Your baby’s first weeks- bowel movements

One of the most common questions new parents ask is “Are my baby’s bowel movements normal”? This is because there is a lot of variation in a baby’s stool.

What is a normal stool color and consistency?
When the baby is first born the stool is black or dark green, thick and sticky. This is meconium. After 2-4 days the stool changes color and consistency. Babies that drink breast milk typically have bowel movements that are yellow. Babies who drink formula may have stool that is yellow, tan or greenish in color. The stool is usually liquid. Sometimes it has a very runny consistency or it may be as thick as peanut butter. Sometimes the stool has small particles that look like seeds. This is all normal. Both the stool color and consistency can vary from time and time and is not usually concerning.

Once the baby starts to eat pureed or solid food the stool will change to look more adult-like. It will look more brownish in color. It may be more formed and less liquid. You may start to notice pieces of undigested food in the stool. This is normal as the body learns to adjust to the new foods.

How often should my baby have a bowel movement?
When babies are first born they may have a bowel movement every time they eat, sometimes even more frequently. You may notice that sometimes there are large stools and other times there are only small smears of stool. This is normal. Some babies only have a bowel movement once a day or once every 2-7 days. This can be normal too, especially if they are feeding and otherwise acting normally.

So when should I be concerned?
If your baby has blood in the stool or around the anus or if your baby has black stool you should see the pediatrician right away. Black stool can be due to partially digested blood. Black or bright red blood in the stool is not normal.

If the stools are hard or dry this can indicate that the baby is not getting enough fluid. It can also occur during illness if the baby is losing fluid (due to fever or vomiting, etc.). If the baby is old enough to eat pureed or solid food, hard stool may means the baby is eating too many constipating foods. These include bananas, baby cereal, rice, pasta, noodles, bread, cow milk.

If you are seeing mucus in the stool this should be evaluated by your pediatrician. Sometimes it is normal but it can be a sign of infection or allergy such as a milk-protein allergy and should be examined further.

If it has been longer than 5-7 days and your baby has not had a bowel movement please contact your pediatrician.

So if my baby has frequent bowel movements how do I know if this is diarrhea?
It is sometimes difficult to know. But if the baby is having more bowel movements than usual and if the stool is more watery than usual this may be diarrhea. If there is an accompanying fever or fussiness this may be diarrhea. If you think your baby may have diarrhea reach out to your pediatrician. They will evaluate for signs of dehydration and may recommend additional appropriate fluids.