Newborn Poop: Understanding The First Few Weeks

Newborns go through several stages of pooping, from their first meconium poop to transitional stools and then to more regular bowel movements. Meconium is the name of a newborn's first poop, which is usually greenish-black and sticky, resembling motor oil. This is followed by transitional stools, which are green and less sticky, signalling that the newborn has started digesting early breast milk or formula. After this, the colour and consistency of a newborn's poop will depend on their diet, particularly whether they are being breastfed or formula-fed.

Stages of Newborn Poop

Meconium: A newborn's first poop is a sticky, tar-like substance

Meconium: A newborn's first poop

Meconium is a newborn's first poop, typically passed within the first 24 hours of life. It is a sticky, tar-like substance with a thick, dark greenish-black or brown colour. The appearance of meconium in the diaper is a good sign, indicating that the baby's bowels are functioning properly. It is composed of everything the baby ingested in utero, including amniotic fluid, mucus, and skin cells. While it may look unsettling, it is completely normal and usually does not have a strong odour.

Meconium is produced by the baby during their stay in the uterus, gradually filling their intestines. It is typically passed within the first 24 hours of life, and hospitals generally do not discharge newborns until they have had their first bowel movement. In some cases, meconium may be passed in the womb or may take longer than 24 hours to pass, but if it takes longer than 48 hours, further evaluation may be needed.

The appearance of meconium marks the beginning of a newborn's transition to regular stool. Within 2-4 days, the meconium will transition to a dark green colour and become thinner. As the baby starts breastfeeding or drinking formula, their poop will turn green or yellow and have a more liquid consistency. This transitional stool is often referred to as "seed-like" in texture, especially in breastfed infants.

Meconium is an important milestone in a newborn's development, and its passage is essential for the baby's health and well-being. While it may be surprising and even unsettling for new parents, it is a normal part of a baby's growth and development.

Transitional stools: After meconium, stools become greenish-yellow and loose

Transitional Stools: What to Expect

After the first 24 hours of life, a newborn's first stool, called meconium, will have passed. Meconium is a sticky, tar-like substance that is typically dark brown or green in colour. Once all the meconium has passed, you will start to see transitional stools.

Transitional stools are a result of your baby's diet. They are usually greenish-yellow and loose, and sometimes seedy in texture, particularly for breastfed infants. They may also contain mucus or traces of blood, likely caused by your baby swallowing blood during delivery. It is important to save any diapers with blood to show to a nurse or doctor.

Transitional stools usually last for around three to four days. After this, the type of food your baby is eating will determine the colour and consistency of their poop. This can change day to day, and even from bowel movement to bowel movement, so it's important not to be alarmed.

When to Be Concerned

While transitional stools are usually nothing to worry about, there are some instances where you should contact your doctor. If your baby's transitional stools are white, black, or contain blood, this could be a sign of a more serious issue. White stools could indicate a liver condition, while black stools could be a sign of stomach bleeding. If you see any blood in your baby's stool, it could be a result of your baby swallowing blood during delivery, or it could be an indicator of allergies or bleeding in the gastrointestinal tract.

Frequency of Transitional Stools

The frequency of transitional stools can vary. Some newborns may poop every time they eat, while others may only poop every few days. This is usually nothing to worry about as long as your baby is eating regularly, has soft stools, and is acting and eating well. However, if your newborn goes more than a week without pooping, it is best to contact your paediatrician.

Breastfed baby poop: Yellow or green, seedy, pasty, and sweet-smelling

Meconium

In the first 24 hours after birth, a newborn's poop is called meconium. This is a thick, tar-like substance that is typically greenish-black or dark brown in colour. Meconium is made up of amniotic fluid, mucus, skin cells, and other things ingested in utero.

Transitional Stools

Two to four days after birth, you'll notice "transitional stools" that are green and less sticky than meconium. After around 48 hours, the stool may become looser and lighter in colour, transitioning to a mustard yellow or yellow-green.

