Referral guideline – Pale stools in neonates and infants


  • Pale stools are not common in the neonatal / early infancy period. Despite the infant looking well, they are a potential sign of serious liver disease.
  • Dark urine can also be a sign of biliary obstruction.
  • Extra Hepatic Biliary Atresia is a condition where the bile drainage from the liver is poorly developed or damaged. Early surgery is vital to reduce the future need for liver transplantation.

GP management

  • Compare the infant’s stool to this stool chart to determine if colour is abnormal.
  • Arrange same day serum bilirubin and LFTs and refer promptly to a Paediatric Gastroenterologist/Hepatologist if abnormal.

When to refer

  • If persistent neonatal jaundice is confirmed on blood testing.

Essential referral info

  • Family History of neonatal jaundice or significant liver disease.
  • Patient details
  • Medicare number
  • Parent/carer name and contact details
  • Referring clinician details (name, contact details, provider number, date and length of referral)

Helpful referral info

  • Antenatal history – in particular ask about jaundice or pruritus

Parent service

Gastroenterology, Hepatology and Liver Transplant

Contact details

Hospital Switchboard
(Ask for Gastroenterology On-call Registrar)
t: 07 3068 1111