereby the body cells attack the lining of the small intestine when gluten is eaten. This reaction causes damage to the gut which means that the body is unable to absorb nutrients properly. It affects about 1% of the population. It is important to note that celiac disease is not a food allergy or intolerance.

What are the symptoms of celiac disease?

Common presenting symptoms are:

  • Poor growth in children
  • Tiredness
  • Diarrhoea
  • Abdominal pain
  • Feeling constantly bloated
  • Constipation
  • Skin rash
  • Loss of weight
  • Passing gas frequently

Some patients with celiac disease may have no symptoms.

How is celiac disease diagnosed?

If you suspect your child has celiac disease, he or she should see a paediatric gastroenterologist. Diagnosis is made by blood tests for specific antibodies of celiac disease and genetic testing. Depending on the results of the blood tests, an upper gastrointestinal endoscopy may be performed to confirm the diagnosis.

What is the treatment of celiac disease?

Once the diagnosis of celiac disease has been established, your child will need to see a dietician. The dietician will advise on a gluten-free diet including shopping guides and meal plans.

What are the follow-up plans for celiac disease?

As celiac disease may lead to complications such as thyroid disease and diabetes, patients will need to be followed up regularly. The doctor will monitor growth and overall health of the child. Blood tests are performed to check for if the celiac disease is well controlled and to assess for any disease complications.

At our clinic, our doctor offers a comprehensive review and diagnostic workup for celiac disease including blood tests, genetic testing and/or upper gastrointestinal endoscopy. We will also follow-up children with celiac disease to monitor their control as well as check for any disease complications.

What is colic?

Colic is a condition whereby a baby with no known medical condition cries excessively for a prolonged period of time.

How do you know if your baby has colic?

Babies with colic may cry for hours for no apparent reasons (e.g.not hungry, clean diaper, no fever etc). Colic tends to occur at a similar time every day, usually in the evening after a meal. The baby may become very agitated, clenching his fists and drawing up his legs. In between the colic episodes, the baby is well.

What causes colic?

Nobody knows the root cause of colic. Several reasons have been suggested including food allergies, lactose intolerance and overstimulation of the baby. The good news is that colic usually resolves naturally by about 4 months of age.

Strategies to soothe a baby with colic:

  • Cuddle him with skin to skin contact
  • Give him a gentle massage
  • A nice warm bath
  • Play soft soothing music
  • Go for a walk- if possible, carry him in a baby’s carrier or sling

If the symptoms persist or you are worried, please bring your baby for a check-up.

Cow’s milk allergy and food intolerance

Cow’s milk allergy and other food intolerance are common in infants and young children.

Some of the symptoms to look out for if your child has milk allergy include:

  1. Rash
  2. Vomiting
  3. Diarrhoea
  4. Blood in the stools
  5. Eczema
  6. Irritability
  7. Wheeziness

Babies with cow’s milk allergy need to be fed on specialised formula for a period. If the baby is being breast fed, the mother will need to avoid certain foods such as dairy in her diet.

If you suspect your child has cow’s milk allergy, take him to see a specialist for further workup.

Irritable Bowel Syndrome in Children

Irritable Bowel Syndrome (also known as IBS) in children occurs mainly in school age children and teenagers. It is a long term disorder that affects the intestines. The intestine does not work normally and is particularly sensitive. The intestine in IBS reacts more strongly to normal stretching or movement that should not affect it. Symptoms of IBS include:

  1. Abdominal pain
  2. Bloated-ness
  3. Feeling of nausea
  4. Change in bowel habit such as diarrhoea or constipation
  5. Feeling of incomplete emptying after passing motion
  6. Dizziness
  7. Cramping sensation

Certain food, stress or bacteria overgrowth may make IBS worse. Treatment involves lifestyle modification and medications targeted towards the child’s symptoms.

What is Inflammatory Bowel Disease?

Inflammatory Bowel Disease or IBD refers to chronic inflammation of the bowel.  In general, there are 2 types of Inflammatory bowel disease:  Crohn’s disease (CD) and Ulcerative Colitis (UC). IBD is not the same as IBS (Irritable Bowel Syndrome) which is a benign functional bowel condition nor is it infectious. Approximately 30% of IBD presents during childhood and adolescence.

