Acholic Stools in babies – what to look out for and what it means
Parents of babies and children, in my opinion, often over-concern themselves with the color of their child’s stool. In my clinic, parents frequently describe their children’s stool color in great detail.
I’ve already mentioned elsewhere on this website that the color and smell of stool do not matter when a child has a diarrheal illness.
However, in this section, we are not talking about diarrheal illnesses, but rather about babies in their first few weeks of life. There is one stool color that is important to pay attention to: pale or white stools in a baby.
If this short chapter helps catch even a single case of acholic stools due to biliary atresia in 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 may indicate a problem with the bile salts, which might not be reaching the intestines to give the stool its normal colour.
Why would that happen to a baby?
It could be due to a condition called biliary atresia.
What else is consistent with such a diagnosis, other than acholic stools?
Prolonged jaundice in an infant lasting beyond several weeks of life, and very dark urine. Often, the child will also struggle with poor weight gain.
Is this an important diagnosis in the world?
Yes, it is very important.
Although biliary atresia is not very common in most parts of the world, I have seen cases diagnosed several weeks too late, preventing accurate and optimal treatment.
In some countries, parents are given a stool color card to help them recognize normal versus abnormal stool colours. This has been proven to assist with earlier diagnosis and treatment, especially in regions where the disease is more prevalent.
Do pale stools (acholic stools) necessarily indicate a problem?
Not always.
Sometimes babies pass stools that haven’t yet been pigmented by bile salts—especially when they have increased stool output. So, an occasional pale stool may be normal. However, if pale stools occur more than twice in a row, appear in a baby older than one month, or are accompanied by unresolved jaundice, you should consult your pediatrician as soon as possible.
In summary, this is another important sign to watch for in newborns.
Good luck!
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