Acholic Stools in babies – what to look out for and what it means
Parents of babies and children over-occupy themselves, in my opinion, with the colour of their child’s stool. Parents describe their children’s stool colour very frequently in my clinic.
So, I have already mentioned elsewhere on this website that the colour and smell of stool does not matter when a child has a diarrheal illness.
Here, however, we will not be talking about diarrheal illnesses but rather about a baby in their first few weeks of life. There is one colour that is important to look out for and that is pale stools or white stools in a baby.
If this short chapter helps catch a single case of acholic stools due to biliary atresia on time, then I’ve earned myself a place in heaven.
What gives stool its colour?
It is mainly bile salts that give stool its yellowish – green colour.
So, what does it mean if my baby has pale stool?
It means there could be a problem with the bile salts and they may not be able to reach the intestines in order to give the stool its colour.
Why would that happen to a baby?
It may say that there a disease called biliary atresia.
What else is consistent with such a diagnosis, other than acholic stools?
Prolonged jaundice in an infant that extends beyond several weeks of life and very dark urine. Often the child will also be struggling with poor weight gain.
Is this an important diagnosis in the world?
It is very important.
Even though it is not a very common disease in most places around the world, I have seen cases that were discovered several weeks late and this prevented accurate and optimal management.
In some countries around the world, parents receive a stool card to help them distinguish between normal stool colours and abnormal stool colours.
This has been proven to be helpful in earlier diagnosis and earlier treatment in certain countries in the world where the disease is more prevalent.
Do pale stools (acholic stools) necessarily indicate a problem?
No.
Sometimes babies have stools that do not get the chance to get pigmented with bile salts (especially when the baby has increased stool output), so here and there it is still normal to see pale stools. However, if it happens more than two consecutive times or if it occurs in a baby who is older than one month of age or if there is any concern for unresolvable jaundice – please see your pediatrician as soon as possible.
In summary, here is another little piece of information that we have now learned to look out for in a newborn baby.
Good luck.
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