Every Diaper Tells A Story—Listen Carefully

By Sonali Shivalani *

If you are an anxious new parent trying to figure out what makes your little prince or princess comfortable, bank on his/her poop! Yes, trust me—that's the best indicator of what's going on in your little one's yet-to-mature system. And that without invasive and expensive testing! Here are some poop essentials every parent needs to be aware of.

How much poop is normal?

An exclusively breastfed baby may poop a lot and multiple times in a day. Babies do not have bowel control in the first few weeks of life and hence it is natural for them to poop with every feed, poop with every pee, and poop every time they pass wind. As stated by Dr. Mahesh Balsekar, the noted paediatrician, in his book 0 to 2 Baby & You, "A baby typically passes a stool after each feed and this may be 6 to 8 times a day." Stool patterns change with the feeding pattern of the baby. Breastfed babies may have more frequent stools than their formula-fed counterparts.

The colour and consistency of poop are your guides to what's going on inside your baby.

Note, though, that an exclusively breastfed baby may even go up to 10 days without having a bowel movement. As long as the baby is comfortable, feeding well and overall happy, do not fret. This is not constipation!

Poop in the first few days

The colour and consistency of poop are your guides to what's going on inside your baby. As much as you might hate to look into it, you must!

Here's how your baby's stool could look in the first few days of life:

When to worry?

Normally, breastfed babies have loose, watery stools with a seed-like granular consistency. However, if the baby suddenly passes very watery stools, it may indicate diarrhoea. Diarrhoea stools may be foul smelling or may contain mucus.

If the baby finds it difficult to pass a stool and if the stools appear hard, dried and pebble-like, that could indicate constipation. Very hard stools can also indicate dehydration, so this should ring an alarm.

Colour decoder

In the first few months of life, you may notice some other colours in your baby's poop and here is what it could mean:

Green poop

In most cases, an occasional green bowel movement is no cause for concern. However, if your baby is passing green poop consistently then it could be due to:

1. Jaundice—physiological or breastmilk related.
2. Formula milk which is iron fortified.
3. Too much foremilk and very little hind milk which means s/he is not getting enough of the fat content.
4. High salad /green leafy vegetable content in the mother's diet.

Black poop

The first poop—meconium—is always black and tarry. If you see black poop again in your baby's diaper, it could be due to iron-fortified formula or iron supplements. If this is not the case, then it is important to discuss it with the paediatrician as it could be because of intestinal bleeding.

Chalky white poop

If the baby's liver is not able to produce enough bile, which is required to digest food, then it can result in white poop. This surely needs investigation. The baby will not show adequate weight gain and there may also be other signs of mal-nourishment as well!

Blood in stools

Blood in the poop can indicate constipation. It can also be caused if the mom has sore and cracked nipples, which passes her blood in the breastmilk. At times, food allergies can also cause a bloody show in the stools so better be alert!

Poop changes

Many times, parents will worry that their baby strains and looks in pain when having a bowel movement but passes soft stools. As explained by Dr. Barry Steinmetz, a paediatric gastroenterologist. "A baby does not know how to contract the abdominal musculature and push. Plus they don't have gravity helping them like when you sit on a commode." A baby may actually appear surprised once the bowel movement is passed! Funny but true! As your baby grows and starts getting introduced to solid foods, expect a change in the colour, consistency and pattern of the stools.

A baby post six months of age will pass two or three bowel movements per day. The stools will be more formed and once your child learns how to use a potty, you will see that the stool comes out in the shape of letter "S", which is actually the shape of the colon. The colour of the stools will also change according to the food eaten and a child may pass green stools post eating spinach or red stools after eating beetroot. You may also see chunks of undigested foods in the stools and that's perfectly normal! It's then time for you to train your child on how to chew or introduce softer forms of food.

As a general rule of thumb, it is a good idea to pay attention to your baby's bowel movements, especially in the first few months!

* Sonali Shivalani is a pregnancy, birthing and lactation educator as well as a child nutritionist on the expert panel of BabyChakra. She is an Internationally Certified Pregnancy, Lactation and Child Nutrition Counsellor. Sonali heads CAPPA in India which is the largest Birth Professional Training organization in the World and is the Executive Director of the CAPPA International Pregnancy Fitness Educator Program.