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Doctors now screen children for NAFLD if they have obesity. A child with NAFLD has a higher risk of other health conditions, such as diabetes. Share on PinterestThomas Barwick/Getty ImagesFatty liver occurs when there is an excessive buildup of fat in the liver. Over time, the fat deposits can irritate the liver and cause scarring, leading to more serious health issues. This article discusses fatty liver in children, including its signs, causes, risk factors, and treatments. It also explores the dangers and health risks of fatty liver if left untreated. Overview of fatty liver types NAFLD affects 10% of children in the United States, including:1% of children aged 2–4 years17% of children aged 15–17 years38% of children with obesity There are two types of fatty liver that may result in further complications: Simple fatty liver disease or nonalcoholic fatty liver This type of fatty liver happens when a child has excess fat in the liver, but there is little or no liver inflammation or damage. It typically does not cause further liver damage or complications. Nonalcoholic steatohepatitis NASH This type occurs when the fat deposits in the liver cause inflammation and liver damage. Around 20–50% of children with NAFLD have the NASH form. However, researchers do not know why some children have simple fatty liver disease while others have NASH. Symptoms Specialist child doctors, or pediatricians, sometimes refer to NAFLD as a silent liver disease because children do not usually have symptoms. Children who do have symptoms may:feel tiredbecome tired easilyhave discomfort over the liver, in the upper right side of the abdomen Doctors may suspect NAFLD due to abnormal blood test results, an abdominal ultrasound, or a CT scan ordered for a different purpose. Pediatricians may refer children to other specialist doctors, such as pediatric gastroenterologists. These doctors specialize in health issues relating to the digestive system, liver, or nutrition. Causes of fatty liver Doctors do not fully understand why some children develop NAFLD. The Children’s Liver Disease Foundation suggests there are genetic factors involved. Environmental triggers that allow for insulin resistance and fat buildup in the liver may also contribute to the development of NAFLD. Most children with NAFLD are in their adolescent years. However, the condition is becoming increasingly common in young children. Risk factors The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition recommends screening for the following groups:children with obesity aged 9–11 yearschildren who are overweight with additional risk factors, such as:accumulation of fat in the lower torso around the abdomen, which is called central adiposityprediabetesdiabetesdyslipidemiasleep apneayounger children with severe obesity or hypopituitarism, where the pituitary gland fails to produce hormonessiblings and parents of children with NAFLD Doctors screen children for fatty liver disease using the alanine aminotransferase test (ALT). While ALT and imaging tests may help screen fatty liver, having a liver biopsy is the only way to diagnose NAFLD, determine its severity, and rule out other conditions that may cause elevated liver enzymes. A parent or caregiver can consult a pediatrician if they have any concerns about their child’s risk of NAFLD. Dangers if left untreated Doctors recommend early screening to detect fatty liver before it progresses to cirrhosis. NAFLD, specifically NASH, is the leading cause of chronic liver disease and liver transplants in older children. Cirrhosis is a late-stage, irreversible disease where scar tissue replaces liver tissue, and the organ becomes permanently damaged. A child may require a liver transplant if cirrhosis leads to liver failure. NASH-associated cirrhosis can also lead to liver cancer. A parent or caregiver should consult with a doctor to receive a prompt diagnosis and ensure that their child receives the appropriate treatment. Is fatty liver reversible If a person receives appropriate treatment early, liver damage may still be reversible. In some cases, the liver can stop or reverse the damage itself. Losing excess weight reduces fat and inflammation in the liver. This weight reduction can help reverse or at least control the progression of the disease. Treatments and lifestyle changes for fatty liver Currently, there are medications approved to treat fatty liver in children. Making certain lifestyle changes can help reverse or control the fat buildup in a child’s liver. These include:getting regular exercise and participating in sporting activitesmaintaining a moderate weighteating a balanced dietlimiting portion sizeslowering cholesterol and triglyceridescontrolling diabetesconsulting a nutritionist Parents or caregivers can consult a pediatrician for support and guidance when implementing the lifestyle changes above. Recent research suggests that vitamin E supplements may decrease inflammation and cell injury. However, the role of vitamin E in the long-term management of NAFLD is not clear, so further research is required. Another study from 2021 found vitamin E effective in normalizing ALT levels in 38% of children with NASH. Furthermore, a 2017 trial found that a mixture of docosahexaenoic acid, choline, and vitamin E was effective in decreasing severe NASH in children. Before trying supplements as a treatment, a parent or caregiver should discuss their use with a pediatrician. Summary Fatty liver disease is when the liver stores excess fat. The condition may not produce symptoms in children. However, early screening is vital to diagnose the condition and prevent serious complications, such as cirrhosis. Current treatments focus on losing weight through eating a balanced diet and doing physical activities. These lifestyle changes can reduce fat buildup, inflammation, and scarring in the liver. Last medically reviewed on April 14, 2022Liver Disease / HepatitisPediatrics / Children's HealthMedically reviewed by Mia Armstrong, MD — By Rachel Ann Tee-Melegrito on April 14, 2022 Latest newsWhat sets 'SuperAgers' apart? 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