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Children's health

Blood tests show elevated AST liver enzyme in baby DS - does anyone have experience of this?

67 replies

lowrib · 30/07/2009 22:26

My DS had some blood tests, they came back with raised AST, a liver enzyme.

Apparently it could mean liver damage for a number of reasons, or it could come to nothing.

We have to test again in a month. I'm trying hard not to worry. My DS is 7mo and appears healthy.

He only had the blood tests as a precaution because he's large and it's standard for babies over the 99.6 percentile. Everything else came back normal.

Does anyone have any experience of AST / raised liver enzymes?

OP posts:
splodge2001 · 30/07/2009 23:06

PLease do not panic - in all likeliness it will be nothing. DD was found to have raised ALT which is another Liver Enzyme after a prolonged jaundice screening.

AST can be a marker for liver damage but as it's found in other tissues it may point to something else. How high is it? Babies can have deranged levels of liver enzymes by comparison to adults, often it means nothing because hospital use reference ranges meant for adults. This is because reference ranges for babies sometimes dont even exist - they dont take blood from healthy babies routinely! There is some evidence to suggest that that the range of 'normal' for liver enzymes in babies is somewhat wider than the adult range. If you give me your email i will send you a very interesting paper on this.

I have done a lot of research on this and we are off to the specialist liver clinic at kings on tues. I really hope this helps.

remember if your baby seems well chances are he is.

Northernlurker · 30/07/2009 23:28

I agree with splodge - if he seems well - good energy levels, developing normally? then the chances are he's fine. I won't say don't worry because I don't think there's much chance of that - but do try not to dwell on horrible scenarios.

lowrib · 31/07/2009 11:02

splodge2001 and Northernlurker thanks for your responses and for the reassurance. I am trying my best not to worry.

splodge2001 that stuff about reference ranges is interesting. I'll try to CAT you my email address.

I can't say how high the level is as I haven't actually seen anything in writing - I spoke to my Dr on the phone. I got the impression the levels are not enormously raised but I would need to speak to him again to confirm this for sure.


OP posts:
lowrib · 31/07/2009 11:06

splodge2001 you're not set up for CAT, so I'm not sure how to get my email address to you. Would you mind maybe sending me your email address via CAT (click 'contact poster' by my name) and I can email you back?

My email address is my full name so if I post it here I'll completely out myself on MNET!

OP posts:
splodge2001 · 31/07/2009 21:07

Here is one

click view pdf on right to see the whole thing

here is the second

i cant do the cat thing im afraid

hope this helps

lowrib · 04/08/2009 02:11

splodge2001 thanks for that I really appreciate it

OP posts:
Gambrosius · 20/07/2014 23:41

I realize this thread is extremely old but upon searching for ALT/AST information for my newborn DD, I found your discussion and would love to hear how all of your babies made out?? My DD had some remaining jaundice in her eyes at her one month checkup and doc requested the bili be rechecked along with liver panel. Bili is still low (coming down slowly from a 4), and AST was elevated. Since then, retested several more times...levels continued to come down from a 69. Recently however both AST and ALT shot up to 89 and 103. Have stayed there since last test- with no symptoms whatsoever... She's seen a specialist who suspects breast milk jaundice? We're in limbo just waiting and worrying from one test to another (with a perfectly healthy baby otherwise). Any resolutions or discoveries you made with your own experiences with this would be greatly appreciated! I keep thinking the worst... Thank you!

lowrib · 24/09/2014 22:33

Goodness, I had totally, completely forgotten about this.

DS is now 5.5, and a picture of health!

We've had no issues related to that AFAIK.

However, we have had a series of blood tests done recently. DS was complaining his legs were hurting, which lead to a blood test. The test showed low Vitamin D, Low Mean Cel Volume (that means small red blood cells if I've understood correctly) and low white blood cells. He's been given a Vit D supplement + multivits + iron. After a few months we've tested again, Vit D is fine now, and white blood cells still low but not as much, so we were sent to a haematologist.

The haemotologist was very reassuring. Vitamin D deficiency very common apparently (much more so that people previously realised), and he suspects he must have had an infection the first time, which accounts for the white blood cell being low.

We're happy with that. DS seems perfectly healthy. The occasional pain in his legs is still a mystery however, but he seems to be complaining of it less now. (It wasn't that often in the first place).

Not sure why I mentioned all that! I don't think it's related, but you never know I guess ...

I hope you get some good results soon. Please try not to worry too much! I know it's easier said than done, but the chances are in your favour.

