New parents have a steep learning curve. Infants don’t come with an instruction manual and as we all know, children are not little adults. Along with all the love felt for your new little one, there is also a lot of uncertainty, from “Are they growing enough?” to “Is their poop normal?”
What Is Meconium?
While babies are still in the womb, their bodies are making a special kind of poop that is called meconium. It is typically dark brown or green, and very sticky. Meconium usually appears in the diaper for a couple of days after birth, but as your baby starts to eat, they begin to have what is called transitional stool, which is more yellowish-green. As your baby moves out of the neonatal period, their stool color will more closely reflect their diet, ranging from brown to green to yellow. While some infants have a bowel movement every time they eat, others can go up to two weeks between bowel movements. This can be concerning to some new parents, but it is perfectly normal if your baby is otherwise gaining weight appropriately, acting and eating well. Some infants turn red, hold their breath, cry or grunt while having bowel movements even if their stools are soft and as much as it may seem worrisome, this is also a normal occurrence.
What Are Other Changes to Expect?
Around four to six months of age, many infants are introduced to solid foods, meaning anything that is not milk or formula. In addition to the epic messes made while eating, their poops can change significantly as well. Depending on the foods introduced, stools may change in color, consistency, or frequency.As children start to eat more chunky fruits and vegetables, parents may see these in the diaper and be concerned that they are not digesting their food or absorbing nutrients, but there is nothing to worry about. If we examined our own stool as closely, we would see the same! It is not uncommon for children to have their first episodes of constipation or diarrhea after the introduction of solids foods or a change in milk (breast to formula or a change in formula). A brief change to their normal pattern is normal, but continued watery stools or hard, painful stools are something to bring to the attention of your pediatrician.
When Should Parents Be Concerned?
Meconium should be passed ideally within the first 24 hours and less frequently within the first 48 hours.There are a number of reasons why infants take longer to have their first poop, but if it is longer than 48 hours, they may need further evaluation.
Stools should generally be a version of yellow, green, or brown.Infants who are having grey, white, red or black stools should see their pediatrician.
Karla Vaz, MD, MEd, is an attending pediatric gastroenterologist at Nationwide Children's Hospital and member of the Motility Center. She is also an assistant professor of clinical pediatrics at The Ohio State University College of Medicine.
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