What is Crohn’s Disease?

Crohn’s Disease (CD) is the more common type of Inflammatory Bowel Disease in children. It affects any part of the digestive system, from the mouth to the stomach and intestine all the way to the anus. Areas of inflammation are often patchy, with sections of normal gut in between. The most common areas of involvement are the small intestine and the large intestine. Both the lining and the deeper muscle layers of the intestine wall may be affected in Crohn’s disease.

What Causes Crohn’s Disease?

Crohn’s disease is a form of autoimmune disease when the body’s own immune fighting system starts attacking healthy cells. The exact cause of Crohn’s disease is unknown. It is thought to be caused by a combination of both genetic and environmental factors which lead to activation of the immune system causing injury to the lining of the digestive tract. The inflammation further leads to ulcers and bleeding.

What are the signs and symptoms of Crohns Disease?

  • Abdominal pain
  • Diarrhoea
  • Weight loss or poor growth
  • Fatigue/Decreased energy level
  • Loss of appetite
  • Anal fissures or perianal infections
  • Unexplained fevers, joint pains, or mouth ulcers
  • Anemia (low red blood cell count)

Not all patients with Crohn’s disease will have all the features listed above.  Some patients may just present with recurrent abdominal pain and tiredness. Others may have chronic diarrhea while some patients have loss of appetite.

How is Crohn’s Disease diagnosed?

If you are worried that your child may have Crohn’s disease, he or she should see a paediatric gastroenterologist early for further workup.

Following a thorough medical history and physical examination, your doctor will order blood tests, stool tests and/or imaging studies. An upper endoscopy and colonoscopy will be performed by the paediatric gastroenterologist to confirm the diagnosis and evaluate the severity of the disease.

If you are worried that your child may have Crohn’s disease, he or she should see a paediatric gastroenterologist for further workup.

How is Crohn’s disease in children treated?

In general, medications for treatment of Crohn’s Disease are divided into 2 categories. The first category is drugs used to control the disease. The second category of medications helps keep the symptoms from starting or coming back. Your child might have to take a combination of medication to control his condition.

Upon diagnosis of Crohn’s Disease, it is common for your paediatric gastroenterologist to start your child on a liquid diet for a while.  This can help the lining of the digestive tract to heal. Absorption of nutrients will improve which will help your child to grow. Your doctor will monitor your child’s weight and height closely during follow-up.

The inflammation of the digestive tract in Crohn’s disease can make it hard for a child to get sufficient nutrients from food. Your doctor might prescribe vitamins and other supplements together with the rest of the medications.

Will my child get better?

Crohn’s disease is a lifelong condition. There is currently no cure. However with treatment, we can aim for your child to lead as normal a life as possible: going to school, playing sports and going on family holidays.

It is also important to work closely with your doctor to get the disease under control early so that your child’s growth potential is not compromised. Unlike adults, children need to grow and there is a window period for growth to occur, usually towards the teenage years. If the Crohn’s disease is under control, there will be improvement to the damage of the digestive tract. Food nutrients can then be absorbed allowing optimal growth to occur.

What about the long term?

The goal in our treatment of Crohn’s disease is to enable the child to lead as normal a life as possible. It is likely that he or she will need to continue with long term medications with regular visits to the doctor. However, if the disease is well controlled, treatment can be maintained without further escalation.

Crohn’s disease can increase the risk of colon cancer especially in those with poorly controlled disease. It is recommended that patients with Crohn’s disease get screened early and often. The best modality for screening is a colonoscopy which might need to be performed every 1-2 years after a few years of Crohn’s diagnosis.

What is Inflammatory Bowel Disease?

Inflammatory Bowel Disease or IBD refers to chronic inflammation of the bowel.  In general, there are 2 types of Inflammatory bowel disease: Crohn’s disease (CD) and Ulcerative Colitis (UC). IBD is not the same as IBS (Irritable Bowel Syndrome) which is a benign functional bowel condition nor is it infectious. Approximately 30% of IBD presents during childhood and adolescence.

What is Ulcerative Colitis?

Ulcerative Colitis (UC) is a type of IBD involving mainly the large bowel also known as the colon. In UC, the inner lining of the colon becomes inflamed resulting in many tiny ulcers developing on its surface.