What is Breast Milk Jaundice by the way? Are you in touch with any breast feeding experts like La Leche League ?

OP posts:
lowrib · 24/09/2014 22:35

Sorry that sounds like I've contradicted myself above, by saying DS is a picture of health and then going on about blood results!

But DS is rarely ill. He's a solid child, strong and full of energy and joy.

OP posts:
walnutlemon · 09/10/2014 05:08

I'm going through a similar situation as Gambrosius with my daughter. I thought I'll post here so I can share my experience too. My daughter is 4 months old - at her 6 week check, her paed noted she looked jaundice and ordered blood tests to check her bili levels. Her bili levels were high (173) but they came down over time and are in a normal range now. However the test picked up elevated AST and ALT levels which at 6 weeks were very marginally high (around 50+) but they were obliged to repeat the blood tests and track the AST and ALT levels since they were an anomaly. We have been doing blood tests every 2 weeks since then (we've done 7 by now) and her levels have steadily increased every time (now at around 150-170). We did have one instance where there was a slight downturn (when she was 3 months old) from 129 to 120. But it went up again after that which is what's puzzling the doctors. She's exclusively breast fed, and feeds well.

We've tested for CMV, muscle disorder and both came back negative. We were referred to a specialist paed gastroentrologist who we just saw last week and she ordered up tests for inborn errors of metabolism (which as I understand are a broad spectrum of disorders). She said these are very rare - for a baby to have metabolic disorders, she must receive a faulty gene from BOTH parents (one faulty gene each). Luckily, the results just came back and she is all clear of metabolic disorders. So the course of action now is the repeat the blood test again in 3 weeks and hopefully see the AST and ALT levels come down. In her experience, she said these mildly elevated levels are usually from a viral infection that will resolve itself over time. We've more or less tested for everything else that could cause the elevated AST/ALT (CMW, muscle disorders, metabolic disorders). She said if AST/ALT levels continue to rise, she might consider testing for even rarer disorders like autoimmune disorders. However she seemed inclined to feel that we will be able to see the AST and ALT levels come down. She said our daughter looks very well upon physical examination, no swollen liver, stomach or spleen and is putting on weight (doubled her birth weight at 4 months old), but she will continue to monitor her physical well-being at the next blood test visit (3 weeks' time).

So, we're waiting now, hoping that the levels will go down. This has been and is still stressful, not knowing and waiting, and just having your mind go wild thinking about every possible scenario. We're focusing now on the present, enjoying our baby girl and not let worry and anxiety take away from our enjoyment of our precious little girl. I'll give updates as and when I know.

If any one of the moms from the original posts (5 years ago!) have an update on how their kid is doing now, 5 years later, and what was eventually the outcome of the elevated AST/ALT, that would be really helpful! Thanks so much!!

ioaname · 23/11/2014 15:57

I found this looking for elevated levels for AST and ALT. My doughter is 9 weeks old and we also have breast milk jaundice. Her billi level is 4 and AST/ALT are 83/60. Our doctor said that we can help her liver to "get started to work" and she gave us a syrup LIV52 for a month....
I am positive that everything will be fine because they are so perfect little creatures but theyr bodies are adjusting to this life now...
All the best and please let me know how your analyses are now.

Gambrosius · 23/11/2014 17:36

My daughter's numbers remained elevated until 6 months (when we recently re-tested her again). Her numbers are completely normal now and all she needed was time. She has been the picture of health all along but we still had "specialists" trying to intervene; formula supplement, perform a biopsy, complete an ultrasound, etc.. we did not do the supplementing or biopsy and I'm so glad we didn't! I've spent so much time worrying over this and we incurred many more medical bills on top of delivery costs. While not always the case, often these tests are unnecessary and shouldn't be ordered in the first place. I wonder how many babies (including my own) have had elevated numbers in their early months as their little systems learn to operate properly? Most babies aren't tested outside of the typical bilirubin tests so it's possible many babies have "abnormal elevations" that just naturally resolve over time...

My advice is to trust your own instinct and judgment when observing her every day and to give it more time (unless you're seeing unusual symptoms). Our family found peace and answers through praying and trusting God. It took some time to resolve but we are so grateful that it did! Praying for you and your daughter!

ioaname · 24/11/2014 11:21

thank you so much for your answer. it means a lot to me to see that you were in the same situation and everything is fine now. I wish you and your little one all the best in the world. :)
yes, I agree that babies so little shouldn't be tested if they seem ok. I am upset because I gave her phenobarbital at my dr advice for lowering the billi level. And it worked but it is a strong drog and I am positive that it would have been fine over time without takeing it.
Your dr didn't prescribe anything for lowering the billi level?
It is so stresfull with the first baby...
May God give us wisdom to make the right choices.

