When you become a new parent, it is amazing how many of your thoughts and conversations are about poop. Babies can’t tell you how they are doing, so we have to look for clues. Many parents are left wondering, “Is my baby’s poop normal?”
Baby stool is classically yellow, tan, brown, or even green.
Red blood is concerning and would require an urgent visit to the baby’s doctor or even to the emergency room if there is a significant amount.
Very pale stool can be concerning and means the baby should be seen by a doctor as well.
Very dark black sticky stool is normal in the first few days of life, but after that, it is abnormal and requires attention.
There is a wide range of “normal” stool frequency. An infant can stool once per week and be normal, or stool 12 times a day and be normal. This is true for babies fed with breast milk or formula. In addition, it can be normal to have changes in frequency along this spectrum. Thus, pooping frequency doesn’t really define constipation for a baby.
Constipation in a baby is defined by having hard stools, or having a hard time passing stools.
Infant stools should be soft and have a mustardy consistency or be runnier than that. Anything of a peanut butter consistency, or more firm, is abnormal. And infants certainly shouldn’t have firm stools.
It is normal for a baby to bear down, push and get red or purple in the face. But if this takes longer than 10 minutes or involves crying, it is abnormal.
If a baby is trying to poop and failing, that is abnormal as well. If a baby is significantly fussy for a long stretch and isn’t happy until after they stool, that can suggest they are constipated and need help.
To help with constipation, you can give an infant under two months dark Karo syrup. Five milliliters (1 teaspoon) at a time can be given directly to the baby, or mixed into a bottle of breast milk or formula. This can be done several times per day.
For babies older than two months of age, prune juice can be very effective. Adult prune juice seems to work the best. You can give the baby 30 milliliters (1 ounce) at a time, either straight, or mixed with breast milk or formula. This can be done several times per day as well. There is no need to water down the prune juice because we are using it like a medicine.
The sugars found in dark Karo syrup and prune juice aren’t digested and absorbed very well. Instead, they draw fluid into the intestine, softening the stool and encouraging the stool to get moved through.
Some constipation can be related to mother’s diet (for breast-fed babies) or which formula the baby is on, but this isn’t very common. It would probably be best to discuss this with your baby’s doctor before making dietary or formula changes.
At four months old, babies can start to eat rice or oat cereal. At six months, they can start to eat baby food. It is very common to become constipated during these diet changes. If this happens, prune juice or baby food prunes are usually the best remedies.
If your baby has a strange poop and you are going to go see your baby’s doctor, take a picture with your phone – it helps if we can see what you are seeing. Don’t worry – we won’t think you are weird, because poop questions are normal!
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This is the 1st installment in a healthcare series from Mercy Des Moines.