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 AOral5,000-25,000 IU/day
Vit DOral400- 1,200 IU/day
Vit EOral(Cap Evion 200/400IU)50-400 IU/day or 15-25 IU/kg/day
Vit KParenteral (im or iv) 5mg monthly
Water soluble VitaminsOral1.5 -2 times RDA
CalciumOral20-100 mg/kg/day
PhosphorusOral25-50 mg/kg/day
ZincOral1 mg/kg/day
MagnesiumOral1 meq/kg/day
Elemental IronOral5-6 mg/kg/day
DOSES OF VITAMINS AND MINERALS IN CHOLESTASIS

READ ALL SECTIONS ON NEONATAL CHOLESTASIS

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