Management of Cholestasis

Continued from Previous Post: Role of HIDA Scan in Cholestasis

Treatment of neonatal cholestasis depends on underlying etiology. 

• Biliary atresia needs early Kasai porto-enterostomy, before the age of 3 months
• Galactosemia needs lactose free diet.
• Nutrition and supplementation of vitamins play an important role in neonatal cholestasis irrespective of the underlying cause. Supplementation of fat soluble vitamins (A, D, E, K) is important. Usually 1.5- 2 times of the Daily recommended doses are used for most of the Vitamins and minerals/nutrients.

DOSES OF VITAMINS AND MINERALS IN CHOLESTASIS

Vit A	Oral	5,000-25,000 IU/day
Vit D	Oral	400- 1,200 IU/day
Vit E	Oral(Cap Evion 200/400IU)	50-400 IU/day or 15-25 IU/kg/day
Vit K	Parenteral (im or iv)	5mg monthly
Water soluble Vitamins	Oral	1.5 -2 times RDA
Calcium	Oral	20-100 mg/kg/day
Phosphorus	Oral	25-50 mg/kg/day
Zinc	Oral	1 mg/kg/day
Magnesium	Oral	1 meq/kg/day
Elemental Iron	Oral	5-6 mg/kg/day

READ ALL SECTIONS ON NEONATAL CHOLESTASIS