skip to main content

Urate crystals — DCH MCQ

Instant feedback + full explanation. One question, done properly.

EasyNeonatologyUrate crystalsDCH

A 5-day-old term baby has a single small red-orange, “brick-dust” stain in the nappy. The baby is alert, feeding effectively, has produced six heavy wet nappies in the past 24 hours, and has a normal examination. What is the most appropriate advice?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Continue normal milk feeds, explain that this is likely urate crystals, and arrange review if the staining persists or the baby becomes unwell

The red-orange “brick-dust” deposit is most likely concentrated urinary urates. The baby is feeding effectively, clinically well and producing more than the expected minimum of five heavy wet nappies at 5 days, making significant dehydration unlikely. Normal milk feeding should continue; supplemental water is inappropriate and breastfeeding should not be interrupted. Because urates are most typical during the first few days, parents should seek review if the staining persists or recurs, urine output or feeding decreases, or the baby becomes unwell. There are no features suggesting a urinary tract infection, bleeding disorder or structural renal disease, so antibiotics, coagulation studies and urgent imaging are not indicated.

Reference: South West London Healthier Together, Bottle feeding your baby: Wet and dry nappies, current webpage, https://swlondon-healthiertogether.nhs.uk/new-baby/keeping-your-child-safe-2-1/bottle-feeding-your-baby