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On Yellow Alert for liver disease: Nappy know-how could save lives

EMBARGO: 00:00, 9 October 2007
For consumer press

Parents need to be on the look-out for the signs of potentially life-threatening liver diseases when changing their baby’s nappy, a national children's charity urges today. Delays in spotting these signs and getting early treatment can lead to the need for a liver transplant at a young age and could ultimately cost them their baby’s life.

The Yellow Alert campaign, launched by Children’s Liver Disease Foundation (CLDF), is aimed at community healthcare professionals and parents and spells out the warning signs of liver disease in newly born babies. The key signs are: prolonged jaundice, lasting beyond two weeks after birth, pale stools and/or yellow urine (it should be colourless). Any of these must be reported to the midwife, health visitor or GP and a special blood test called a split bilirubin test must be done to rule out liver disease.

Catherine Arkley, Chief Executive at CLDF, says: “At least one baby is born with liver disease every day in the UK but we have no way of telling which baby will be affected. There is no specific group at risk of liver disease. It could strike any family, anytime, so it is important that everyone remains alert to the signs, which are easy to spot. That is why we are launching Yellow Alert, which clearly tells parents and community health practitioners about the signs and what they should do.”

Arkley continues: “For more than 25 years we have been supporting families devastated by their child’s death or their need for a liver transplant at a young age due to late diagnosis of liver disease. This is a human tragedy. In the early stages of liver disease a baby can look and feed entirely well, which can be misleading for everyone. Checking nappies for the warning signs and responding to prolonged jaundice may prevent the human cost we deal with, day in, day out.

“As a guide, parents should know that a healthy newborn’s urine is usually colourless whereas the stool colour should be English mustard yellow or green in bottle fed babies and daffodil yellow or green in breast fed babies.”

Emma Browne, whose daughter Ellie was diagnosed with the lethal liver disease, biliary atresia, recounts: “It was heart breaking to find out that Ellie had liver disease and needed a liver transplant at only five-and-a-half months old. What made the situation worse was that the transplant might have been avoided.”

Emma continues: “Ellie’s prolonged jaundice was missed as a sign of possible liver disease by our health visitor, midwife and GP. It was only when Ellie was three months old that my GP then realised it could be something more serious than breast-milk jaundice. By this point, Ellie’s liver was so badly damaged that a transplant was the only option.”

Mark Davenport, consultant paediatric liver surgeon at King’s College Hospital, London, reinforces the importance of early diagnosis: “The earlier a diagnosis is made, the less damage will have occurred in the liver and the higher the chances of sparing the child from a liver transplant at a young age. Time is of the essence when dealing with a condition like biliary atresia. I urge parents to speak to their health visitor, midwife or doctor if they spot any of the warning signs described by the Yellow Alert campaign.”

A leaflet for parents, Jaundice in the new born baby, is available from the CLDF website or by calling 0121 212 3839 or via email on


For further information contact:

Claire Eldridge
Tel: 020 7424 7942

Sarah Hoffman
Tel: 020 7424 7944

Notes to the editor
Please also see Liver disease in newborn babies – the facts

Available experts and photos
The following people are available for interview:
■ Catherine Arkley, Chief Executive of CLDF
■ Mr Mark Davenport, Paediatric Hepatobiliary Surgeon, Paediatric
Liver Centre, King’s College Hospital, London
■ Sarah Tizzard, Clinical Nurse Specialist, Paediatric Liver
Centre, King’s College Hospital, London

The following high resolution images are available on request:
■ Yellow Alert logo
■ Yellow Alert material shots
■ Photos of babies with liver disease

What is Yellow Alert?
Yellow Alert is a campaign targeted at parents, parents-to-be and community healthcare professionals and aims to raise awareness of the signs of liver disease in the new born baby and the action which needs to be taken in those babies who have the signs. It is accompanied by a set of resources for community health practitioners and parents. It includes a concise jaundice protocol giving professionals information and a care pathway algorithm for early identification of liver disease, a stool colour chart bookmark, a poster for health centres and surgeries and an information leaflet aimed at parents and parents to be.

Yellow Alert is approved by:
The three supra-regional paediatric liver units at King's College Hospital London, Birmingham Children's Hospital and St James's University Hospital, Leeds.

And endorsed by:
Royal College of General Practitioners (RCGP);
Royal College of Nursing (RCN);
Community Practitioners and Health Visitors Association (CPHVA);
Royal College of Paediatrics and Child Health (RCPCH);
British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN);
British Association Perinatal Medicine (BAPM); and
British Association for Community Child Health (BACCH).

Children’s Liver Disease Foundation
Formed in 1980, Children's Liver Disease Foundation (CLDF) is a unique national charity dedicated to fighting childhood liver diseases.

CLDF has three core areas of activity: it is the lead charity supporting medical research into all aspects of children's liver diseases, acts as a comprehensive information hub for healthcare professionals and the general public and provides a tailored support service for young people with liver disease and their families.

CLDF gives thousands of families one strong voice to effect change in the diagnosis and care of childhood liver disease.

For further information please visit theCLDF website or call 0121 212 3839.