Cecilia Koh

Baby’s Bowel Movements and How To Deal With It



Posted: Sunday, February 07, 2010

by Cecilia Koh
http://www.Babiesconsult.com

One of the areas of baby care that a lot of new mothers worry about is the baby's poo. Most commonly asked questions asked are:

In this article I will try to address these questions with some sample photos so that you will have an idea of what to look for. If you want to view the photos you will need to click on the links. Do not click on the photos if you are squeamish about looking at these photos.

The first time that your baby opens his bowels the stool that is passed is called meconium which is dark green in colour, thick and sticky. This will continue for the next couple of days until feeding is established. The passing of meconium indicates that the lower bowel is not blocked.

Click here to view a picture of a meconium-stained bottom.
Click here to see a close-up view of the meconium.

Being very sticky and thick it is sometimes difficult to clean off the meconium. I find that applying a little petroleum jelly or baby oil to the bottom before baby's first bowel movement will prevent the meconium sticking to the skin. If you did not manage to apply anything, the meconium can still be wiped off by using a little baby oil on the cotton balls.

Once feeding is established, the baby will pass ‘changing stools' which is greenish-yellow in colour. This stool indicates that the whole gastrointestinal tract is patent. By the fourth or fifth day the stools become yellow.

Normal stools

Breast fed babies will have soft or slightly loose inoffensive mustard colored, seedy and runny stools whereas the baby who is formula fed will have tan coloured, more formed and slightly offensive smelling stools which should not be any firmer than a peanut butter consistency.

Click here to view an image of normal stools.

Frequency of bowel movements

Babies that poop a lot

Breastfed babies often have a bowel movement after every feeding for the first few weeks. This could be after every feeding or he may go several times a day. Don't be alarmed by this. If it is runny and seedy that is perfectly normal for a breastfed baby. A lot of new moms mistake breastfed stools for diarrhea.

Formula-fed babies will poop a lot in the beginning too but eventually do not have as many bowel movements as breastfed babies but you can expect four or five poops a day in the first few weeks.

Tip

Bowel movement 5-7 times a day is usually normal
Bowel movement 5-7 times within one to 2 hours is abnormal and baby needs to be seen by a paediatrician
Wait for your baby to finish before changing otherwise one bowel movement becomes counted as 2 or 3 movements.

Babies that don't poop for several days

Once your baby is about one month old, he may start having fewer bowel movements. If your baby is breastfed, he may go several days to a week without having a bowel movement. Exclusively breastfed babies rarely have problems with constipation. There is nothing to worry about as long as he does not show any signs of discomfort or pain. If he does not poop for more than a week, he seems to be in pain, or if you are concerned, check with your pediatrician.

Formula-fed baby's poops slow down at about a month as well. However, formula is more likely to cause constipation than breast milk. Most formula fed babies will have about one bowel movement a day. The stools should be soft. If your baby's stools are firm or hard and pellet-like, he may be constipated.

Babies that grunt and cry when they poop

If your baby does a lot of grunting when he poops, don't worry. This is normal. Babies sometimes grunt, cry or turn red when they have a bowel movement. This is nothing to worry about. A lot of new parents mistake this grunting for straining and constipation. Once your baby gets used to his bodily functions and how they feel, he won't be as vocal about having them.

Tip

A sign that your baby shows when he wants to open his bowels is he will suddenly become very quiet with a concentrated look on his face. A toddler who is running around will suddenly stand very still is a sign that he is doing his business.

Green stools

Sometimes baby's stools may be green in colour due to the following reasons:

Click here to view an image of green stools.

