PEDIATRIC SERVICES

Pediatrics

Non-Alcoholic Fatty Liver Disease

In children and adults struggling with excessive weight, fat can accumulate in the liver, causing liver damage. In some cases, this may result in a condition called non-alcoholic fatty liver disease (NAFLD), which can lead to progressive liver injury resulting in liver scarring and eventually liver failure.

At the NewYork-Presbyterian Morgan Stanley Children’s Hospital NAFLD Clinic and NewYork Presbyterian Komansky Children’s Hospital, multidisciplinary teams of experts are committed to improving the lives of children and adolescents with this disease.

Our comprehensive and holistic approach to care includes diet and exercise guidance and therapies that are tailored to each child’s needs. Our goal is to instill lifelong habits that reduce the toll of NAFLD on children to improve their health, longevity, and quality of life.

The NewYork-Presbyterian Morgan Stanley Children’s Hospital NAFLD Clinic is solely dedicated to the care of children and adolescents with non-alcoholic fatty liver disease (NAFLD).

What is Non-Alcoholic Fatty Liver Disease (NAFLD)?

Nonalcoholic fatty liver disease (NAFLD) occurs when too much fat accumulates in the liver, causing liver damage. NAFLD is the most common chronic liver condition in children and adolescents. If left untreated, NAFLD can lead to serious conditions including liver scarring (cirrhosis) and inflammation (non-alcoholic steatohepatitis, or NASH). Adult patients with NASH are at risk for heart disease and liver cancer.

Risk Factors

Being overweight or obese is a major risk factor for NAFLD. Other risk factors for NAFLD in children include:

  • Fat concentrated around the abdomen
  • High blood sugar
  • Type 2 diabetes and insulin resistance
  • High cholesterol and other blood lipids
  • Hormonal disorder (such as an underactive thyroid or pituitary gland)

About Our Program

At the NewYork-Presbyterian Morgan Stanley Children’s Hospital Fatty Liver Disease Clinic and NewYork Presbyterian Komansky Children’s Hospital, multidisciplinary teams of liver disease specialists provide advanced and comprehensive care to children with NAFLD.

Because some children are susceptible to NAFLD due to a combination of medical, genetic, and lifestyle factors, we believe it is important to act early in a child’s life to prevent excess weight gain and subsequent liver damage that can lead to NAFLD. Starting in early childhood, our liver disease experts screen, diagnose, prevent, and treat NAFLD to give your child the best chance of combatting this serious disease.

Our team includes specialists in hepatology, gastroenterology, endocrinology, pediatrics, and nutrition who collaborate to address the unique needs of children with NAFLD. We use a variety of tools, including genetic testing, imaging, lifestyle modification (diet and exercise), and experimental therapeutics in clinical trials to create comprehensive plans of care for children of all ages.

Because we are part of a world-class medical center, we have the ability to centralize care for our patients and connect them to providers in more than 100 specialties and subspecialties. When the time comes, we can provide the support patients and their families need to ensure a smooth transition from pediatric to adult care.

Our Approach to Care

If your child has been diagnosed with NAFLD, our expert pediatric care team will tailor care based on your child’s unique needs. Our goal is to manage and monitor your child’s liver condition from diagnosis until adulthood, so that any disease progression can be managed quickly and effectively.

Holistic and Comprehensive Care

We recognize that every child with NAFLD has a unique set of symptoms, circumstances, and needs. We take a holistic approach to care that considers the entire patient, including his or her physical, emotional, and social factors. We strive to partner with patients and their parents in shared decision-making, empowering them with knowledge, support, and the most effective treatment options to achieve the best possible outcome for every child.

Multidisciplinary Team Approach to Care

NewYork-Presbyterian’s multidisciplinary liver teams have a history of close collaboration among clinical specialists, including hepatologists (liver experts), gastroenterologists, geneticists, endocrinologists, cardiologists, pathologists, social workers, nutritionists, and nurse practitioners. This multidisciplinary team approach extends to the ongoing management of the liver condition throughout the childhood years.

Continuity of Care Throughout the Lifespan of the Child

At NewYork-Presbyterian, a vital aspect of our liver disease programs is continuity of care. Children who have a lifelong need for specialized care, such as those diagnosed with NAFLD, are embraced by our care teams. We understand the continuous needs of patients regardless of age and are vested in making certain that the transition from childhood to adulthood is simplified by not needing to change care teams. Our integrated care team seamlessly transitions patients from childhood through the teen years and early adulthood. When the time comes, we help our patients transition to NewYork-Presbyterian adult care practitioners.

Parents As Team Members

As a parent, only you can provide important information about your child, especially how they were before becoming ill, and how they are feeling now. You can also help other team members shape your child's personalized treatment program based on your child's physical, emotional, and practical needs. Your input is critical for making final decisions regarding your child's care and our multidisciplinary team is here to work alongside you and your family to achieve the greatest possible outcomes for your child.

How We Diagnose NAFLD

Rendering of LiverNAFLD is diagnosed by identifying the presence of fat in the liver and excluding other causes of fat accumulation in the liver. Your child’s diagnostic tests may include:

  • Blood tests to check your child’s liver enzyme levels and for other causes of liver injury.
  • Imaging tests, such as an ultrasound, specialized ultrasound (Fibroscan) or MRI (MR elastography) to determine the extent of damage to the liver.
  • Liver biopsy (removing a small sample of tissue) to confirm the diagnosis of fatty liver and examine for signs of inflammation and scarring of the liver.
  • Advanced focused genetic analyses to determine the genetic risk for overweight/obesity.

How We Treat NAFLD

After we make an accurate diagnose of your child’s condition, our pediatric specialists craft a safe and effective treatment plan together with you and your child. Treatments may include:

Lifestyle Modification

A healthy lifestyle with healthy foods and daily exercise is the best treatment for NAFLD. Our team of physicians and nutritionists can work with you and your child to develop food and eating habits that reduce excess weight and help the liver. Once weight loss is achieved, it is important for children to maintain a healthy weight by continuing a heart-healthy diet (low fat, low cholesterol, low salt), limiting simple sugars, and exercising regularly.

Clinical Trials

Our physicians participate in clinical research studies concerning NAFLD and liver disease. Your child may have the opportunity to participate in a trial and therefore, receive treatments only available here, or at a few hospitals across the country.

Education

At NewYork-Presbyterian, we are committed to empowering parents and patients with information that enables them to make informed decisions about healthy lifestyle choices. You and your child have access to our nutritionists, weight loss therapists, and other practitioners who can provide tools and information for healthy living.

Why Choose Us

Nationally Ranked Children’s Hospitals

Both NewYork-Presbyterian Morgan Stanley Children's Hospital and NewYork-Presbyterian Komansky Children's Hospital are among the nation's leading centers for the diagnosis and treatment of childhood diseases. Both are major referral centers for complex and rare digestive disorders in infants, children, and adolescents.

Expertise in Pediatric Liver Disease

At NewYork-Presbyterian, our multidisciplinary teams have extensive experience diagnosing and treating all forms of liver disease in children using a range of different therapies, all personalized for the best results. With a world-renowned team of doctors in multiple specialties, families everywhere come to us for diagnosis, treatments, surgery and transplantations, and long-term care.

Access to World-Class Pediatric Specialists

Your child's healthcare team has access to all of the various pediatric medical and surgical subspecialists who practice at NewYork-Presbyterian, ensuring that all of your child's medical needs can be addressed.

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NewYork-Presbyterian Morgan Stanley Children's Hospital

NewYork-Presbyterian Komansky Children's Hospital