The interesting paper by W. B. Wadlington and Harris E. Riley1 discusses clearly the hepatic problems encountered in the newborn period, particularly metabolic disorders such as galactosemia, fructose intolerance and amino acid disorders. Also pertinent is the statement "abnormal accumulation of fat in its parenchymal cells is one of the most common responses of the liver to injury."

It is quite possible that this infant had galactosemia with liver damage, presenting early with steatosis, poor hepatic cell function producing high indirect (and some direct) bilirubinemia and poor albumin production.

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