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Rebecca brings her 3 week old baby girl, Josie, into the Emergency department as her GP is concerned she has been having pale stools. Josie is fully breastfed, and jaundice was noted soon after birth. She remains jaundiced and there is a concern this is biliary atresia.

Which of the following clinical features would be least in-keeping with biliary atresia if this was her correct diagnosis?

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