Home-based color card screening for biliary atresia: the first steps for implementation of a nationwide newborn screening in Germany

German pilot program distributed 120,000 stool color cards through maternity hospitals in Lower Saxony to enable early detection of biliary atresia, aiming to reduce age at Kasai portoenterostomy. High hospital participation (98.7%) contrasted with limited practitioner engagement, prompting transition from voluntary to proposed nationwide obligatory screening.