Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency care now for:
Vomiting blood or passing black, tar-like or visibly bloody stools
Severe breathing difficulty, collapse or difficulty waking
A rapidly enlarging or painful abdomen
Significant uncontrolled bleeding
Signs of severe dehydration, such as very few wet nappies and marked drowsiness
A baby younger than 3 months with a fever also needs prompt emergency assessment, particularly after liver surgery.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Arrange urgent same-day medical assessment if a baby has pale, grey or white stools, dark urine, or jaundice that is persisting or worsening.
These signs do not prove biliary atresia, but direct bilirubin testing should not be delayed.
After a Kasai procedure, seek urgent medical advice for fever, worsening jaundice, newly pale stools, poor feeding, vomiting or unusual sleepiness.
These can be signs of cholangitis or another infection.
Do not wait for the next routine appointment if jaundice, stool colour, fever or your child’s overall condition changes suddenly.
3
Does any of this apply?
Book an appointment
Routine follow-up is appropriate for stable concerns such as feeding-plan adjustments, vitamin monitoring, gradual growth changes or help managing scheduled medicines.
Every sign above is quoted from the sofidex article on Extrahepatic biliary atresia. If you are not sure, err upward — it is always reasonable to be checked.