What Causes Ulcerative Colitis?

Ulcerative Colitis is a form of autoimmune disease when the body’s own immune fighting system starts attacking healthy cells. The exact cause of the disease is unknown. It is thought to be caused by a combination of both genetic and environmental factors which lead to activation of the immune system causing injury to the lining of the intestine. The inflammation further leads to ulcers and bleeding.

What are the signs and symptoms of Ulcerative Colitis?

  • Tummy pain
  • Diarrhoea often with blood in the stool
  • Weight loss or poor growth
  • Fatigue/Decreased energy level
  • Loss of appetite
  • Unexplained fevers, joint pains, or rashes
  • Anaemia (low red blood cell count)

How is Ulcerative Colitis diagnosed?

If you are worried that your child may have Inflammatory Bowel disease or ulcerative colitis, he or she should see a paediatric gastroenterologist early for further workup.

Following a thorough medical history and physical examination, your doctor will order blood tests, stool tests and/or imaging studies. An upper endoscopy and colonoscopy will be performed by the paediatric gastroenterologist to confirm the diagnosis and evaluate the severity of the disease.

How is Ulcerative Colitis in children treated?

In general, medications for treatment of Ulcerative colitis are divided into 2 categories. The first category is drugs used to control the disease. The second category of medications helps keep the symptoms from starting or coming back. Your child might have to take a combination of medication to control his condition.

Frequent diarrhoea might affect your child’s body ability to absorb sufficient nutrients from food. Your doctor might prescribe vitamins and other supplements together with the rest of the medications.

What about the long term and cancer risk?

The goal in our treatment of Ulcerative Colitis is to enable the child to lead as normal a life as possible.  It is likely that he or she will need to continue with long term medications with regular visits to the doctor. However, if the disease is well controlled, treatment can be maintained without further escalation.

There is an increased risk of colon cancer after 8 years of diagnosis of Ulcerative Colitis especially in those with poorly controlled disease. It is recommended that patients with Ulcerative Colitis get a screening colonoscopy every 1 or 2 years after eight years of diagnosis. The paediatric gastroenterologist can look for cancer and treat if they find it.

Poor Growth and Nutrition in Children

In early years, children have increased energy and nutrient requirements as they are undergoing rapid growth. In some children, the growth may be poor for various reasons including the following:

  1. Acute illness
  2. Chronic illness
  3. Malabsorption
  4. Hormone problems
  5. Restricted diet
  6. Feeding problems

If your child has poor growth, it is important that he or she see a specialist for a formal assessment. Depending on the history and physical examination, the doctor will perform appropriate investigations to determine the cause. Treatment will be started depending on the cause of the poor growth.

Hepatitis A

Hepatitis A is a virus that attacks the liver. It is transmitted by consuming food and drinks contaminated with the virus or through direct contact with an infected person. Symptoms of Hepatitis A include:

  1. Fever
  2. Feeling tired
  3. Pain on the right side of the belly
  4. Jaundice (yellow discolouration of the skin)
  5. Nausea and vomiting

Diagnosis of Hepatitis A involves blood tests. Patients with Hepatitis A need close monitoring of the liver and symptomatic treatment. Most patients will make a full recovery from hepatitis A. Rarely, hepatitis A will cause severe damage leading to liver failure.

Prevention of Hepatitis A is possible by vaccination.

Hepatitis B and C

Both Hepatitis B and C are viruses that affect the liver. In children, the most common cause of Hepatitis B and C infection is by vertical transmission from mother to child. Children with Hepatitis B or C will need regular 6-12 monthly follow-up by a paediatric liver specialist to check on their liver status.  Some of these patients will require treatment with medications for their hepatitis.

Fatty Liver disease in children and adolescents

Fatty liver disease occurs when fat builds up in the liver. Although more common in adults, this condition also affects children and adolescents particularly those who are overweight. Fatty liver may result in hardening of the liver.

The diagnosis is normally made from blood test, specialised scan of the liver and occasionally a liver biopsy. It is important that children or adolescents with fatty liver are followed up regularly by paediatric liver specialists to monitor the liver condition. Medications may also be prescribed to reduce the inflammation and damage caused by fat deposits in the liver.

