One of the most common topics I get asked about as a pediatrician is… yup, poop. It may seem gross to some people, but it doesn’t faze pediatricians one bit. I rarely go through an appointment with a patient without someone mentioning poop, at some point. It’s a topic of conversation for kids of all different ages.
Newborn and infant stooling patterns can be difficult to determine because they can vary so much from baby to baby.
- Newborn babies pass “meconium,” which is a dark, tar-like stool. These stools start to normalize a few days after birth.
- How often babies pass stools can vary, especially between breastfed and formula-fed babies. A breastfed baby will typically pass stool every time they feed, whereas a baby on formula may pass stool every day or every other day.
- Stool consistency can also vary quite a bit. Breastfed babies pass stools that are yellow, loose and seedy. Some think and refer to this as diarrhea, but it is perfectly normal for breastfed babies. Formula-fed infants tend to have stools that are more formed.
- Parents will often call to report changes in stool color. I worry about stools that are pale (clay colored) or black. Otherwise, green, yellow or orange stools are all perfectly normal for babies!
- Within the first couple of months after birth, the gut biome (the normal bacteria that live in the human gut) changes dramatically. During this period, as the gut biome matures, stools can change as well. Again, this is all normal unless stools become hard or baby becomes uncomfortable. There is a lot of research about how gut bacteria influences overall health. If you’re interested, talk to your child’s doctor about their opinion on probiotics. Some baby formula even contains probiotics.
If babies are going a few days without pooping, that is usually okay – as long as the stools aren’t too hard (think pebbles or rocks), the baby isn’t uncomfortable when pooping and there isn’t any blood coming from around the anus or on the sides of the stool. However, if an infant is showing any of those symptoms, it could be a sign they are becoming constipated.
To relieve constipation:
- Parents can first try bicycling the baby’s legs and pressing gently on the baby’s abdomen to stimulate a bowel movement.
- Parents can also gently insert a rectal thermometer in the rectum as this can sometimes stimulate stool movement too.
- Pediatricians will sometimes recommend changing the formula if an infant is formula-fed. For a breastfed baby, changes to the mom’s diet may be recommended.
- If none of the above is helping, contact your baby’s doctor again. Pediatricians like to work individually with mom and baby to find ways to alleviate the constipation. This can sometimes involve medication, depending on the age of the baby and how bad the constipation is for the baby.
For infants who struggle with gas, there are over-the-counter gas drops and “gripe water” that claim to help. There is not a lot of data proving either way if these supplements are effective, so I suggest talking to your baby’s doctor about what they recommend for your little one.
Beyond the infancy period and into toddlerhood, we continue to see constipation. Toddler-aged children should have one pudding-like consistency stool per day. If they are pooping less frequently than this, they may be constipated.
It is important to get constipation under control as children are about to start potty training. For kids that are chronically constipated, they can develop “stool withholding” behaviors where they will intentionally not poop because they have developed a fear of pain from past experiences when struggling to poop. This can make toilet training more challenging. Children with special needs can especially develop stool-withholding behaviors.
Pediatricians can work with parents and children on strategies to overcome stool withholding and constipation through a variety of techniques such as behavioral modification, diet changes and sometimes medication. If your toddler is not pooping at least once a day, consistently, talk to your child’s doctor.
Unfortunately, constipation can continue throughout childhood.
- School-age children often don’t have enough time to poop at school, which can contribute to constipation.
- Teenagers tend to have poorer diets and may not drink enough water. In addition, parents are less aware of their older children’s stooling patterns, so it’s not a bad idea to check in with them occasionally.
The most common cause of abdominal pain in children and teenagers is constipation, so if your child is complaining of a stomachache, I would start there and ask about their stool.
Hopefully, this information demystifies poop for a few parents out there. If you have any questions, reach out to your child’s doctor – we are not afraid to talk about poop at all!
Rebecca Gehrmann, MD
Prevea East De Pere Health Center
3860 Monroe Road, De Pere
“As a pediatrician, I strive to be a resource for families for all the ups and downs of parenthood, and to be there to answer their questions. It’s my ultimate goal to help kids grow and develop into healthy adults. Having worked with underserved children and children with diverse backgrounds, I have experience caring for children with a variety of health conditions.
I am originally from Wisconsin and enjoy practicing medicine in my home state. In my free time I love running, hiking, camping, baking and spending time with my daughter. My husband and I enjoy exploring new restaurants and cooking together, too.”