Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease among children and teenagers. It’s often linked with obesity and diabetes. At the Kentucky Children’s Hospital Pediatric Fatty Liver Clinic, we have a team of specialists devoted to treating fatty liver disease and helping children manage their weight.
Treating children early can reduce complications and prevent the need for a liver transplant in the future. NAFLD is the second most common reason for liver transplant in adults, so it’s important to treat it while your child is young. Ours is the only program of its kind in Kentucky helping children with this condition. Often, we can reverse the effects of the disease and help your child live a healthier life.
NAFLD is a buildup of too much fat in the liver. Over time, this buildup can cause liver scarring (fibrosis/cirrhosis) and liver failure. Another proposed name for this disease is metabolic dysfunction associated fatty liver disease (MAFLD).
NAFLD can develop at any point in life, but it often starts during childhood. Most children don’t have any symptoms and signs of damage don’t appear until later stages.
The good news is that children who lose 5 percent of their body weight can reverse fat accumulation in the liver. Losing 5 percent of their body weight can improve liver scarring.
Researchers don’t know exactly what causes NAFLD, but risk factors include:
- Environmental factors, such as lack of access to fresh, healthy foods
- Family history of NAFLD
- Genetic predispositions
- Hispanic ethnicity
- Insulin resistance or diabetes
- Sleep apnea
Children with obesity and insulin resistance are more likely to develop liver scarring and liver dysfunction.
Your child’s treatment team will include experts in liver disease, nutrition and obesity. Your child’s team includes:
- A physician who specializes in treating children with fatty liver disease
- An obesity specialist trained to diagnose and treat children who are overweight
- A dietitian who evaluates children and provides nutritional counseling
- A nurse coordinator who schedules your child’s appointments and tests and makes sure your child gets the care prescribed in the clinic
Your child might need to see other specialists to address the problems that can develop because of obesity. Our clinic works closely with specialists in endocrinology, genetics, neurology, nephrology, radiology and sleep medicine.
First, we rule out other causes for your child’s liver disease, such as:
- Autoimmune issues
- Viral infections of the liver
- Abnormal iron or copper storage
- Common genetic causes of liver disease
- Thyroid issues
- Glucose problems
We then perform imaging to look for scarring of the liver. Imaging tests are simple, painless procedures and may include:
- Magnetic resonance imaging (MRI): This test doesn’t use radiation and can pick up even small signs of scarring.
- FibroScan: This specialized ultrasound measures the amount of fat buildup and scarring in your child’s liver.
- Ultrasound: Standard ultrasound can provide information on liver size and texture.
If your child has scarring, we may perform a liver biopsy. During a biopsy, we’ll insert a small needle into your child’s liver to remove a tiny sample of the tissue for testing.
Weight loss is the best way to treat NAFLD. Successful treatment for obesity involves your whole family. You’ll receive nutrition and exercise counseling for your child. This will help you support your child during their weight management journey.
We’ll follow up with you and your child regularly. This will give you a chance to ask questions and get support. Steps we will recommend for your child typically include:
- Reducing and eliminating sugary drinks (soft drinks, fruit juice, milkshakes and smoothies)
- Choosing healthy foods
- Eating breakfast regularly and limiting food consumption in the evening
- Daily physical activity to help with weight loss
- Taking a vitamin E supplement
If your child has liver scarring, we may also recommend medications to help with weight loss and reverse the scaring. Some teens 16 and over who struggle to lose weight may also be eligible for bariatric weight loss surgery.
We also study NAFLD treatment and medications and the impact of dietary counseling on children so we can learn more about the condition and develop new, effective treatments. Your child may have the opportunity to take part in one of these clinical trials.