Some babies do not poop every day. In fact, infants who are exclusively breastfed may not pass stool for up to a week without it being a cause for concern.
Dr Sukumaran Kanniapan, Specialist Paediatrics and Neonatology at UAE-based Aster Hospital, explains this clear diaper syndrome: “The reason is that breastmilk has less excretory material and there is higher absorption by the body. This is important for a baby to gain weight. So it is likely for the baby who is only fed with breastmilk to pass stool once in four or five days.
“There is nothing to worry about as long as the baby is gaining weight consistently and the urine output is good.”
If the child is not passing stool and not gaining weight, however, it may point to them not drinking enough milk.
The stool rainbow
A newborn will excrete faeces in the first 48 hours after his or her birth. However, don’t be surprised when you notice a black tar-like substance coating the diaper. This is completely normal. Here’s a look at the rainbow of stool every baby goes through before settling on the usual hue.
Black: Dr Anuradha Ajesh, Specialist – Paediatrics at Bareen International Hospital, explains: “A baby's first poop within a few days of birth will be greenish black and tar-like.” It’s called meconium and contains materials such as amniotic fluid and various molecules known as metabolites.
Golden yellow: Babies who are nursed on only breast milk will expel sticky stool. “There will not be any foul smell and the baby will not experience any difficulties such as vomiting, abdominal pain or other difficulties,” says Dr Kanniapan.
Green tinted: Should you choose to feed the child formula – and once he or she begins solids – you’ll notice the poop shift into this colour. When on solids, the infant may also pass undigested bits of food such as kernels or pea skin. This is because babies’ digestive systems have not evolved to a degree where they can digest these. A study in 2016 by the University of Oslo found that newborns have no bacteria in their gut. It’s only a year on that kids begin to have a rich gut microbiome, with diversity enough to rival an adult’s.
On to the danger zone. While some hues are harmless, others may point to some serious problems. Dr Ajesh says: “Parents should consult the doctor if the colour is red or pale and if it returns to black after three days of life.”
A baby's first poop within a few days of birth will be greenish black and tar-like.
Red: US-based Cleveland Clinic explains on its website that while some foods may cause a red tint – think beets or food colourings – red may indicate blood in the excrement. “Small amounts may be caused by constipation while larger amounts are cause for a greater concern,” it says.
White: The only reason a child would be pooping white chalky stuff is if their body isn’t producing bile. This can be a sign of a serious liver or gallbladder problem, warns Cleveland Clinic.
Black: While tar-like stools are normal in newborns, they are a cause for concern if your child is more than three days old. Called melena, this type of thick, black stool may be a sign that blood has entered your baby’s gastrointestinal tract, it adds.
As long as the baby is gaining weight and the urine output is good enough - there is nothing to worry about. However, if the baby is not gaining enough weight, parents should take the baby to a doctor for a thorough examination.
Keep an eye on the weight gain and urine output, says Dr Kanniapan. “As long as the baby is gaining weight and the urine output is good enough - there is nothing to worry about. However, if the baby is not gaining enough weight, parents should take the baby to a doctor for a thorough examination.”
Breast milk consists of two parts: foremilk and hindmilk. Foremilk comes out for several minutes as the baby begins to feed. The richer and thicker hindmilk then follows.
Foremilk has fewer nutrients than hindmilk, and if a baby is getting too much foremilk, they will not be able to digest lactose correctly, which may cause stool changes.
If a baby has foamy stool frequently, it may be a good idea to breastfeed for at least 20 minutes on one side before switching to the other. This will ensure that the baby is receiving enough hindmilk.
Source: Medical News Today, UK-based online portal for medical news
Too hard, too soft?
Don’t ignore the signs of diarrhoea or constipation when it comes to a baby, say experts, because it could be a symptom of something else. Here’s what you should look for, says Cleveland Clinic, while on diaper duty.
Too liquidy: “While baby poop isn’t as solid as adult poop, if it’s extremely loose and watery – that’s diarrhoea. Don’t ignore these diapers as they can be a sign of an infection and put your little one at risk for dehydration. Other causes: food sensitivities/allergies, giving a toddler too much juice, a side effect of antibiotics or a symptom of inflammatory bowel or celiac diseases. Call your paediatrician if it lasts for more than 24 hours. Most cases resolve in two to three days,” it suggests.
Too hard: “If your baby is straining before bowel movements and producing dark, hard stools, your little one is constipated. Sometimes it’s just that a baby’s digestive tract absorbs too much water – ask your paediatrician because there may be some simple solutions. Other possible causes: food sensitivities/allergies, dehydration, or in rare cases, more serious conditions such as anatomical problems, thyroid dysfunction, metabolic disorders or Hirschsprung’s disease, which impacts the large intestine,” it explains.
“You might want to lift your baby's legs by the ankles to get underneath. Research and evidence practice shows us that among infants wearing disposable diapers, there is an increased risk of urinary tract infections as the frequency of changing diapers decreases. Therefore, frequent changing of diapers is paramount.”
There’s a whole spectrum of stool frequency, consistency and colour for infants – just keep calm and diaper on.
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