I was surprised to see streaks of blood in my daughter’s stool when she was just a few days old. I rushed her to the doctor, and after he checked her out, he assured me there was nothing to worry about. I quickly learned two important new-mom lessons. One: Newborn poop comes in many varieties. Two: Get answers before freaking out.
This is easier said than done, especially when it comes to our baby’s bowel habits, according to Richard Schreiber, paediatric gastroenterologist at BC’s Children’s Hospital and clinical investigator at BC Family Research Institute. “Parents concerned about the frequency, consistency or colour of their baby’s stools make up about 25 percent of people who see me as a specialist,” he says.
Keeping track of a newborn’s “output” can be comforting, especially for breastfeeding moms who can’t see their baby’s intake, and records are helpful when discussing any issues. But Schreiber says that when it comes to newborn poop, there’s a lot of variability in what’s normal.
Your baby’s first stools, called meconium, appear within 36 hours of birth. Composed of material ingested in utero, it’s a tar-like substance that can be dark green or greenish-black—and hard to wipe off your baby’s bottom. Soon after, your baby’s poop will become softer and lighter in colour.
The poop of breastfed newborns tends to be pasty and seedy, and more solid for formula-fed babies, but Schreiber says that these characteristics aren’t important in terms of baby’s health. Colour also varies widely. While most newborn poop is mustardy yellow or yellowish-brown, it may be brown or even green, a colour that can be related to the contents of certain formulas, or to stools passing quickly through your baby’s body. Let the doctor know if you see pale yellow, pale green, chalk white or grey poop. A light-coloured stool, especially in a jaundiced baby, could be an important indicator of a liver problem.
Breastfed babies usually have one to eight bowel movements (BM) a day, with an average of four. But some healthy breastfed babies only have a BM every seven to ten days, depending on their digestive systems. Formula-fed babies average two stools a day but could have many more.
Saul Greenberg, a paediatrician at Toronto’s SickKids, says to expect a BM each day in the first few weeks. After that, as each child’s system settles into a routine, he only suggests parents contact him if a breastfed baby goes ten days without pooping, or a formula-fed infant (expected to be more regular) is not having a daily BM. If your child is feeding every two to four hours, producing several wet diapers a day and gaining weight, don’t worry about counting stools.
You may suspect your newborn is constipated if he appears to be pushing hard and turning red, but Schreiber explains that babies may fuss while passing stool because of their small anal canals. However, if your child appears extremely uncomfortable or gassy, is vomiting, or has a belly that looks distended or feels hard to the touch, contact your doctor. Never use an enema or suppository or insert anything into the rectum without a doctor’s OK.
As I learned, blood in newborn poop can be alarming, and while you should see the doctor, there may be a simple explanation. “The most common reason is a small fissure or tear in the anal region,” says Schreiber, which was the case with my daughter, “or it could be a sign of a cow’s milk protein allergy, which can sensitize the baby’s intestine, resulting in the blood.” (This can occur in both formula-fed and breastfed babies, as the protein in dairy can pass through the mother and, in turn, affect the baby.)
Since every newborn is different, it’s always best to check with your doctor if you have worries about what your child is—or isn’t—producing.
Is green poop normal? Here's a guide to your baby's poop colour:
Why: Mustard yellow is a very standard colour for breastfed babies. The "seed" texture is from partially digested fat and calcium (entirely common). What to do: Keep doing what you're doing!Illustration by Dave Quiggle
Why: Formula-fed babies commonly have pasty yellow-brown poos. "Seed" texture is common here, too. What to do: Keep doing what you're doing!Illustration by Dave Quiggle
Why: Sticky, tar-like newborn poops are meconium. Though alarming, black stool could also be dried or digested blood from mom's cracked nipples. What to do: Meconium will pass. For new breastfeeders, heal your nipples (check your latch, use your own milk to soothe and give the ladies plenty of air time). If you're concerned, your doctor can perform a quick test to see who the dried blood belongs to.Illustration by Dave Quiggle
Why: Poo gets its colour from bile, so an absence of colour—chalky white poo—means there isn't enough bile. This may signal a problem with the liver or gallbladder. What to do: If it's a one-off, don't worry. But if it's more than one bowel movement in a row, chalky poo should send you to the doctor.Illustration by Dave Quiggle
Why: Unless your baby has been gorging on beets, the red in your baby's poo may be blood. Red specks or streaks may be a sign of a reaction or allergy, which affects both breastfed and formula-fed babies. It may also indicate an intestinal problem. If your baby is constipated–passing hard, pellet-like stools–blood could be coming from small anal tears. What to do: See your doctor if you've ruled out constipation as a source of blood in your baby's stool.Illustration by Dave Quiggle
Why: A very common colour, green means stool is passing through the gut more quickly than usual. What to do: If your baby is feeding well and happy, and shows no signs of discomfort, don't sweat the green stuff.Illustration by Dave Quiggle