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Neonatal cholestasis, comprising a range of diseases including biliary atresia, is rare (about 1 in 2500 births) but can be life-threatening. Cholestasis is best discovered by age 3 to 4 weeks, and early diagnosis and treatment of biliary atresia can improve outcomes, but are often delayed.
In a survey of 108 pediatricians in Missouri, only 16% reported that they were very familiar with the American Academy of Pediatrics management recommendations for prolonged neonatal jaundice (JW Pediatr Adolesc Med Aug 9 2004). Furthermore, at the initial newborn clinic visit, 25% did not schedule a follow-up visit until after 4 weeks of age. Only two thirds said they would recommend immediate referral to a gastroenterologist for a 6-week-old well-appear…