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The Scoop on Poop: Understanding Your Breastfed Baby's Bowels

Admit it. You find yourself staring obsessively into your newborn's diaper.As gross as it may sound on paper, this is something most parents can relate to.
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Admit it. You find yourself staring obsessively into your newborn's diaper.

As gross as it may sound on paper, this is something most parents can relate to. Especially if your child is breastfed, baby poop can seem like a barometer of how your little one is doing. Depending on the color, amount and frequency of a breastfed baby's stool, you may wonder if she's getting enough milk, if she's constipated, or if she's reacting to something you ate.

We're pretty much set up for poop obsession. Most breastfeeding classes go over the "stages" of newborn breastfed baby poop: tarry black or dark green meconium at the beginning, changing to green/yellow when your colostrum starts getting digested, and finally yellowish, mustardy, seedy stool when your milk comes in. Other than weight gain, tracking your baby's poop consistency and color is the only gauge you have of how well he's eating. It's no wonder you spend more time thinking about poop than you ever thought possible.

"The only thing I enjoy more than a question about poop, is when parents bring in a diaper filled with poop for me to examine very carefully," jokes Santa Monica pediatrician Jay Gordon, MD, IBCLC. "When mom´s milk comes in, poop changes to green, orange, yellow or brown, seedy, always liquid, many different colors... Stool changes color sometimes on a daily basis, and you don´t need to worry about it."

There are some red (or green, or black) flags when it comes to breastfed baby poop, however. For example, while green poop can be totally normal, it can also signify a problem. "Babies are growing quickly and sometimes have a little more bile in their stool, so they can get greenish stool," says Gordon. "Babies who catch a virus also can get a little extra bile because the poop is moving through faster and the bile doesn´t get reabsorbed, and the diaper is green... even lime green. If the stool is persistently green and watery, it can be a sign of carbohydrate overload or maybe a virus that is bothering the baby." If this is happening to your child, Gordon advises calling your pediatrician.

If you see a random streak of red blood in your breastfed baby's diaper, don't panic. There's a chance it could be your own blood that your child has digested, especially if you're having latching issues, which can cause nipples to crack and bleed. It could also be blood from your baby's rectum, if he was straining to poop. However, if you are frequently seeing blood, mucous, or what looks like black coffee grounds in your baby's stool, there could be something more serious going on. According to nutritionist Nicole Meadow, MPN, RD, this may be a sign that your baby is reacting to something in your diet that is coming through your breast milk. The most common offenders are dairy and soy (this is known as milk-soy protein intolerance, or MSPI). Your pediatrician may suggest cutting these or other foods out of your diet to see if it makes a difference.

The only color that warrants an immediate call to the pediatrician, says Dr. Alan Greene, a pediatrician and founder of the popular parenting website, is chalky white. This suggests that the liver isn't making enough bile, which is a serious medical problem.

Sometimes, it's not an ongoing problem that concerns parents, but rather an abrupt change in a baby's stool pattern. "One of the most common calls that I get from parents is when there are changes in their baby's poops that they weren't anticipating, especially first time parents," says Greene. "And that's because for most of us, if there's a change it's because of something that's 'off' a little bit. Not so with babies." These changes are usually developmental, says Greene. "Breastfed babies typically have 8-10 poops a day by the end of the first week of life. But just a few weeks later when they're a month old, the number drops in half. That doesn't mean they're constipated, it means they're maturing. They may go 3 days, or 4 days or 7 days… and it's completely normally, because breast milk is the perfect food, so there's just not the waste to be gotten rid of... [Parents] are very concerned that there's constipation if the baby hasn't gone in the last week. But most of the time, that's a normal thing, that's actually a healthy sign of great food being processed well." Some parents also worry if a breastfed baby's poop is not seedy, but that can be perfectly normal, too -- especially when solids are added, around the middle of the first year.

There's one more concern parents have regarding their infant's waste, and that's what it can do to clothes, blankets, and (unfortunately) the couch. Those bright yellow breastfed baby poop stains are one of the hardest to get out of fabrics, and blow outs are sure to happen. Many parenting bloggers Kids In The House has interviewed recommend pre-soaking stained garments and then washing them in warm water using a detergent like Oxi-Clean; others suggest laying the stained fabrics out in the sun after rinsing them in cold water, and then throwing them in the washing machine after the stains fade. Since babies have a way of pooping through their clothes at the most inopportune times, do yourself a favor: always pack an extra set of clothes for yourself and your baby, and invest in a good stain remover.

It may not seem like it now, but there will come a time when you stop neurotically fixating on your baby's bowel habits. Until you start thinking about toilet training, that is!

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