Hannahlatay1210 · 10/01/2015 20:14

Well some of these post are little old! Hope someone reads and gives me peace of mind!
My daughter will be 4mo the 16th of this month, we recently have seen her pedo, which due to her small size insisted on blood work. My husband and I are pretty small people. As well as his entire family! None of the men are over 5'7 and the woman are all 5' if that and very petite. His sister weighed 18# on her first birthday and 20# he second birthday, but was very healthy! So my LO is a tiny thing. Anyways, her liver enzymes appeared to be elevated. Normal her dr said is 60 hers were 113. She eats good, I am now supplementing beCause

Hannahlatay1210 · 10/01/2015 20:19

Sorry it posted before I was done!
....because I do believe maybe I was not producing enough. She's been strictly breastfed till last couple days. Dr loves her energy and her smile and feels she is developing great she is just a little smaller then he'd like but otherwise he has no complaints. However because of the number he is referring us to childerns hospital in Seattle. We live 3 hours away. I am freaking out! To me she is fine and healthy. Never had any odd symptoms. We struggle with acid reflux but that's it! I am so stressed! We will see them in a couple weeks. They are to call to set the appt up. They have not yet. I am happy to read some of the other posts! But I'm still stressing out!

Chelckins56 · 14/01/2015 19:55

Hannahlatay1210, I'm curious how your LO's situation turns out. We're going through practically the same situation and it's honestly freaking me out a little. I'm waiting for liver enzyme test results as I type this. My LO started out very chunky (9 lbs, 1 oz) and had lost a pound between her 4 and 6 month checkup. We had labs done Friday and had to repeat this morning due to high liver enzymes and high blood acidity. I doubt they would have worried though before weighing her! She is on track developmentally, happy as can be, and eats a ton. She is breastfed too though, so I'm wondering about the connection? She's on solids now and since her last checkup, I added a bottle of formula, but she still isn't gaining weight according to the growth curve. Me and my husband's families are both tiny too though (I'm 5'1", he's 5'10" but his dad is a jockey). I would love for it to be just a plateau in growth and she is just turning out to be smaller than they thought, but these tests are freaking me out.

sunnimama · 26/01/2015 02:07

So glad I found this thread! My 6 week old also has elevated enzymes, he's been monitored since they were picked up accidently 3 week ago and have been steadily rising. I keep finding info about 'mildly' and 'highly' elevated results but I can't find info on what is high and what is mild! Would be very curious to know others results - my boys are ferritin 1693, total bilirubin 63, direct bilirubin 16, alk phosphatase 510, alt 230, ggt 430, ast 282. He seems completely happy and healthy with no jaundice, but like you all I'm freaked out!

metisprincess · 21/02/2015 01:30

hello my grandson is 10 weeks old with elevated liver functions, he was born at 9lb 12oz 23 inches long. He dropped down to under 8lbs and when weighed last night at 10 weeks he is only 9lbs 4oz..... He has elevated levels and does not appear to be thriving. He is breastfed only. He was admitted to children's hospital yesterday...we r concerned....did anyone else have significant weight loss?

sleekgirl · 21/03/2015 08:32

My 7 week old has been jaundiced since 1 week, but bili levels did not concern drs. Yesterday blood work confirmed elevated liver enzymes. I have now been advised by her paediatrician to cease bf for 1 week and the enzyme levels will be tested again to see if breast milk jaundice, or my medication (5mg Cipralex) is causing the problem. It is so worrying when there is so little research on new borns and effects of medication, even though I have been advised by my pharmacologist that bf would not be a problem. Would love to hear if anyone ekse is taking Cipralex whilst bf?

