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What is Neonatal Hepatitis? Causes, Symptoms, and Treatment

By Riddhi Roy
Updated: 9 Aug 2026, 5:00 pm
Medically Reviewed by Dr. Sahana K P, Consultant – Obstetrics and Gynaecology, Apollo Hospitals

A newborn's yellow skin is often harmless, but when jaundice lasts longer than expected, it could signal a liver problem called neonatal hepatitis. Although rare, this condition needs prompt diagnosis to prevent complications and support healthy growth.

Pregatips
Neonatal hepatitis is inflammation of the liver that develops in babies, usually between one and two months of age. It causes jaundice, pale stools, and dark urine because bile builds up in the liver instead of flowing normally into the intestines. About 20% of cases are linked to a viral infection passed from mother to baby, while the remaining 80% have no identifiable cause and are termed idiopathic. Early diagnosis matters because neonatal hepatitis shares symptoms with biliary atresia, a more serious condition requiring surgery within the first two months of life.
In this article:

What Is Neonatal Hepatitis?

Neonatal hepatitis is inflammation of the liver in infants, usually occurring within the first three months of life. The liver plays an important role in digesting fats, removing toxins, storing nutrients, and producing proteins needed for growth.

When the liver becomes inflamed, it cannot filter bilirubin or process fats normally. This leads to jaundice, poor fat digestion, and slow weight gain. Neonatal hepatitis is different from viral hepatitis seen in older children or adults.


What Causes Neonatal Hepatitis?

Many conditions can lead to neonatal hepatitis. The most common causes include:

Viral infections: Some infections passed from the mother during pregnancy or acquired after birth can affect the baby's liver, including:

  • Cytomegalovirus (CMV)
  • Herpes simplex virus (HSV)
  • Rubella
  • Hepatitis B
  • Hepatitis C
  • Enteroviruses
Genetic and metabolic disorders: Certain inherited conditions interfere with normal liver function, such as:

Problems with bile flow: Conditions that block or reduce bile flow can damage the liver. One important condition is biliary atresia, as it requires urgent surgery.

Other causes:

  • Sepsis (serious bacterial infection)
  • Rare autoimmune conditions
  • Unknown cause (idiopathic neonatal hepatitis)

What Are the Symptoms of Neonatal Hepatitis?

The symptoms usually appear within the first few weeks after birth.

Common signs include:

  • Jaundice lasting beyond two weeks in full-term babies or three weeks in a premature baby
  • Yellow eyes and skin
  • Dark yellow urine
  • Pale, white, or clay-coloured stools
  • Enlarged liver
  • Swollen abdomen
  • Poor feeding
  • Slow weight gain
  • Excessive sleepiness
  • Irritability
In severe cases, initial symptoms include lethargy and poor feeding, with jaundice worsening within one to two days. An enlarged liver or spleen may also be found on physical examination. Stool colour is one of the most useful early clues for parents: pale, chalky, or clay-like stools indicate reduced bile flow and require urgent medical review.

How Is Neonatal Hepatitis Treated?

Treatment depends entirely on the underlying cause.

Nutritional support: Many babies have difficulty absorbing fats. Doctors may recommend:

  • High-calorie feeds (concentrated formula or added calorie booster)
  • Medium-chain triglyceride (MCT) formula when needed
  • Breastfeeding whenever possible, unless a metabolic disorder requires a different feeding plan
Vitamin supplements: These fat-soluble vitamins may not be absorbed well when bile flow is impaired. Babies with cholestasis often need extra:

  • Vitamin A
  • Vitamin D
  • Vitamin E
  • Vitamin K
Medicines: Depending on the diagnosis, treatment may include:

  • Antiviral medicines for selected viral infections
  • Antibiotics for bacterial infections
  • Medicines to improve bile flow in appropriate cases
  • Treatment for inherited metabolic disorders
There is no single specific cure for idiopathic neonatal hepatitis, and most infants recover liver function over months, though a small number go on to develop chronic liver disease.

When Should You See a Doctor

Many newborns develop physiological jaundice, which usually improves within the first two weeks. However, parents should seek medical advice if:

  • Jaundice lasts longer than two weeks
  • Stools become pale or white
  • Urine appears dark
  • The baby is not feeding well
  • Weight gain is poor
Neonatal hepatitis is manageable when caught early. Watching for prolonged jaundice and pale stools gives parents the best chance of protecting their baby's liver health for the long term.

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FAQs on What is Neonatal Hepatitis? Causes, Symptoms, and Treatment

  1. Is neonatal hepatitis contagious?
    Only when caused by a virus such as hepatitis B, which can pass from mother to baby during delivery. Idiopathic cases, which make up most cases, are not contagious
  2. Can babies with neonatal hepatitis breastfeed?
    In most cases, yes. Breastfeeding is encouraged unless the baby has a specific metabolic disorder where a special diet is required. Parents should follow their doctor's advice.
  3. Can neonatal hepatitis be prevented?
    Hepatitis B vaccination for the mother and timely infant immunisation at birth reduce the risk of viral transmission. Idiopathic cases cannot be prevented.
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