instruction: hello doctor my granddaughter was normally born on april 20 her birth weight was 6 keg currently weighing keg with persistent jaundice her total bilirubin is 47 and direct is 19 she is breastfeeding along with formula as per pediatrician suggestion with couple of blood tests and ultrasound the ultrasound was tested for biliary atresia and was negative I am recently seeing oil in her stools pediatrician has evaluated it as conjugated hyperbiliruminemia it would be nice if you could review and let me know your opinions is this could be the reason for not gaining weight
output: hi persistence of direct bilirubin at two months of age needs to be evaluated properly most importantly what is the color of her stool is your doctor told you anything about the liver whether it is big or normal there are so many causes but most important and serious and need timely intervention is extrahepatic biliary atresia which as per information has been ruled out other common causes can be neonatal hepatitis or some metabolic disorder the list of causes is long so better if you can share all the reports blood urine sonography torch titer tit enzymes alpha anti trypsin etc I can advise you on how to proceed further and whether it needs further investigations