Q: When will my baby be able to leave hospital and what happens next?
A. Providing that there are no complications following surgery, your baby will be home within two weeks of the operation. Before returning home the wound must be healed and your baby must have a normal temperature and have started to put on weight. You will be given an outpatient appointment.

Before your baby leaves hospital, you will be taught all about the special medicines and feeds. It is quite common for the hospital staff to advise your General Practitioner (GP) and local hospital about your child's condition and any special aspects of care, which are needed. They can offer you useful support when you are at home.

When you get home you must try and treat your baby as normally as possible. Obviously you will be worried at times and this is quite normal. Babies with biliary atresia get common illness just like any normal baby. However, if your baby has a high temperature for more than 24 hours or becomes jaundiced, or if there is an obvious change in colour of the urine and stools, or your are worried, it is important for your to see your doctor as soon as possible.

Unless there is some problem other than biliary atresia it is very important that your baby is immunized against Diphtheria, Whooping Cough, Tetanus, polio, Hib and MMR in the normal way. It does not matter if the immunisations are a little late starting because of the operation and hospital stay.

If you or your local doctor have any queries regarding your child, please contact the Consultant or Ward Sister at the hospital treating your child

Q: What medicines may my baby need and why are they given?
A.The medicines needed will depend upon your child's condition and progress but some commonly used are:

• Antibiotics - After the operation a course of antibiotics is initially given by "drip" and completed by mouth. They are used to reduce the risk of infection spreading from the gut into the liver. Further courses will be prescribed as required.
  
  
• Vitamins - Additional vitamins are necessary because poor bile flow can reduce absorption of vitamins. Some may need to be given by injection.
  
  
• Phenobarbitone - This may be given to increase the flow of bile. As it may make your baby sleepy at first it is usually given in one dose a day, in the evening.
  
  
• Cholestyramine - This comes in the form of a powder in individual sachets. Each sachet is mixed with water and given in liquid form. This may be given to improve liver function and remove substances which may otherwise cause the skin to itch. Cholestyramine can affect the absorption of some drugs, especially vitamins. Therefore, with babies it is best to give some at each feed time except when vitamins are given. As your baby becomes older and manages larger volumes the daily dose of Cholestyramine can be given all at once or split into two. For a toddler or an older child needing Cholestyramine, it is best given in one or two doses away from the main meal times and vitamins. Always leave two hours between giving Cholestyramine and vitamins.
  
  
• Spironolactone - This may need to be given to help your baby get rid excess fluid which otherwise collects in the abdomen and is called ascites. It is not needed in all cases.
  
  
• URSO - This drug may be given at the onset of feeding after Kasai. It is thought to help promote the flow of bile.
  
  
• Ranitidine - It is common to find stomach irritation after any type of abdominal operation and this drug may be given to help alleviate this problem