           


The Chinese believe that sometimes a baby can become frightened and cries almost all the time and passes green stools. The treatment is to give the baby ‘Keng Foong San'. I have used this treatment and it does work.
Diarrhea or frequent and watery stools

Diarrhea is the body's way of getting rid of toxins and foreign substances. The stools contain mainly liquid with little or no solid matter and often accompanied by a lot of wind. Simple diarrheas are usually caused by viruses which invade the child's intestinal tract, causing irritation and inflammation of the intestinal walls. Viruses also induce the cells lining the intestines to secrete fluids. The increase in fluid volume in turn increases peristalsis, the wavelike contractions of the intestines. The result is cramping and the loose, watery, frequent stools characteristic of diarrhea. Most cases of simple diarrhea should not be suppressed too quickly. It may be healthier to allow your child's body to flush itself clean, while supporting her with adequate fluids. Depending on the cause of the diarrhea, a fever may or may not be present. When a child is suffering from diarrhea, dehydration is always a serious concern, especially if her temperature is elevated. In the first two or three months of life, an infant can become dehydrated very quickly, so if your newborn develops diarrhea, call your physician.

Click here to view an image of baby diarrhea.

Causes of diarrhea

Food poisoning

Your child can pick up viruses (rotavirus), bacteria (e-coli, salmonella), or protozoa from other children or from contaminated food and water. Often called gastroenteritis or stomach flu, food poisoning causes diarrhea very quickly.

Milk or food allergy

Milk allergy or food sensitivity may surface with the introduction of new foods.

Medical conditions

Less common causes of diarrhea include reactions to medication, inflammatory bowel disease, hepatitis, cystic fibrosis, and pancreatitis. An anatomical deformity, such as a fistula, or a congenital defect, such as Hirschsprung's disease or short bowel syndrome, can also cause diarrhea. If your child's diarrhea arises from any of these conditions, she requires medical attention.

Medications

Some medications especially antibiotics or those containing sugar may cause diarrhea. Check with your paediatrician.

Teething

Sometimes teething may cause a baby to have loose stools which looks like diarrhea. Teething stools are greenish looking, loose and seedy. It is quite normal for the baby to have bowel movements up to 7 times a day.

Click here to view an image of stools from a teething baby.

Looking after a baby with diarrhea

Prevent dehydration by giving her lots of fluids. Continue breast feeding and if on formula reduce the amount of milk powder by 1 – 2 scoops until the diarrhea is over. Your paediatrician may prescribe an electrolyte replacement solution or changing to a lactose free formula.

Studies have shown that live bacterial cultures, found in yogurt, are a safe and effective way to cut down on the amount and duration of diarrhea. It's an easy way to treat the problem, especially if your baby loves the taste of yogurt. Just be sure to buy yogurt with lactobacillus or live cultures. An alternative and more effective way is to give your baby lactobacillus in capsule form. Open the capsule and add the powder to the milk or water. The powder should be white in colour.

A home remedy which I find very effective and cheap is to boil some rice with lots of water. Add a pinch of salt. Once the rice porridge is cooked give only the rice water to the baby. This prevents dehydration and is better than giving plain water. Often the diarrhoea will stop fairly quickly.

For older children avoid sweetened fluids like sodas (including ginger ale), athletic drinks, Jell-O, sugar water, and undiluted fruit juices. All of these contain sugar that will draw water into the intestine and make the diarrhea worse. Also, do not use anti-diarrhea medicine unless the doctor prescribes it.
   
If your baby is uncomfortable during a bout of diarrhea, try to cuddle and comfort him as much as possible and keep him dry. Use care and tenderness - and diaper cream - at changing time, since it's easy for a baby's bottom to become red and irritated from the loose stools.

Prevention of diarrhea

The most important aspect of prevention is proper hand washing before handling the baby especially during the first 4 months, after handling soiled diapers and before handling his food or feeding equipment.
 
Get medical attention immediately if your baby is 3 months old or younger and he has diarrhea. If he is over 3 months, call the doctor if your baby has diarrhea and any of the following:

Constipation – difficulty in emptying the bowels

Constipation generally occurs when the muscles at the end of the large intestine tighten, preventing the stools from passing normally. The longer the stool remains there, the firmer and harder it becomes, making it more difficult to pass without discomfort.

