Elevated Liver Enzymes in Newborn

Updated on October 24, 2008
R.D. asks from Murrieta, CA
5 answers

Hi all. My 2 month old has elevated liver enzymes and she is 2 months old. She's had a fever once for less than 12 hours. Has anyone experienced this? I'm a little concerned.

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answers from Los Angeles on

Hi R.,

Lots of things can cause elevated liver enzymes, including malnutrition, inflammatory disease processes, and a variety of liver and blood diseases. Is your daughter jaundiced? Does she have unusual color (e.g., gray) or consistency of feces? Does she have dark urine? Does she seem unusually sleepy? Doe she have poor muscle tone (this can be difficult to tell with a 2 month old, but check her startle and grabbing reflexes to get an idea). If she has any of these symptoms, especially jaundice, check in with the doctor ASAP and ask for a more complete evaluation, including a recheck of the liver enzymes (ALT, AST and Alkaline phosphatase, especially). Depending on the results of these and other tests, your doctor may also want to do a liver ultrasound and/or a biopsy. More likely than not, however, there is nothing to worry about: the elevation could be transitory and a holdover from high neonatal bilirubin levels.

Not all babies are immunized against HBV at birth, although this is per CDC guideline and most hospitals are pretty diligent. Even so, only a portion of the viral surface protein is used to make the vaccine. While this will cause an immune response (usual symptom is fever), it should not cause elevation of the liver enzymes, as would happen if she actually had the disease. Elevation occurs because the liver is being damaged through the disease process.

Here's a caveat to the above -- is there any chance that you have chronic hepatitis B? If so, then you could have given it to your daughter at birth. Often, perinatal HBV vaccine will be sufficient to prevent infection of the newborn, but standard treatment is to also give immuneglobulin as well (HBIG). Also, is there any chance you have chronic hepatitis C? Again, if so you could have transmitted it to your daughter and the symptoms would be the same. Unfortunately, there is no vaccine for HCV, but infected infants can clear the virus without adverse effects. Please do not be insulted by this, but if you have ever engaged in high risk sexual activity, used injected drugs, or even had a blood transfusion before screening practices were instituted in 1992, you could be have contracted either HBV or HCV and never known it as many adults have either no or very mild symptoms.

I'm sure everything will be OK, but if you're concerned you should go seek the advice of your daughter's doctor, not nonmedical folks.


1 mom found this helpful


answers from Los Angeles on

Hi R.,
Was your baby vaccinated at birth for Hepatitis B? Most babies are unless the parent requests them not be. Maybe that could be it if her body is responding to the vaccine?
Just a possibility! What does her Dr. say?




answers from San Diego on

My son had this when he wasn't getting enough breast milk. We didn't know that he wasn't until he wasn't gaining weight and then they ran tests and his liver enzymes were elevated. Is she breast fed?? Is she gaining weight?? What made them test her enzymes in the first place? Good luck!



answers from Los Angeles on

Please do what you can to not do anymore vaccinations, especially at this time. Take the time to educate yourself on all sides of them - check the ingredients and the side effects and it is ok if you delay them for a bit until you have the knowledge to make the decision of what is best for your child, not what the doctor thinks is best based on what he /she was told from medical school advice from 20 years ago and is pharmaceutical backed now.

Dr. Stephanie Cave "What Your Doctor May Not Tell You About Childhood Vaccinations"

Dr. Robert Sears "The Vaccine Book"



answers from Los Angeles on

My daughter had elevated liver enzymes too at that age. She was malnourished because she is allergic to diary and was throwing up most of the breast milk she was taking in. We switched her to soy formula, she gained a lot of weight quickly, and her liver enzymes normalized.

Good luck.

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