Poo

One concern frequently expressed by new parents is whether baby's poos are normal: are there too many? not enough? Are they an odd colour? the wrong consistency?. they might also question what differences there would be between between formula feeding and breast feeding and how this impacts their baby's poo.

In the first few weeks of your baby's life, the colour, frequency and consistency of your newborn's poop will change: the character of your baby's poo depends on their age, whether they are breast- or formula- fed and whether solids have been introduced. As a result, baby's stool will change on a regular basis during the first year of their life.

When it comes to frequency, there isn't a magic number! Depending on whether your baby is fed on infant formula, or breastfed, or a combination of the two, they can have several bowel movements a day or not a pass a bowel movement for two or three days.

The colour of your baby's stool can be different on a day-to-day basis, ranging from yellow to green, which odd as it may seem at first, is quite normal, and just indicates a faster tansit through the bowel, for one of a number of reasons, see 'green poo' below

As your baby grows, you will get to know what is normal for them.

In the first couple of days, your baby will pass meconium, a sticky green-black substance made up of bile, mucus and amniotic fluid which builds up in baby's digestive system during gestation.

Babies usually start passing meconium some time in the 12 hours after birth; this is a sign that the bowel system is healthy and functioning properly. If your baby doesn't pass meconium within the first 24 hours, it could be a sign of intestinal obstruction and you should speak to your midwife.

In a formula fed baby, once the meconium is expelled from the body, expect your baby's poo to change in colour to brown-green and loose and grainy in texture to increasingly yellow with the consistency of peanut butter: relatively sold in texture. Babies fed on infant formula produce stools which have a strong smell that is similar to adult poo. Bottlefed babies usually poo once daily.

In a breastfed baby, it will change to a loose, grainy textured stool - the mustardy or chicken korma descriptions are common. The poo of babies that are breastfed tends to have a sweet smell which is not unpleasant.

The chart below, taken from 'Off To A Good Start', produced by NHS Scotland and adapted slightly for the Health Promotion Agency in Northern Ireland, is often useful.



Breastfed babies can have a bowel movement a few times a day - even after every feed, although as they get a little older the freqency of bowel movement may slow right down> Mums report that it's not unusual for a baby of a a month or more old to only poo every few days - even up to a week or ten days is within the range of what is normal!

If you're thinking of changing your baby's feeding method from breast to formula, but unsure how it'll affect baby's bowel movements, it's important that when making the transition, that it is done slowly over the course of a couple of weeks. This can help to ward off constipation and allows your baby's digestive system to adapt. Also, this slow transition also helps avoid engorgement for Mum.

When baby is much older, around the middle of their first year, you may start slowly Introducing solids into your baby's diet - and this will have the greatest impact on bowel movements. Solid foods change the smell, consistency and colour of your baby's stool, so the colour of your baby's stool will reflect what food they have eaten. For example, if your baby's just had her first peas, expect to see green poo! Also solids high in fibre like raisins, sweetcorn etc will usually be passed whole until your baby can properly digest them. Solids, especially meat, can make your baby's stool thicker, darker and (you guessed it) smellier.

There are some things that aren't normal when it comes to your baby's bowel movements.

Streaks of blood in baby stool is usually a sign of constipation, so contact your HV if you are concerned.

Green Poo?
If your baby's stool is an unusual green colour over a number of days, this can be caused by too much iron in infant formula, or increased speed of transit through the bowel, which has numerous causes - some more of a concern than others - for example it could be too much sugar (in a fully breastfed baby this can dealt with by 'block feeding' - ie using the same breast for any feeds in eg a 3 hour period); it could be that the mum is suffering from over supply or an overactive letdown, meaning baby gulps air down with the milk; it could be that baby is teething and so swallowing lots of saliva; it could be that baby has bit of a cold and is swallowing 'snot;, it could be a short-term milk allergy, possibly caused by an upset stomach or by eating something new which disagreed with them. If the poo continues to be green for more than a few days, consider if you have changed anything in baby's diet - or your own if you are breastfeeding, though this is less likely - and, as ever, if you are concerned, speak to your Health Visitor.

Constipation can be a sign of dehydration; mild dehydration often occurs when introducing your baby to solid foods. Breastfed babies are less likely to be constipated because breast milk has a natural balance of fat and protein which promotes soft stool. The symptoms of constipation include irritability when passing a bowel movement, blood in the stool, and pellets, so do contact your GP or HV if this is bothering your baby - or you! If baby is on solids and it is age appropriate, Increasing your baby's fibre intake can also help: foods high in fibre include prunes, pears and apricots and whole grain bread, pasta and cereals. But just including more fruit and veg in the diet, and giving water with meals, can help. Feeding your baby yogurt containing live cultures (lactobacillus) can also help ward off infant constipation. These 'freindly bacteria' are found naturally in breastmilk - see our article on 'Probiotics'

While an occasional loose stool is nothing to fret over, a sudden, increased frequency of bowel movements and watery, looser stool are signs of diarrhoea. Diarrhoea can be a sign of infection or a milk allergy. Contact your HV or GP if you suspect your baby has diarrhoea. Limit sweetened foods like undiluted fruit juices and try to keep baby off raw cows milk until you ahve checked with a health care professional, as an upset tum can trigger a dairy intolerance.