Your infant’s stool change over time. It is important to know that stools can vary greatly from baby to baby.
In the first week of life your baby’s stool will be dark green to black and may be sticky in consistency. This is stool that the baby made while in the womb and is called meconium. Your infant may have several meconium stools a day. Once the meconium has passed, the stool will vary depending upon whether baby is breast or formula fed or a combination of the two:
Breastfed babies have stools that that resemble mashed potatoes and are yellow to brown in color. Sometimes breastfed babies have stools that are watery which is normal.
In the first weeks of life breastfed babies can have stools 1-2 times a day. If a breastfed baby under 2 weeks of age is having infrequent stools, it may be due to underfeeding.
It is important to follow up with your baby’s pediatrician and or lactation specialist to determine if baby’s feeds are adequate.
Formula fed babies have stools that are more firm than breastfed babies. The stool is also more yellow to green.
They generally have stools from every day to every other day. If your baby is having very firm stools and seems uncomfortable, your pediatrician may recommend a change in formula.
Babies that are both breast and formula fed will have stools that vary from soft to firm depending upon what they have been fed prior to a stool.
If a young infant under 2 weeks of age is having infrequent stools that are hard and dry, it is important to follow up with your child’s pediatrician to evaluate your baby.
There is a rare cause of severe constipation called Hirschsprung disease. Babies with Hirchsprung disease have an abnormality in the gut where they are missing the nerve endings necessary to cause intestinal contractions that move the stool out of the body.
Your pediatrician may need to examine your baby’s rectum to determine if stool is present or primarily in the abdomen.
Your baby may be referred to a pediatric gastroenterologist or pediatric surgeon if Hirschsprung disease is suspected.
Breastfed babies older than 2-3 weeks of age can have infrequent stools up to once a week. This is due to breast milk being very digestible and baby absorbing most of the breast milk.
As long as the stool is soft and baby is happy and gaining weight, this does not represent constipation.
Older infants greater than a month of age may have constipation, especially once solid foods are introduced.
If your baby is fussy, spitting up more, straining more than 10 minutes to pass a stool, check in with your baby’s pediatrician.
Your baby’s pediatrician may recommend giving your baby a small amount of apple, pear or prune juice to soften the stool. The amount will be about an ounce per month of age.
Some doctors recommend 1-2 teaspoons of corn syrup daily to soften the stool. Check in with your baby’s doctor before adding juices or corn syrup if your baby is less than 6 months of age.
Your baby’s doctor may also recommend using a lubricated thermometer in the rectum or a suppository to stimulate a stool.
It is important to ask your baby’s doctor first about either of these techniques as too frequent usage could cause a rectal tear or abrasion, making passage of stool more painful.
Other techniques such as abdominal massage or leg bicycles (moving legs in bicycle like motion) are not likely to be effective in resolving constipation.
Dr. Poinsett is a board certified general pediatrician with over 25 years' experience. She is California based. She has a special interest in health care advocacy and health care social media.