The liver is a remarkable organ — the largest solid organ in the body — and it plays a central role in digestion, detoxification, immunity, and metabolism. When liver disease affects a child, the consequences can be wide-ranging and, in some cases, serious if not detected early.

Dr Harveen Singh FRACP has subspecialty training in paediatric hepatology (liver disease) and provides specialist assessment and ongoing management for children with a range of liver conditions across Sydney.

Warning Signs of Liver Disease in Children

Jaundice

Yellow discolouration of the skin and whites of the eyes (sclera) is one of the most recognisable signs of liver disease. In newborns, a degree of jaundice in the first few days of life is common and usually harmless ("physiological jaundice"). However:

Jaundice persisting beyond 2 weeks of age in a newborn requires urgent investigation

Pale/white or clay-coloured stools and dark urine alongside jaundice strongly suggest a bile flow problem (cholestasis) and require prompt assessment

Abdominal Swelling or a Palpable Liver/Spleen

A visibly swollen abdomen or an enlarged liver (hepatomegaly) or spleen (splenomegaly) felt on examination can indicate liver disease with portal hypertension or liver enlargement.

Other Warning Signs

Prolonged or unexplained fatigue and poor energy

Unexplained poor growth or weight loss

Easy bruising or bleeding (the liver makes clotting factors)

Itching (pruritus) without a rash — particularly at night

Persistently elevated liver enzymes on blood tests (ALT, AST, GGT)

Common Causes of Liver Disease in Children

Liver disease in children is categorised differently from adults. Common causes include:

Neonatal cholestasis — including biliary atresia (a surgical emergency in newborns)

Autoimmune hepatitis

Wilson's disease (copper accumulation)

Alpha-1 antitrypsin deficiency

Non-alcoholic fatty liver disease (NAFLD/MASLD) — increasingly common with rising rates of childhood obesity

Viral hepatitis (hepatitis A, B, C)

Metabolic and genetic liver conditions

What Happens at a Specialist Assessment?

If liver disease is suspected, Dr Singh will:

Take a detailed history and perform a physical examination

Order blood tests including liver function tests, hepatitis serology, autoimmune markers, and metabolic screens

Arrange liver ultrasound

In some cases, arrange a liver biopsy for definitive diagnosis and staging

Early diagnosis is important. Many conditions causing paediatric liver disease have effective treatments if detected early.

If you are concerned about your child's liver health, please ask your GP or paediatrician for a referral to Dr Harveen Singh FRACP at our Sydney clinics.

Last reviewed by Dr Harveen Singh FRACP, Paediatric Gastroenterologist & Hepatologist