At what age should a neonate with suspected biliary atresia be referred to a specialist for further evaluation and potential surgical intervention?

Neonates with suspected biliary atresia should be referred to a specialist urgently, ideally within the first 2 weeks of life, for further evaluation and potential surgical intervention. Early referral is critical because biliary atresia typically presents with prolonged jaundice beyond 14 days of age, pale stools, and dark urine, which are signs that warrant specialist assessment. Prompt referral allows timely diagnosis and consideration of the Kasai portoenterostomy surgery, which has better outcomes when performed before 60 days of age.

Specifically, UK guidelines recommend that any baby with jaundice lasting more than 14 days (in term infants) should have conjugated bilirubin measured and be assessed for serious liver disease, including biliary atresia, and be referred for specialist evaluation without delay ³.