When a baby first becomes constipated, it can be the start of a vicious circle.

Tendency to constipate seems to run in families. It may start in infancy and remain as a lifetime pattern, becoming worse if the child does not establish regular bowel habits or withholds stools. Stool retention most commonly occurs between the ages of 2 and 5 when the child is coming to terms with independence, control and toilet training.

Symptoms include difficulty in passing stools which appear like small, dry pellets, abdominal pain and a tight tummy, irritability, and sometimes blood-streaked stools which could be due to anal fissures (tiny cracks in the skin) caused by passing hard stools. Baby turns bright red and pushes hard when she passes stools, sometimes she may cry if the stools are very hard and cuts the inner membrane of the anus. A baby who is constipated often has colic pains, because the large amount of stool in the intestines makes the intestines dilate. In some cases, the child may not want to eat and may even retch a little.

Types of constipated stools:

What to do if your baby is constipated

                                                                                                           


Give your baby extra water but sometimes this may not work if the peristalsis of the intestines are slow which increases absorption of water from the intestines leaving the stools very firm and hard. It may be necessary to give your baby diluted prune juice.



 Check that the formula is made up correctly. It is dangerous to add extra powder instead of the recommended amount. Some formulas may not be suitable for babies with our climate so you may need to change the formula. Check with your paediatrician first.



 If your baby is taking solids, leave a little fat on the meat when cooking the food. The extra fat will help to lubricate the intestines allowing easier passage of the stools.



Massage baby's abdomen in an inverted U along the path of the large intestines. This may help stimulate peristaltic movements of the large intestines.

         



    		Apply Vaseline gel or baby oil around the anus to lubricate it thereby making it easier for the stools to come out

   


Hold baby's legs up with the knees pressing on the abdomen. This position increases the internal pressure of the abdomen therefore making it easier for your baby to push the stools out.

         



Sometimes holding your baby in this position may help your baby to poop. The upright position provides gravity together with the increased internal abdominal pressure and slightly opening the anus will make it easier for your baby.



 If your paediatrician prescribes dulcolax suppository, wet the tip slightly with water to make it easier to insert into the anus. The suppository melts very quickly so you have to be fast in inserting it. Try to keep the suppository inside for about 2-3 minutes for best results.



If the constipation is very severe your paediatrician may prescribe an enema. You will need help with this. Lay your baby on the left side with knees bent. Remove the cap and insert about ½ inch of the nozzle into the rectum. Gently and quickly squeeze the fluid into the rectum and try to prevent baby from opening her bowels for about 2-3 minutes. Enema can cause stomach cramps so sometimes baby may fuss for a while. Apply some windy oil on the tummy to relieve the discomfort.
A home remedy - If your baby goes longer than two or three days without a bowel movement you can try a home remedy of adding 1 level teaspoonful of brown sugar to one bottle of formula milk. Sugar draws water into the intestine which helps to soften the stools. Most times the baby will open his bowels after a couple of hours. I learnt this remedy when I was a community midwife in England.

If you have tried all the above without success or your baby is screaming with pain, then the very last resort is to manually remove the stools by putting your little finger into the baby's rectum and literally pull the stools out. It is heartbreaking listening to your baby's screams but the relief on her face once the stools are out is worth it.

If you are still worried check with your pediatrician who may prescribe a medication called lactulose.

How to prevent constipation

I hope that I have answered all the questions mentioned at the beginning of this article.

Cecilia Koh is a British trained nurse/midwife with over 30 years working experience. She operates a child care centre for children aged 1 month to 2 years.
 
http://www.Babiesconsult.com
This Article has been viewed 6,588 times. (Not updated in real-time.)
Top-level comments on this article: (1 total)
» left by DJ
from INDIA 9 days 6 hours ago.
Thanks for writing the atricle...i was totally confused so it will helped me lot to easily understand my babies problems and which home remedy to use.
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