Chandigarh: The “yellow alert” in newborns is far more than routine infant jaundice—it is a crucial diagnostic window that is being widely missed across rural India, particularly in Punjab. Prof Sadhna Lal, a senior paediatric gastroenterologist at PGI, has warned that delayed detection of biliary atresia is leading to severe, often irreversible liver damage in infants.Biliary atresia, an aggressive condition in which bile ducts are blocked or absent, causes toxic buildup that rapidly damages the liver and leads to cirrhosis. Though the disease can be identified through simple visual signs, many infants are reaching specialist centres at around three months of age—well beyond the critical 60-day window for the life-saving Kasai procedure.The issue was highlighted at a national conference on paediatric cholestasis held on Sunday, where experts from PGI and other institutions discussed the urgent need for early diagnosis.Doctors stressed that detection does not require advanced tests but careful observation during routine care. Three key warning signs include jaundice persisting beyond 14 days, urine dark enough to leave a yellow stain on cloth nappies, and pale or clay-coloured stools. In healthy newborns, urine should be nearly colourless and should not leave a visible stain.“When these signs are ignored, the liver sustains permanent damage, leaving families with no option but liver transplant—an agonisingly expensive process that often forces them to sell all their assets,” said Prof Sadhna Lal.Despite the presence of several medical colleges, she flagged a “terrible” lack of awareness and accountability at the peripheral healthcare level, adding that Punjab’s situation is significantly worse than neighbouring Haryana and Himachal Pradesh.Biliary atresia progresses rapidly if untreated, as trapped toxins begin to destroy the liver, leading to irreversible scarring. Early intervention remains the only effective way to prevent long-term complications.PGI’s paediatric gastroenterology unit handles over 15,000 outpatient visits and around 1,000 emergency admissions annually, underlining the growing burden of such cases and the need for timely referral and diagnosis.
