Published on in Health Tip of the Week
New moms and dads usually come up with plenty of things to worry about as they learn to care for their baby. It’s not uncommon for your baby’s bowel movements to be at the top of that list. Are they going too often or not enough? Is that greenish color normal? Should it smell the way it does? And why is it that texture?
To decode what’s going on in your baby’s diaper, we spoke with Joseph Gwiszcz, MD, FAAP, a pediatrician at CHOP Primary Care, Haverford, about all things poop. Here’s what to expect, what’s “normal,” and some common signs it may be time to call a pediatrician.
The first days
“Your newborn will often start off having very frequent bowel movements,” says Dr. Gwiszcz. “It may seem like she’s going after almost every feed. The bowel movements will start out as tarry black stools (this is called meconium) and then turn to a more yellow and seedy texture, that’s almost rice pudding consistency. This transition should happen within the first few days of your baby’s life.”
Establishing a pattern
After this initial change in your child’s bowel movements, the bowel pattern will soon start to vary greatly. Your infant could have bowel movements anywhere from several times a day to one every few days. “Some breast-fed babies will even have one bowel movement every four to five days, and this can be totally normal,” says Dr. Gwiszcz. “As long as it is always coming out in a soft, seedy, rice pudding or pasty consistency, any of these patterns are fine.”
As far as stool color, your baby’s poop can be yellow, green, brown or any combination of the three. “The only colors we get worried about are bright red like blood, pale white like chalk, or black like coffee grounds (after that initial first few days of life), at which point you should call your pediatrician,” recommends Dr. Gwiszcz.
If your baby is starting to have hard, small, ball, or pebble-like stools, she could be constipated. For children under 2 months old, you should talk with your pediatrician for advice on how to treat constipation. If your child is over 2 months old, Dr. Gwiszcz suggests mixing 0.5 ounces of prune juice with 0.5 ounces of water in a bottle separate from a feed, daily to help soften the stools. Babies older than 6 months can increase to 1 ounce of prune juice mixed with 1 ounce of water daily if the smaller amount isn’t working. And remember, otherwise pediatricians don't recommend anything else to drink other than breast milk, formula, or Pedialyte® (if your child is sick and you have discussed with your doctor) for babies under 6 months of age, and that includes no plain water until after 6 months old.
When to call the pediatrician
Since pooping patterns and stool colors can vary so widely, there’s not much reason to worry as long as your baby's stays fairly consistent and she’s acting like herself. If you notice any sudden changes, any indication she’s uncomfortable, or if she’s having small hard stools, be sure to check in with your pediatrician.
Contributed by: Joseph A. Gwiszcz, MD