Autoimmune Liver Disease

Autoimmune liver disease is caused by an abnormal response of the body cells against the cells in the liver. This reaction causes damage to the liver. If left untreated, the liver may become scarred and hardened over time leading to liver failure. Treatment normally involves immune suppressant medications.

Gallstones

Gallstones are small, stone-like objects that form when the liquid in the gallbladder hardens. Gallstones are common in adults but much less common in children.

There are many causes for the formation of gallstones in children including various blood disorders, obesity, liver and kidney disease, certain medications etc.

Most children with gallstones do not have any symptoms. However, there may be complications from the gallstones including infection of the gallbladder, obstruction of the bile-ducts caused by the stones or intermittent abdominal pain. Patient may have the following symptoms:

  • Fever
  • Nausea and vomiting
  • Jaundice (skin turning yellow)
  • Abdominal pain
  • Chills

Children with gallstones should have a formal assessment by a paediatric gastroenterologist to establish the cause and/or start appropriate treatment. If you suspect your child may have complications from the gallstones, it is advisable to seek urgent medical attention.

 
   

Pancreas Conditions in Children

The pancreas is an organ that lies behind the stomach at the upper abdomen. The main function of the pancreas is to produce enzymes for the digestion of carbohydrates, fats and proteins.

Acute Pancreatitis

Acute pancreatitis occurs when the pancreas becomes inflamed. Causes of acute pancreatitis include infection, gallstones, drugs, excessive alcohol, high lipids etc.

Patients with acute pancreatitis may experience fever, severe pain, nausea and vomiting. It is important to seek medical attention early for proper evaluation and treatment.

Chronic Pancreatitis

Chronic pancreatitis occurs as a result of chronic ongoing inflammation of the pancreas. The causes of chronic pancreatitis include autoimmune conditions, genetic factors, anatomical problems with the bile ducts or pancreas etc. Complications such as diabetes, poor absorption of food substances and chronic abdominal pain may occur. Patients with chronic pancreatitis will need close follow-up.

Jaundice in babies

Jaundice refers to yellow discolouration of the skin or white of the eyes. There are 2 types of jaundice in babies: Newborn jaundice (Jaundice that develops within first few days of life) and prolonged jaundice (Jaundice lasting more than 2 weeks)

What is Newborn jaundice?

Jaundice is caused by a buildup of bilirubin in the blood. Bilirubin is produced when red blood cells break down. The bilirubin is then processed in the liver and excreted through the intestines. In newborn babies, there is an increased breakdown of red blood cells. The liver of the newborn is not mature hence it is less effective in handling the increased bilirubin leading to jaundice.

How can I tell if my baby is jaundiced?

Gently press one finger to your baby’s nose or forehead. If the skin becomes yellow when you press, your baby has jaundice.

Assessment and treatment of newborn jaundice

Jaundice occurs in about 60% of newborn term infants. In some cases, jaundice may be severe and lead to brain damage. It is important to get your baby’s jaundice checked especially if there are signs of increasing yellowness of the skin, high-pitched cry, difficult to wake etc.

Your doctor will examine your baby and if indicated measure your baby’s jaundice level by a simple blood test or scan. If the bilirubin level is high, light therapy (also known as phototherapy) may be necessary usually for a few days.

My baby’s jaundice has persisted beyond 2 weeks. Should I be worried?

There are many reasons why a baby’s jaundice may be prolonged (lasting more than 2 weeks). The most common cause is breastmilk jaundice. Nobody knows the exact cause of breastmilk jaundice but it may be related to a substance in breastmilk that affects the way the infant’s liver handle bilirubin. Breastmilk jaundice resolves spontaneously after a few weeks.

It is recommended that babies who are still jaundiced beyond two weeks are checked by a paediatric gastroenterologist or paediatrician. Apart from breast milk jaundice, there are other conditions that cause prolonged jaundice such as liver disease, infection, hormone problems, metabolic conditions etc.

About Dr. Christina Ong

Senior Consultant
Paediatrician & Paediatric Gastroenterologist

“Dr Christina Ong is a senior consultant paediatrician and paediatric gastroenterologist. Her clinical expertise includes management of children with gastrointestinal conditions as well as performing endoscopic procedures. As an experienced paediatrician with more than 20 years clinical experience, she also specialises in treating children with general medical conditions”

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