The liver is responsible for digestion processes, the fight against microbes and the removal of toxic substances. It is the gland of internal secretion, the largest in the human body. In a child who has just been born, her weight is eighteenth of the total body weight. Sometimes a enlarged liver in a newborn is an occasion to conduct a full medical examination.
Norm and pathology
Enlarged liver is a common occurrence in the lives of children, doctors say. However, it should be remembered that in a child under the age of 5 years in a healthy state this organ should protrude a maximum of 2 cm from under the edge of the rib. And parents should not worry if the liver is slightly larger. A slight increase in this organ is characteristic of many children under 5 years of age and does not require special attention. An alarm should be raised when hepatomegaly occurs, which is accompanied by an increase in the diseased organ of the child by 1-5 cm.
In any case, pathological or normal changes in the liver are diagnosed in the newborn by a doctor by palpation. If necessary, the child is sent for an additional ultrasound.
Physiological jaundice
When examining a baby, it should be borne in mind that the liver of a newborn can have an elongated or flattened shape. Sometimes in children there is a phenomenon of "additional" tissues. These are parenchymal neoplasms that surround the main organ.
Often the liver is enlarged in a newborn with jaundice. This is a physiological problem that arises due to the fact that the gland is not yet able to fully cope with its functions in comparison with intrauterine development. After two weeks, these symptoms disappear without a trace.
An enlarged liver in a newborn 2 months old or older can no longer be a sign of physiological jaundice. It is necessary to look for another cause of the disease.
Sometimes the main factor in the yellowing of the skin of the child may be excessively fatty milk from the mother. The baby's body is unable to qualitatively process and absorb it. In this case, the termination of breastfeeding and the transition to artificial nutrition is indicated.
Pathological Factors in Infants
If the newborn has an enlarged liver, the causes should be sought in violations of the internal organs. Among the main factors that can cause pathological changes in the gland, the following can be distinguished:
- Primary lesion. It is provoked by the presence of a cyst, hemorrhagic telangiectasia or biliary cirrhosis.
- Inflammatory processes. In infants, they appear due to congenital infections (rubella, herpes, cytomegalovirus, hepatitis of all groups), blockage of the bile ducts and the like.
- Diabetic hepatosis.
- Hereditary pathology of metabolism. In a newborn, an enlarged liver and spleen may indicate amyloidosis, Gaucher disease, Neman-Peak.
- Difficulty in the outflow of blood and bile due to pathology of the excretory tract, cirrhosis of the liver and other diseases.
- Cooper cell hyperplasia, which can be triggered by excessive amounts of vitamin A, sepsis, hepatitis.
It also happens that a baby is born with poor absorption of sugar. This leads to an increase in the liver.
False and moderate hepatomegaly
How do doctors explain the term? Other ailments can also affect the change in the size of the liver in the newborn. There are frequent situations when doctors diagnose the so-called false hepatomegaly. It occurs when the lungs in newborns greatly increase with the development of emphysema. This situation can be traced by x-ray photographs. The lungs seem to displace the liver from its place. Moreover, the organ itself is not damaged and no pathological changes occur in it.
Moderate hepatomegaly occurs when the baby's body fights the infection. Such a struggle becomes the cause of an enlarged liver in a newborn child due to excessive load on it during illness. This phenomenon does not apply to pathological conditions and does not require special treatment. However, it is worth keeping the situation under control.
How does hepatomegaly manifest
This ailment is not considered a disease in the full sense of the word, but is only a manifestation of liver problems. To determine it, it is worth paying attention to a number of indicators:
- The child's skin and mucous membranes acquire a characteristic yellowish tint.
- An increase and bloating becomes noticeable.
- There are problems with feeding the baby. The kid flatly refuses to eat, is naughty, becomes tearful.
- The chair becomes white.
- There is bad breath from the baby's mouth.
- A mesh of vessels appears on the skin of a newborn.
- Pain occurs when pressing on the stomach of the child.
- Nausea, vomiting is noted.
- Frequent burping appears.
- Sleep disturbances occur, the baby often cries at night.
If the child has manifested at least one of these symptoms, you can not hesitate to consult a doctor for a minute.
Tests and examinations
Diagnosis will require examination by a pediatrician, therapist, hematologist, gastroenterologist and infectious diseases specialist. In this case, the child is assigned a number of tests and examinations: blood monitoring to study the basic biochemical parameters, radiography, electrocardiography and echocardiography.
The most complete picture for the diagnosis of liver disease can provide an ultrasound procedure. Thanks to it, it will be possible to determine the size and pathological changes that occur in the organ. In complex cases, a biopsy can be used. If there is a suspicion of hereditary diseases, an appointment with a geneticist is additionally prescribed.
Ultrasound and CT scan
Ultrasound and CT will be most effective for accurate diagnosis of diseases of the liver of newborns. However, when performing CT for babies, sedation is often used, and this is dangerous for the child's body, so most often the choice falls on ultrasound. With this examination, pathological changes in the liver are diagnosed by the following indicators:
- An increase in the right or left lobe (or both at once).
- The protrusion of the organ is 0.4 cm or more from the edge of the rib.
- Smoothing the angle of the left lobe (in healthy form, it is somewhat pointed).
- Enlargement and inflammation of the hepatic lymph node.
Among the additional indicators that may indicate specific diseases:
- The presence of cysts or cystic formations. They may be congenital or indicate parasite damage.
- Deformation of the portal vein. Normally, in a small child, its diameter should not exceed 41 mm.
- The heterogeneity of the tissues of the organ, increased echogenicity. May indicate intrauterine infection of infectious diseases and viruses.
- The development of neoplasms of a round or irregular shape with blood flow around the periphery.
Based on these and other examinations, treatment of the affected liver is prescribed. In this case, suitable drugs are used and special procedures are performed.
Treatment methods
Therapy depends directly on the causes of liver damage. If it was a virus, the baby is prescribed antiviral drugs, if the child has problems in the metabolic system from birth, then it is regulated medically. Indications for surgery may be abnormal structural features of the bile ducts or heart defects.
When diagnosing hepatomegaly in a newborn, hepatoprotectors, antibiotics, antiviral drugs and enzymes are prescribed.
Mom's Diet - Baby's Healthy Liver
For the effective treatment of diseases of the liver of a newborn, it is first of all necessary to establish the cause of the disease. An important point remains the observance of the diet by patients, doctors say. Since most newborns feed on mother's milk, the basic requirements for proper nutrition relate to a nursing woman. First of all, all fatty, spicy dishes, smoked meats, alcohol, nuts, milk, coffee, tea, cocoa and chocolate should be excluded from the diet. You can not drink carbonated drinks during this period. The daily diet of a woman should consist of boiled meat, stewed fish, vegetables, fruits.
Any disease, including one that affects the liver, undergoes effective treatment when it is detected at the initial stages. Therefore, parents should pay special attention to the ailment of the child and promptly seek help from a doctor. It is necessary to conduct research and find out why the newborn has an enlarged liver. Self-medication in this case can lead to irreparable damage to health and loss of precious time.