Urate Crystals: What are they?

In the first days after birth, some parents are greeted with an alarming sight: a reddish-orange stain on their baby’s diaper. But don’t worry, it’s probably not blood! Likely, it’s urate crystals, and nothing to worry about. 



Urate crystals are made or uric acid, which is one of the waste products we get rid of when we urinate. While uric acid is usually dissolved into urine, the high protein and low volume of colostrum in the first few days can mean there are undissolved crystals in a baby’s diaper. Infants also have a higher level of uric acid in their blood to begin with, which is why urate crystals are much more common in infancy than any other time. 



You can differentiate urate crystals from blood by looking at their color, texture, and smell. Blood is typically brighter red, a liquid texture, and may smell metallic. Urate crystals are usually reddish-orange, have a chalky texture, and smell like urine. If you do determine it’s blood, it’s important to note that some female infants may have a small amount of blood in their diaper in the first week of life; this is a product of the hormone change from being in the mother’s womb, and not typically a cause for concern. 



What to do?

Because urate crystals are most often a product of the amount of fluid in a baby’s diet, monitoring your baby’s urine output is a good reaction to finding urate crystals. A good rule of thumb is that babies should be filling at least one diaper for each day of life, up to 6 days, when they should be using 6-10 diapers a day. If your baby is not meeting this goal, it could be a sign of potential dehydration, and a good time to check in with your pediatrician. If urate crystals continue after the first few days of life, it is also a good idea to consult your pediatrician.



In summary, urate crystals are common and likely not a cause for concern. Monitor your infant’s urine to make sure that they are urinating an appropriate amount to rule out dehydration. If urate crystals continue past an infant’s earliest days, it may be appropriate to consult your pediatrician. 


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