New parents are often baffled by just how often infants poo. They find themselves wondering, is this normal? Should it look like this? When should I see a doctor? Well, rest assured as we answer all these and more in this article.
What Is the Expected Stool Frequency in Newborns?
There is no hard and fast rule where it comes to the normal stool frequency in newborns. It can be affected by factors such as the age of the infant and also whether they are breastfed or not. Let’s take a look at the various changes in stool frequency during the first few weeks of life.
Expected Stool Frequency Within the First Few Days of Life
A newborn goes through a surprising number of diapers in the first few weeks of their life. New parents are usually left baffled at just how many bowel movements an infant can have in a single day. Your infant may have up to 5 to 10 bowel movements a day by the end of their first week.
The frequency of meconium (this is the first stool a child passes) in newborns is generally variable, and it may be 3 to 5 times a day. Meconium looks like licorice or tar and is greenish-black and sticky. It is perfectly normal and healthy in newborn infants but is only temporary.
It usually takes 2-3 days, 3-5 times a day, for the dark-green color to disappear. If the baby does not discharge meconium within 24 hours after birth or you notice an abnormally swollen abdomen within 24 hours of delivery, you should take the child to the hospital immediately. This may suggest congenital malformations of the digestive tract which may cause a fecal obstruction and requires immediate intervention.
Check with your doctor if meconium lasts more than 3 days. Call your healthcare professional immediately if your child passes pure black meconium as this may be a sign of bleeding within the intestinal tract.
Expected Stool Frequency After the First Few Days of Life
The frequency of the infant’s bowel movements usually goes down during their first month as their digestive system further matures. At 6 weeks the infant may go a whole day without passing stool. For breastfed babies, the frequency of bowel movements will be very flexible, especially in the neonatal period. The frequency of defecation for breastfed babies is generally 2-5 times, it can be as high as 7-8 times a day, or even after each feeding. Breast milk promotes this because it is easily digestible, easy to discharge, and causes reflex peristalsis after the intestine is fed with food.
Therefore, if a breastfed baby has loose stools and frequent stools, as long as he is in good spirits, still breastfeeding, has a normal weight gain, and has no difficulty in defecation, abdominal pain, or flatulence, it is all normal. There is no need to worry. Artificially fed babies generally defecate 1-2 times a day.
What Is the Normal Appearance of Breastfed and Artificially Fed Infant Stools?
The normal appearance of stool in newborn infants can vary widely depending on their age, diet, health status, feeding pattern, and so on. Let’s take a look at some common stool patterns in infants.
Stool Appearance in Breastfed Infants
Newborn babies who are breastfed may have bowel movements 7-8 times a day. However, parents don’t have to worry about this. This is called physiological diarrhea, which is a perfectly normal phenomenon. The diarrhea typically regresses spontaneously once the infant is reached a certain age. Also, if the baby has dark green mucus-like stools, it means that there is insufficient breast milk and the baby is not being breastfed frequently enough.
Therefore the amount and/or frequency of breastfeeding needs to be increased. If the mother’s breast milk is indeed insufficient, fresh milk and milk powder can be added to the baby, but generally, breast milk alone is sufficient enough to provide all the energy and nutrient needs of an infant for the first six months of life.
The stool of infants who are breastfed is usually bright yellow, mild-smelling, frequent, and soft. It may also contain tiny, loose seed-like particles.
Some breastfed infants who are not properly breastfed may have bright green stools. This occurs when they nurse for short periods on each breast and receive more fore milk (which is thinner and less energy-dense) than hind milk (richer and fatter). To avoid this, allow your infant to nurse for at least 20 minutes on each Brest before switching them.
Stool Appearance of Artificially Fed Infants
Formula-fed newborn babies will have fewer stools, which are usually drier, rough, and slightly harder than that of breastfed infants, for at least the first 2 months of their lives. Stool color varies and yellow, green, and brown are all common color variants.
However, as long as it is not too hard, causes the infant pain during defecation and the child still looks healthy and happy, then it does not matter. If there is no issue with a newborn’s digestive system, it will usually be earthy or golden yellow, with a slightly sour smell.
The only time to be concerned is if the poop frequently becomes hard (a sign of constipation), watery (a sign of diarrhea) is stained with blood, fat, excess mucus, is unnaturally pale or black.
How Does an Abnormal Stool Appear in Newborns?
Let’s take a look at some examples of abnormal stool appearances in children:
1. If the baby passes stool 5-10 times a day and contains more undigested milk pieces and no mucus, it is classified as egg drop-like stool, which is abnormal stool.
2. If the stool is pale, and the baby’s white eyes and skin are usually yellow, which may be due to biliary obstruction, thick bile, or even hepatitis.
3. Black stools may be due to bleeding from the stomach or upper intestine. This situation may also occur if iron drugs are taken to treat anemia.
4. Stool with bright red streaks may also be dry and hard or you may notice cracked or inflamed skin around the anus. The stool is loose and tinged fed, it may be a sign of hemorrhagic enteritis, which usually occurs in premature infants.
5. Stool that is light yellow, mushy, oily in appearance, and unnaturally offensive is called steatorrhea, which is due to fat indigestion. The stool contains more milk flaps and fat droplets and floats on the water. The stool volume and frequency of bowel movements are relatively high.
6. Yellowish-brown watery stool, with milk pellets, and a pungent rotten egg smell may suggest protein indigestion. The stool is also frequent, small in volume, green or yellow-green, with transparent filamentous mucus. The baby may appear constantly hungry, due to insufficient nutrient absorption, hunger, or constant diarrhea.
7. Stool which contains mucus and blood is suggestive of dysentery.
What Should You Watch Out For In Your Newborn’s Stool?
Your newborn’s stool is a great indicator of their overall health. However, due to the fact that the stool frequency and appearance of newborns vary so widely, it is often hard for parents or caregivers to recognize what is normal and what isn’t. Generally, the hard or dry stool could be a sign that your infant is not receiving an adequate amount of liquids or is losing fluid at a higher rate than normal. This could be because of a fever or other illness.
An increase in the number of bowel movements above the normal pattern or passage of poorly-formed stools could be a sign of diarrhea.
Explosive diarrhea may indicate an infection. Diarrhea in infants is most likely due to a viral infection, but certain bacteria are also common culprits. Note that diarrhea is life-threatening in infants and should be taken very seriously.
When Is the Right Time to Call Your Doctor About Concerns of Your Newborn’s Stool?
Contain your pediatrician immediately if:
Your baby has new symptoms such as vomiting or a distended abdomen.
You notice the following changes in your infants stools:
- Maroon, pinkish or stained with blood.
- Black or coffee-ground brown
An increase in stool frequency that is more than usual for the infant.
Excessive amounts of mucoid material within the stool.
Your baby strains to pass stool due to the fact that they are dry or hard.
Never use enemas, stool softeners, laxatives, suppositories on an infant.