With this post let’s talk about everyone’s favorite subject, poop! Specifically I want to cover some basics about infant stooling.
Infant stooling patterns can change a lot in the first days to weeks to months of life.
The first type of stool you will see in a newborn baby has its own unique name – meconium. This stool is thick, dark black/brown, and a little slimy. The worst part is how many wipes it takes to get all that sticky poop off! The meconium will probably last for 1-3 days and then the stools will start transitioning and become lighter colored and less sticky.
As the first week of life continues, the stooling frequency will increase. There’s a wide range of normal here, but most infants who are more than a few days old should be having multiple stools per day. When I talk with parents, I focus on if the baby is gaining weight and feeding well. If those things are happening, then the exact number of stools per day isn’t too important to me.
Typical stools for breast fed infants are yellow, seedy, and pretty runny. Stools for formula fed infants can vary more in color (yellow/brown/green), and look a bit more formed – more of a paste consistency.
Around 3-4 weeks of age, your baby’s stooling pattern may change again. Babies predominantly receiving formula may slow down to stooling once a day, or once every few days. Babies predominantly receiving breast milk tend to poop a bit more often than formula fed babies. It is also possible for babies to start going multiple days without stooling (we’re talking even 5, 6, 7 days here). I know if we as adults went 4 days without stooling that would not be comfortable, but babies are often not bothered at all when this happens. It’s important that your infant continues feeding well, gaining weight, peeing frequently, and acting their normal self during the days they aren’t stooling; if that doesn’t seem to be the case then please call us!
It is very common for infants to act uncomfortable during stooling. You may notice they seem to be straining, grunting, or turning red in the face. We call this infant dyschezia. As long as the poop is soft when it comes out, this is normal and does not mean they are constipated. It happens because to release stool, you have to voluntarily relax your external anal sphincter and babies have to learn how to coordinate that. Basically they are trying to stool against a closed door – not an easy feat. This will improve over time, but sometimes can take months for them to figure out.
The next stool change will come around 4-6 months of age when your baby starts eating solids. Stools will often change color and get more firm. They still should be easy for your child to pass. You may even see chunks of undigested food in the stool – while this is a bit gross, it’s thankfully not a health concern.
So when should you worry about your baby’s stooling pattern? The big red flags for us are:
- Your baby is not gaining weight, feeding well, or acting like themselves
- Stools that have red blood in them, are black (after the initial meconium clears), or are clay-colored/white
- Stools are hard and dry or pellet-like, especially if accompanied with straining/discomfort with stooling
- Your baby has a very hard or distended abdomen
- Your baby did not pass meconium within the first 24 hours of life and has ongoing infrequent stools
Remember if at any point you are worried just give us a call.
Happy pooping!