title: Management of neonatal cholestasis: consensus statement of the Pediatric Gastroenterology Chapter of Indian Academy of Pediatrics.
abstract: BACKGROUND
  Neonatal cholestasis is an important cause of chronic liver disease in young children. Late referral and lack of precise etiological diagnosis are reasons for poor outcome in substantial number of cases in India. There is a need to create better awareness among the pediatricians, obstetricians and primary care physicians on early recognition, prompt evaluation and referral to regional centers.
  
  
  METHODS
  Eminent national faculty members were invited to participate in the process of forming a consensus statement. Selected members were requested to prepare guidelines on specific issues, which were reviewed by two other members. These guidelines were then incorporated into a draft statement, which was circulated to all members. A round table conference was organized; presentations, ensuing discussions, and opinions expressed by the participants were incorporated into the final draft.
  
  
  OBJECTIVE
  To review available published data on the subject from India and the West, to discuss current diagnostic and management practices in major centers in India, and to identify various problems in effective diagnosis and ways to improve the overall outcome. Current problems faced in different areas were discussed and possible remedial measures were identified. The ultimate aim would be to achieve results comparable to the West.
  
  
  CONCLUSIONS
  Early recognition, prompt evaluation and algorithm-based management will improve outcome in neonatal cholestasis. Inclusion of stool/urine color charts in well baby cards and sensitizing pediatricians about differentiating conjugated from the more common unconjugated hyperbilirubinemia are possible effective steps. Considering the need for specific expertise and the poor outcome in sub- optimally managed cases, referral to regional centers is warranted.
authors.affiliation: Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi; *Department of Pediatrics, King Edwards Memorial Hospital, Pune; $Department of Pediatrics, PSG Institute of Medical Sciences, Coimbatore and #Pediatric Gastroenterology Clinic, Care hospital, Nagpur, India. Correspondence to: Dr Vidyut Bhatia, Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi 110 076, India. drvidyut@me.com.
authors.forename: Vidyut
authors.initials: V
authors.lastname: Bhatia
authors.forename: Ashish
authors.initials: A
authors.lastname: Bavdekar
authors.forename: John
authors.initials: J
authors.lastname: Matthai
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Waikar
authors.forename: Anupam
authors.initials: A
authors.lastname: Sibal
mesh_terms: D000047:Academies and Institutes; D002779:Cholestasis / Q000628:therapy*; D032921:Consensus; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D016031:Liver Transplantation; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D014815:Vitamins