The scoop on baby poop: What’s Normal?
"Dr. Diamond, I am worried about my baby’s bowel movements. He goes five times a day. Is that normal?"
"Dr. Diamond, I am worried about my baby’s bowel movements. She only goes once every 4 to 5 days. Is that normal?"
"Dr. Diamond, I am worried about my baby’s bowel movements. They are always green (or yellow or dark brown or grainy or soft or hard or….). Is that normal?"
When parents experience the grandeur of a new baby and learning how to care for their first child, the mundane day-to-day activities of the baby are the ones we worry about. I am frequently asked questions comparable to the ones above.
So what are normal bowel movements for newborns? The answer can be all of the above scenarios. The key fact to remember is that all babies are unique. Their body chemistry, metabolism and organ function can widely differ depending upon many factors. These can include hydration status, the composition of their diet (and that of their mothers’ if breast-fed) and how their digestive systems function. So we can discuss a "normal" situation, but we have to emphasize that there is a huge variation of what is "normal".
The first newborn bowel movements tend to be a sticky, tarry consistency and often a black or dark green color. This is called meconium, a word derived from words meaning tarry-like. Meconium consists of material formed prior to birth while the baby is still in the uterus. As the baby begins to eat either breast milk or formula, a different type of bowel movement is made consisting of the digested remnants of their diet. A transitional pattern from meconium to a so-called normal bowel movement may be seen for several days. From that moment, the bowel movement takes on a frequency, color, inconsistency based upon how the baby’s digestive system processes its food supply.
Thus, a variety of descriptive words come into play. The consistency of the bowel movement can be seedy, grainy, creamy, like mustard, hard, soft, watery and many more. The color of the bowel movement can range from green, brown, yellow, light, dark and so forth. The frequency of the event can be after every feeding, frequently, once a day or once every few days. And of course any combination of these terms can be employed.
So what is a normal bowel movement for a baby? The answer is whatever makes your baby happy. Or a better answer might be that if having a bowel movement causes your baby significant distress, then we have a problem. This is how I would define constipation. In other words, if your baby strains and grunts for hours before passing a bowel movement, this is constipation. Doing this for only a few minutes is normal. If your baby goes once every five days with no major discomfort, this is normal for your baby. If the baby becomes progressively fussier with more and more distress, and passing the bowel movement brings relief on the fifth day, this is constipation.
Thus the consistency, color and frequency of the bowel movements are not the key factors in determining if the baby’s pattern is normal. It is the effort and possible discomfort that tell us if there is a problem.
Are there signs of potential problems other than constipation? Any blood present in the bowel movement may be warning us of a problem. If associated with significant pain or discomfort, the child’s doctor should be called immediately. If the baby is not uncomfortable but experiences a significant change in the normal pattern, this may be an early marker of a developing problem. For example, your baby changes from several bowel movements per day to one every three or four days. This may indicate the beginning of constipation. The reverse situation where the baby increases the frequency of bowel movements may tell us that a food intolerance or a viral infection may be starting.
The truth about baby poop is that there can be a tremendous number of normal variations. If your baby is pooping without serious discomfort, is very unlikely that he or she is experiencing any serious problems. As always, if you have any doubts, you should ask your child’s physician.
Mark Diamond, MD, is a pediatrician for Children’s Community Pediatrics, an affiliate of Children’s Hospital of Pittsburgh of UPMC, in the South Hills Pediatric Associates office. He is one of several doctors who regularly teach a free Baby Basics class for new and expectant parents. For more information, please visit www.cc-peds.net or call 877-449-PEDS.
About Children’s Community Pediatrics, an affiliate of Children’s Hospital of Pittsburgh of UPMC
Children’s Community Pediatrics is the largest pediatric and adolescent primary care medical network in Western Pennsylvania. With 27 locations in eight counties, you can find expert, sensitive, well- and sick-child care in a community near you. And, if your child needs specialty services, our relationship with Children’s Hospital of Pittsburgh of UPMC ensures that your child will receive the highest quality care available in the region.
About Baby Basics
Learn how to baby your baby with Baby Basics. Baby Basics is a free class that covers the fundamentals in caring for your newborn. A certified pediatrician teaches each class, discussing routine baby care, breast and formula feeding, signs of a sick baby, and other important topics. Questions are always welcome, and being around other expectant parents provides a comfortable, relaxed environment. Moms also receive a free gift bag with items worth more than $50. Classes are offered regularly at Children’s Community Pediatrics offices region wide. Visit www.cc-peds.net or call 877-449-PEDS for locations and more information.