The color of the stools of an infant can signal a serious liver disease.
The color of a baby's stool can vary from golden yellow to ocher bronze through green meadow. Nothing abnormal to this, as long as this color is not too pale: discolored stools can be the sign of a liver disease.
Indeed, this color is given by the bile, which is a yellow or green fluid secreted by the liver, and whose tint is not modified by the milk from which the infants are fed. Bile is normally eliminated by stool. Stools too pale indicate a malfunctioning of the body called cholestasis, "consequence of an anomaly of the formation or elimination of the bile", explains Professor Emmanuel Jacquemin, pediatric hepatologist at CHU Bicêtre (Paris). That is, either the bile is not formed normally, or it does not reach the intestines. Professor Jacquemin continues his explanation: "The bile engorges the liver, which is very quickly damaged."
The bile can therefore be discharged into the blood instead of in the intestine, and it then colors the skin and eyes in yellow, causing jaundice. But the yellow color of the skin does not always indicate a serious illness: many newborns present a physiological jaundice without gravity which disappears through a simple exposure to light. In this case, the color of the stool is normal.
What is the name of this disease?
This disease is called neotanal cholestasis, which literally means "stopping or slowing the circulation of bile affecting the newborn".
In 1 case out of 2, cholestasis is due to a narrowing (atresia) of the bile ducts.
What are the risks to the baby?
Bile stagnating in the liver can cause cirrhosis as early as the 2nd month
Cholestasis is accompanied by a deficiency of vitamin K (which allows a good blood coagulation): the baby risks hemorrhage.
Is it healing?
Detected early enough, neotanal cholestasis due to an atresia of the biliary tract is surgically taken care of as early as the first month of life, thus avoiding the liver being too damaged. "Ideally, it would take a diagnosis in the first 15 days of life," says Professor Jacquemin.
If the screening occurs after 4 months, the child will have to undergo a liver transplant when he is between 2 and 3 years old.
Early maternity leave decreases the chances that the medical team will notice that the stools are too pale.
That is why the Association Liver Diseases Children (AMFE) launches a campaign called "Yellow Alert" to alert on this disease and to encourage parents to monitor the stools of their infants.
A color scale, allowing parents to locate when the color of the stool is too pale, will probably be inserted in the health record as early as 2015.
IN CASE OF DOUBT, ALERT YOUR DOCTOR: NEONATAL CHOLESTASE IS A VITAL EMERGENCY.
How many babies are affected?
Approximately 300 newborns are infected each year with neonatal cholestasis.
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