Becoming a new parent means a hundred little things to fret about. And the color of your baby’s poop often figures on this list – is that color normal, should it be darker/lighter … the possibilities may seem endless and complex.
Baby poop can come in many shades of brown, yellow, or green and these variations are usually normal. Babies who are breastfed generally have mustard-colored poop while those who have formula or have started solid foods can pass brown, darker yellow or green poop. But sometimes, a change in your baby’s poop color can be indicative of a problem. In fact, if your baby’s poop looks white, pale yellow, or chalky gray, it is a good idea to see a doctor immediately. Here’s why.
Why Is Your Baby’s Poop White?
Certain medications with aluminum hydroxide, antibiotics, antifungal medicines, barium based tests such as a barium enema can cause your baby to pass white poop.1 A diet that consists purely of milk may also cause pale or white stools in some babies.2 But these are two of the less common causes of white poop. For the most part, white, pale yellow, or chalky gray poop may indicate that there is a block in your baby’s liver which is stopping bile from flowing properly. Bile is the green fluid which helps digest food and gives poop its brown or yellow color. Any such hindrance is a serious issue and can even be life-threatening.3 Here are some conditions that can cause this4
Pull Quote: It is important to see a doctor immediately if your baby’s poop is white, chalky gray, or pale yellow in color as this can indicate a block in the liver. The most common cause of a blockage is a congenital condition known as biliary atresia.5
Biliary Atresia
Biliary atresia is a condition where the ducts which carry bile from to the gallbladder to the liver get blocked. This condition is present from birth and is caused when bile ducts outside or within the liver fail to develop properly. A baby who has this condition may appear normal when born but by the second or third week jaundice, which is characterized by yellow eye whites and skin, develops. She will also start losing weight after the first month. Other signs that point to this condition include an enlarged spleen, dark urine, floating and bad smelling stools, and slow growth.
Biliary atresia can result in liver cirrhosis and liver failure which can be fatal without treatment. A surgical procedure called the Kasai operation which connects the liver and the small intestine is generally carried out to correct this problem. This operation is best done before the baby reaches 8 weeks of age. In some cases, a liver transplant may be required.6
Hepatitis
Hepatitis is a term used to describe inflammation of the liver. Various kinds of liver disease can cause this in babies including immaturity of the baby’s liver, infection by a virus, and health issues which may cause stress on the liver. A baby with hepatitis will have jaundice, caused by the obstruction to the flow of bile. And as bile is necessary to digest fats and absorb fat soluble vitamins, the baby may also fail to grow normally or gain weight. An enlarged spleen and liver are other signs of hepatitis.
Hepatitis in babies may resolve on its own. Some babies may experience damage to their liver, which too generally improves on its own. But in rare cases, the damage may be bad enough to require long-term monitoring. Jaundiced babies may require supplements of fat soluble vitamins and special baby formulas to support proper development and growth. In some cases, medication to enhance bile flow may also be advised by your doctor.7 8
Biliary Cirrhosis
Cirrhosis is a medical condition where the flow of blood through the liver is blocked due to scarring of or damage to the liver. This blockage halts the normal regulatory and metabolic processes of the baby. Biliary atresia is the most common reason for cirrhosis in babies.9 Treating the underlying cause of cirrhosis can stop the liver damage from getting worse.10
Alpha-1-Antitrypsin Deficiency
Alpha-1 antitrypsin is a protein made by your body that protects your lungs and liver from damage. People with alpha-1-antitrypsin deficiency have a genetic defect due to which they make a form of the protein which is slightly different. This condition doesn’t affect all those who have it equally. For instance, some may not suffer any ill effects while others may develop emphysema and lung damage after remaining healthy for years. Babies with this condition can develop inflammation in the liver, which can result in liver damage. Signs of this like jaundice, problems with weight gain, bleeding from the umbilicus or nose, and liver or spleen enlargement generally become obvious during the first four months.
There is no specific treatment for this condition though your doctor may regularly monitor liver function as well as development and growth. Supplementation with additional calories, vitamins or special milk formula may also be advised to address nutritional deficiencies. Some experts estimate that of the babies with alpha-1 antitrypsin deficiency and liver disease, about 5% need a liver transplant during their first year.11
Alagille Syndrome
Alagille syndrome is a genetic disorder where a person has fewer number of small bile ducts in the liver. This causes bile to accumulate in the liver, which leads to liver disease and damage. In around 30 to 50% of cases this genetic mutation is inherited, while in the rest it occurs spontaneously.
Problems with the liver can be one of the first signs of this disorder in some people and these may be seen in babies as young as 3 months. Signs of liver problems can include dark urine, white stools, itching, and jaundice. While many babies may have slight jaundice in the first 1 or 2 weeks because their liver is still immature, it tends to resolve after that. But jaundice associated with this condition worsens. Also, do keep in mind that Alagille syndrome doesn’t just affect your liver – it’s a complex condition that impacts other parts like your heart, blood vessels, eyes, kidneys, skeleton, and face.
Therapies and medications that improve the flow of bile, deal with nutritional deficiencies, promote development and growth, and manage uncomfortable symptoms like itching are used to treat this condition. It is also estimated that around 10 to 30% of people who have this condition will at some point need a liver transplant.12
Progressive Familial Intrahepatic Cholestasis
Progressive familial intrahepatic cholestasis (PFIC) is an inherited condition which leads to progressive liver disease, which may eventually cause liver failure. In people with this disorder, liver cells are not able to properly secrete bile and the accumulation of bile in liver cells results in liver disease. There are 3 kinds of PFIC – PFIC1, PFIC2, and PFIC3 – and each one is associated with a shortage of certain proteins required for the liver to function normally and has a separate genetic cause. In addition to white poop, signs of this condition can include failure to grow and gain weight normally, severe itching, jaundice, enlarged spleen and liver as well as high blood pressure in the vein supplying blood to the liver.13
Nutritional supplements to help with growth and development, medications that deal with symptoms like itching, and surgical procedures may prove helpful in this condition. Some people may also require liver transplantation.14
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