It Happens: Your Ultimate Poop Guide!
Think back to those early days of dating your partner.
You would sit over dinner and wine and discuss your life goals, families, friends, education, current events, and politics. You would cuddle and watch movies and bask in the new, romantic love.
Now think to back the early days with your baby (whether it was years ago or yesterday). The conversation most likely included lengthy discussions about the consistency, color, texture, smell, and frequency of your baby’s defecation patterns.
There were days when you would have DIED if you farted in front of your partner and now, farts and poops are the absolute center of your universe! My, how things have changed.
I’m a nurse and it is widely known that NOTHING grosses out a nurse! So settle in, shit’s about to get DETAILED!
The facts:
For the first 5 months of life (until solid foods are introduced into the diet), breastfed babies poop more frequently than formula or mixed-fed infants. This is a result of the easier, faster digestion of breast milk, when compared to formula.
The stools of breastfed infants are softer and more yellow in color than those of formula fed infants.
Some breastfed infants may stool at nearly every feed.
After 6 weeks of life, babies may have periods of infrequent stooling. As long as their stools remain soft and easy to pass, there is little to worry about. If they start to strain while having a bowel movement, and the stool is hard, you will want to consult with your family doctor or pediatrician.
Alternatively, babies can have 6 or more stools per day (especially breastfed babies). This is usually normal, but if frequent, loose stools are accompanied by other signs of illness: fever, malaise, foul smell, or blood is seen in the stool, you should be vigilant in suspecting diarrhea and consult your doctor.
If no signs of illness, but stools are watery, explosive and/or frothy, there may be an issue of milk oversupply (or lactose overload- which is VERY different from lactose intolerance or a milk allergy- but that will have to be a whole other blog post).
Studies have shown that babies have the most poops around day 15 of life. In addition, the frequency changes over time, from an average of 4 per day during month 1, to an average of 2 per day by month 3. This is mostly due to the maturation of the gut and proliferation of gut microbiota.
Temporary discoloration of stools (or urine) can result from maternal ingestion of certain foods, vitamins, medications, colored fruit or energy drinks. These color changes can be alarming for parents, but they are usually very temporary and completely harmless.
Meconium
Baby’s first stools are black and tar-like
Breast milk has a mild laxative effect to rid the baby’s gut of this stool and prevent jaundice.
Meconium contains mostly amniotic fluid, skin cells, and water
There is no smell to this poo, but it is very messy. It is sticky, and can be hard to clean from the baby’s skin, your skin, and all other surfaces it gets on!
Transitional
Within a few days of birth, stools lighten in color to greenish brown
By day 4 of life, there should have a minimum of 4 stools per day
Fewer than than is an indication of low milk transfer, may be a risk factor for low weight gain
If stool becomes light and yellow before day 4 of life, or if it is still greenish brown after the first week of life, there may be a risk for inadequate milk intake, dehydration or failure to thrive. Baby should be assessed.
Mature
Stool of a breastfed infant will appear mustard yellow with white sesame seeds or curds
Breastfed stool will be thin, soft, almost diarrhea-like in consistency and has an almost sweet smell
Formula fed babies will have yellow or brown stool that has a consistency like peanut butter; this stool is more malodorous when compared to breastfed stool.
All the colors of the rainbow
Orange, yellow, or brown
These are all normal baby poop colors!
There is a wide spectrum of normal
If your baby’s poop falls into any of these color families, there is generally nothing to worry about!
Red
Can be quite common
A sign of blood in the stool
Most cases of blood-streaked stool (meaning blood is mixed in with the stool) in otherwise healthy infants are often very temporary and benign.
If you have a close look at blood-tinged stool, you will notice that it is either mixed in with the stool or that it appears to “coat” it. Bright red blood that does not appear to be mixed in the stool is often from bleeding in the anus. Darker bleeding or blood that is mixed in with the stool suggests bleeding is occurring higher in the GI tract.
Reasons for blood in the stool can include:
Infection
Imbalance in bacterial colonies
Diet insensitivity (to something mom is eating)
Food or drug reaction
Small anal fissures
Internal bleeding from another cause
Black
Black specks in stool usually mean that baby has ingested blood while breastfeeding (usually if mom has cracked or bleeding nipples)
If stool is still black by day 3 or 4 of life, baby should be assessed, as should feeding
Black stool in an older baby who is otherwise healthy is usually a sign of high iron in the diet, or an iron supplement.
If an older baby is not yet eating solids, and is not on an iron supplement, this may be a sign of GI bleeding. You should see your pediatrician.
Green
Babies who are given an iron supplement will get a green tinge to their poop
Formula fed babies can get a dark green tinge to their stool
Once baby starts to eat solid foods, green vegetables and purees can color the stool
Slimy greenish streaks in the poop mean that mucus is present; this can be normal but can be a sign of infection. Watch to see if it persists and be vigilant for other symptoms of illness.
White
Chalky white or grey poops may indicate a digestive problem, usually with the liver or gallbladder
You should see your family doctor or pediatrician of you are seeing this
Urine
Poops are the most reliable indicator of good milk intake, but urine is also important
Some babies have decreased urine output around day 3, after they’ve rid their bodies of excess fluid, and before mom’s full milk comes in.
In general, you should expect:
Day 1: 1 wet diaper
Day 2: 2 or more
Day 4: 4 or more
Day 5 onward: 6-8 wet diapers
It can be difficult to estimate if diapers are slightly damp, wet, or soaked, especially when using highly absorbent diapers. In order to best estimate, you can try adding 3 tablespoons (15 ml) of water to a clean diaper and compare the weight of that to an unused diaper.
As for urine color, it is usually quite clear. During the first day or two of life, it may be slightly red-tinged. This is sometimes known as “brick dust urine” and it means there are uric acid crystals in the urine. If this appears after the third day of life, it can be an indicator of poor milk intake and dehydration.
Quick Diaper Assessment Guide
By the time you are changing multiple diapers per day, you will find yourself being more consumed than ever with the bowel habits of your precious little angel (parenting: miraculous it is, glamorous it is not).
You will find yourself smelling it, inspecting it up close, taking photos of it, and sending said photos to your mom, sister, friend, or coworker
Don’t worry, you are totally normal. And yes, there is a wide range of normal in all of this. If you ever have any doubts, do not hesitate to contact a trusted care provider, pediatrician or IBCLC. We can help guide, calm, educate, assist, and support you.
No matter how messy and non-glamorous parenting is, remember that it goes by so fast. Enjoy all these moments (even the diaper blow-outs) because before long, you and your partner will be back to cuddling on the couch, talking about politics and current events.