Linzismith30 · 27/03/2015 19:41

My littlen has had similar to all this at 5 weeks she wasn't gaining much weight after having jaundice I was not bf tho and she was referred to the peads who said they think she's dairy intolerant so changed her milk accordingly and done blood tests and her gamma gt were up, so repeat bloods done and they were going down then all of a sudden around 3-4 months her ALT levels were going up so more bloods done (meanwhile she's suffering with reflux and not gaining much weight) my consultant referred us to a liver specialist hospital and we had a scan and more tests done and the scan come back with fat on the liver so they took loads of blood for metabolic and auto immune disorders and I got a phone call today saying her ALT were over 200 and they are sending her to have a biopsy and a sweat test my LO is nearly 6months and only weighs 11.12 she's little and apart from being a bit grumpy with her reflux and fussy with her food she's normal not as advanced as my other 2 but she's good and happy I found this post and found it interesting has anyone had any answers with similar to my story thank you

seahorsewahine · 31/03/2015 19:24

My daughter is in the same boat. 9 weeks old...was 7lbs 6ozs at birth, is just back to 7lbs 11ozs now at 9 weeks. Very active, alert, smiley. No signs of jaundice. Not gaining weight so they did bloodwork and found elevated liver enzymes. They are hospitalizing her over night tonight to monitor, and then do an ultrasound tomorrow. Anyone else have any results yet? I know my supply is on the lower end...but they all keep saying it is fine since she has tons of wet diapers daily.

jchanme · 01/07/2015 09:05

Over the past month, my 3mo old daughter has received several blood tests for liver functions. At first, it was the jaundice that alerted the doctor to order blood tests and ultrasonic, ultrasonic came back good, but the blood test results showed bili level is a little high and AST is 3x higher than referenced highest value, Total Protein is a little low, GGT is about 2x higher. ALT is twice higher.
Today we had the blood tests done again and the ALT and AST is more or less the same level, while the bili is in normal range now. We don't know what the causes are, but last time I presented the test results to the doctor, she asked me if I wanted to give her medicines to protect her level from damaging and for me, it is a no to give my 2mo baby medicine. I don't see any symptoms from my baby, she's beautiful and active, she's perfect. I have no reason to believe anything is wrong with her, besides, the jaundice is gone now.
How do things turn out for your LOs? I'd love to hear from you guys. My wife is very worried because we don't know that exactly is wrong.

walnutlemon · 06/07/2015 14:47

I've not looked back on this thread for a few months and I'm surprised to find it so active! It looks like this issue with elevated AST/ALT levels are more common than we realize. Our regular paed doctor also mentioned that she has seen an increase in elevated AST/ALT cases this year.

I wanted to post to give an update. My daughter is now 13 months old and her ALT/AST levels are completely normal. All clear!!

We had our visit with her specialist paed gastroenterologist last month when she was 1 and that's when she got the all clear. It has taken her longer than expected to reach the normal levels - her specialist was inclined to feel that this was something that would resolve itself over time (because we had tested for everything under the sun including rare inborn errors of metabolism, and the tests all came back negative) although she mentioned that usually it resolves within 6 months but some might take longer. The diagnosis is neonatal hepatitis - a passing viral infection - although why she had it, how she got it, we haven't a clue. And reading all these recent posts, it seems to be more common than we think.

I wanted to give an update to hopefully give some of you parents some peace of mind. It is a extremely stressful situation to be in, not knowing what it is. The not knowing is particularly hard because you keep wondering is there really something seriously wrong? Or do you trust your gut when you see your child healthy, happy and behaving perfectly normally. Not knowing means not being able to say, ok here's what the issue is, and here's how we can so to solve it, to make it better. There is no action plan to take, no end point to say, ok if we did all these things/ treatment options, etc - we can get to this point where it is better.

The worrying and not knowing and not seeing the signs of abating, of the downward trend despite months and months of repeated blood tests did topple me. And I hope that for those of you who are struggling too, please know that you are not alone. Hold on to hope, and know that you are stronger than you realize.

I'm so incredibly grateful that we can say this chapter is now closed. We got through with hope and faith and prayers, and I'm keeping all of you and your little ones in prayer!

Sani1234 · 06/08/2017 06:48

Hi I know no one has posted here since 2015. But I am going through a similar situation. My lo had physiological jaundice in day 3. And now she is 9 weeks and the jaundice is still there. It is now 7.6. The doctor thinks it's breast milk jaundice but her liver enzymes are elevated. Repeat test in 3 weeks. Wanted to find out what turned out after all these years? The liver enzymes came back to normal? If yes, when?

POLLYMURPHY · 08/09/2017 10:42

Hi Sani1234
I have a one year old who had raised liver enzymes ast and alt since she was first blood tested at 4 weeks. She went on to have endless tests scans done and everything has come back normal. She is due back in to get bloods in the next few weeks to see if the results are now normal I will let you know how we get on. Please God they are normal now.

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