The scoop on poop

Constipation in babies and toddlers is no fun for anyone. Get help when number two is your main concern with our handy guide

Lisa Bendall 0

It was a routine middle-of-the-night diaper change. Until my friend saw that her son’s poop was a vile shade of green. Good thing grandma’s a paediatrician — and didn’t mind being called at four in the morning. She quickly assured the new parents that it was completely normal.

Sometimes it’s the colour that gets us disconcerted; sometimes it’s the form or frequency. To put your mind at ease, we’ve assembled this doo-doo dictionary. Read on for everything you (n)ever wanted to know about your kid’s caca.

Frequent flyers and rare releasers

Although most children have one or two movements a day, some kids go more often. Newborns can squirt mustard seven or more times a day. It turns out there’s a wide range of normal when it comes to frequency. “As long as it’s a soft, well-formed bowel movement (BM), no problem,” says Shirley Blaichman, a paediatrician in Montreal.

At the other end of the spectrum, some perfectly regular kids are, well, irregular. Breastfeeding babies can go a week without unloading, and that’s normal, as long as the baby is feeding well and is her usual self.

It’s also not a problem for an older child to poop only every second or third day, as long as it’s soft, and easy and painless to pass. If your little one is straining, if the stool is hard, or if the result looks like dry rabbit pellets, she could be constipated.

Constipation in kids is common, and it’s sometimes caused by diet. Check that she’s taking in enough fibre, fruits, vegetables and water. If she’s over a year old, limit milk (which can make the problem worse) to 24 ounces a day. And prune juice is a wonderfully effective natural laxative. If these changes don’t help, or if your child is younger than a year, talk to a doctor.

If your toddler has watery stools but is otherwise healthy, it could be because he’s loading up on too much high-sugar, high-carb fruit juice. But diarrhea is also a common symptom of viral infection. While you wait it out, keep your child well hydrated by breastfeeding or offering an oral rehydration solution, such as Pedialyte.

What if your child has a sudden change in bathroom habits, and you’ve ruled out diet? Check for other changes in routine, like a new daycare or new baby at home. Your moppet’s diarrhea or constipation may be an anxiety reaction, says Pauline Fitzgerald, a child therapist in Abbotsford, BC.

Looking weird

Apart from shades of red or black (the colour of digested blood), “colour is not important,” says Blaichman. “Stools can be neon green, yellow, whatever.” Red stool can be scary, but dyes and even a good feed of beets may be the culprit. Nevertheless, if there’s a chance the raging red in your tot’s pot could be blood, you should have it checked. Keep in mind that a breastfeeding infant sometimes takes in a little blood when mom’s nipples are chapped. And an older child might swallow blood from a nosebleed or a lost tooth.

Another concern Blaichman often hears is corn or peas in poop. “It’s not really a question of malabsorption,” she says. “It means the child is not chewing completely.” And some foods, like kiwi seeds, are going to come out the other end no matter how well they’re masticated. If you think you’re looking at tiny worms — especially if you’ve travelled recently or your child has other symptoms such as anal itching — have a stool sample tested for parasites.

Size really doesn’t matter, unless the stools are pellet-like. If, however, your child has a habit of blocking the toilet with his big BMs, it may be a sign of chronic constipation.

And when it smells like something rolled over and died in your little pumpkin’s potty? While it may be enough to knock you flat, smell almost always comes from something your child has eaten, and is rarely a sign of anything serious.

It hurts!

It’s not unusual for a little kid to feel a little bit crampy right before a movement. It’s one of the cues that lets her know it’s time to head for the bathroom, and some kids are simply more sensitive to the spasms than others. If the poop is normal-looking and the discomfort disappears afterwards, there’s nothing to worry about.

Pooping that’s painful is usually the result of a hard stool that has caused a small fissure on the way out, which leaves bright red blood around the stool, on the toilet paper or in the bowl. Although it’s common, it should be treated by a doctor right away so it doesn’t turn going to the bathroom into a bad experience.

Sometimes, kids who’ve had a painful time on the privy will hold back because they’re apprehensive. And since this can quickly spiral out of hand, it’s best to see a doctor right away if prune juice doesn’t solve the problem. Fitzgerald points out that many toddlers withhold poop while toilet training. “Quite often, the child wants to have a sense of control.” She suggests giving more control in other areas, like offering choices and giving them simple household chores.

Got a toilet-trained tot who’s started staining her skivvies? Don’t get upset with her. Constipation or holding back for some other reason can lead to a backlog. Chances are you need to look at her history — that big buildup may be distending her rectum and interfering with her natural reflexes so now she has no control over stuff slipping out. “It’s not fun for the child, to say the least,” says Blaichman. Talk to a doctor before problems reach this point because there’s no quick fix and it can have an emotional impact on parent and child. Far better, if you can, to deal with those early warning signs like constipation or control issues.

When it’s serious

The vast majority of intestinal idiosyncrasies are completely normal. But it’s time to see a health care pro when:
• your child’s diarrhea lasts more than five days or is accompanied by a high fever, frequent vomiting or dehydration
• there’s possible blood in the stool (colour is red or black)
• the poop is pale or colourless or stools are greasy, unformed and unusually foul smelling
• your child is under six months of age and has poop problems
• you can’t shake your worry

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