Ongoing Breastfeeding

As long as your baby continues to be breastfed, their poop will stay in the green-yellow-brown palette. It will have a seedy, pasty texture and may resemble diarrhoea. It may also be watery or contain mini-white "seeds." This colour and texture are normal. Breastfed baby stools also tend to smell sweet, unlike regular bowel movement odour.

Solid Foods

As your baby grows and starts solid foods, you may notice changes to the colour of their stool. It may be more greenish-yellow, tan-brown, or shades of brown.

Warning Signs

Contact your baby's doctor if you notice any of the following warning signs in their stools:

• Diarrhoea (green, yellow, or brown and runny) which can indicate an infection or allergy, and may lead to dehydration if untreated
• Hard, pebble-like poop, which could be a sign of constipation or sensitivity to milk, soy, or an intolerance to something in breast milk or formula
• Red blood in the stool, which could be a sign of a milk protein allergy or a bacterial infection
• Slimy, green-coloured streaks with glistening strings, indicating the presence of mucus, which could be a sign of infection
• Chalky white poop, which could mean your baby isn't digesting food properly and may indicate a lack of bile from the liver

Formula-fed baby poop: Yellow-brown, green-tan, or brown, thick, and firm

The first time your baby poops, they will pass a substance called meconium. This is a mixture of amniotic fluid, bile, mucus, and intestinal secretions, and it is usually black and tar-like in appearance. After this initial stage, a baby's poop will start to transition to regular stool, which is typically yellow for both breastfed and formula-fed babies. However, the poop of formula-fed babies tends to be slightly lighter in colour and firmer in texture, with a consistency similar to peanut butter or toothpaste. It may also have a yeasty aroma due to the fermentation of sugars in the formula.

Formula-fed babies typically poop less frequently than breastfed babies, and by the time they are 3-6 weeks old, they may only poop once a week. However, it is still considered normal for them to poop daily. If your formula-fed baby hasn't pooped in four days, this could be a sign of constipation, and you should call your pediatrician.

As your baby starts eating solid foods, their poop will change colour and become smellier due to the range of healthy bacteria populating their intestines. It is normal for their poop to be red, orange, green, yellow, or blue at this stage, as it may contain undigested food chunks. However, if you notice any unusual colours such as white, black, or pale yellow, it is best to consult your doctor to rule out any health problems.

Baby poop with blood: Could be due to a milk protein allergy or bacterial infection

The stages of a newborn's poop vary from newborn to newborn. Typically, newborns pass a substance called meconium, which is thick, dark green or brown, within 24-48 hours after birth. After this, a baby will start pooping and peeing more regularly, usually 2-5 times per day, or after every meal. Between 6 weeks and 3 months of age, the frequency of pooping typically decreases, with some babies only pooping once a week.

While blood in a baby's poop is usually harmless, it can sometimes indicate a health problem. It could be due to a milk protein allergy or a bacterial infection.

Milk Protein Allergy

A milk protein allergy, or allergic colitis, occurs when a baby's immune system overreacts to the proteins found in cow's milk, leading to inflammation in the colon. This can cause blood in the stools, as well as irritability, gassiness, and mucus in the stools. It can also make eating uncomfortable for the baby, causing them to not get the nutrition they need. Treatment for a milk protein allergy involves the breastfeeding mother switching to a dairy-free diet or the baby being switched to a hypoallergenic formula.

Bacterial Infection

Blood in a baby's poop can also be a sign of a bacterial infection, such as gastroenteritis, salmonellosis, shigellosis, staphylococcal infection, Clostridioides difficile (C. diff) infection, or campylobacteriosis. Infections often cause intestinal inflammation and tiny ruptures that allow blood to leak out, resulting in bloody diarrhoea. If you notice diarrhoea with bloody poop, it is important to alert your doctor right away.

Other Causes

Other causes of blood in a baby's poop include constipation, parental nipple injuries, gastrointestinal tract bleeding, and Streptococcus bacteria infecting the skin around the anus.

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