The contents of your baby’s nappy can tell you more than you think about your little one’s health. Public health nurse and lactation consultant Helena O’Grady tells us all about the common colours and shades of baby poo in our Poo Decoder.
Baby’s poo is a hot topic for many new parents. It is a subject that can be heard being openly discussed and explored between new mums, over a cup of coffee. They’re not crazy; your baby’s poo can tell a lot about your baby’s general health, and your baby’s wellbeing is something every parent is concerned about. Baby’s poo normally comes in different colours, textures and odours. This is based on what your baby is eating; breast milk, formula and solid food.
Let’s go back to the beginning; your baby’s first poo is called meconium. It is a thick, sticky residue, which is generally greenish-black in colour. Meconium is a substance that is in your baby’s intestines while he is in utero. It is a mixture of amniotic fluid, bile and secretions from the intestinal glands. Meconium is normally passed on day one to two. It is important that your baby passes meconium within 48 hours, or he could start to reabsorb the bilirubin that should be passed through the meconium. This in turn could rise your baby’s bilirubin levels and may lead to jaundice. The most successful way to help your baby pass meconium is to feed him regularly.
By day three or four, your baby’s poo will be a greenish colour, which is referred to as transitional poo. By day five it will be a yellow and seedy colour if you’re breastfeeding, or if you’re formula feeding it will be a yellow tanned colour. These are all signs that normal digestion is occurring in your baby.
Yellow and seedy – normal for breastfed babies
A yellow and seedy poo in a breastfed baby is totally normal. Breastfed babies’ poo can have a mild smell (dependent on what you have eaten), it might sound loud, and it is often loose. Breastfed babies will poo at least once or twice in the first two days. By day three to four, they will poo at least three times, and from day five to week five, they will poo at least three times a day. From six weeks to six months your breastfed baby will poo once or more every seven days. Breastfed babies tend to have less residual waste after digestion.
Yellow tanned – formula fed babies
A formula fed baby’s poo will be a yellow tanned colour and have a thicker consistence than that of breastfed babies. With formula fed babies it’s not how often they poo, but the consistency, colour and texture, which ranges from peanut butter to soft pudding. Your formula fed baby, after the transitional poo, may poo once a day or more, or every other day. If your formula fed baby doesn’t poo for more than five days you need to call a medical professional.
Dark green after solids
A dark greenish brown poo can be an indicator that you have just moved onto solid foods. Some solid food will stain the poo more that others: leafy green vegetables, carrots (orange colour), sweet corn (yellow pieces in poo). If your baby is on an iron supplement or taking iron-fortified formula, their poo can be a dark greenish/dark brown colour. This is caused by the bacteria in the baby’s intestines reacting to the iron sulphate.
Watery brown poo that is frequent, loud and much looser and profuse can indicate diarrhoea. People often think a breastfed baby is having diarrhoea, however, this can just be part of their normal bowel habit. Diarrhoea can sometimes simply be caused by too much fruit in your baby’s diet if they are on solid food. It can also be a result of giving a breastfed or formula fed baby water in between feeds. If a baby is breastfed or formula fed according to the manufacturer’s instructions, he shouldn’t need additional fluids, unless medically indicated.
Diarrhoea can also be a sign of infection caused by a virus, bacteria or parasite. Contaminated foods, water or baby touching contaminated surfaces, then placing their hands in their mouth are the main ways babies can pick up viral or bacterial infections. Diarrhoea is also associated with teething, however, there is little research to support this theory. The above might explain this, as teething babies like to place things in their mouths to relieve the pain associated with teething. Therefore, it is a good idea to keep your baby’s hands clean and wash or sterilise your baby’s toys, teething rings and soothers regularly. Make sure you also wash your hands after every nappy change to prevent recontamination.
Dry and hard
Dry brown and hard poo can indicate constipation. Your baby’s poo can be hard, clay or pellet-like in appearance. Formula-fed babies or babies moving onto solid foods can occasionally get constipated. To prevent constipation it is important that he is receiving enough fluids, fruit and fibre in his diet. During times when your baby is in hot climates, has an illness, or a temperature it is very important to ensure your baby is receiving enough fluids.
Constipation is an indicator your baby may not be receiving adequate fluid. A hard poo streaked with a small amount of bright red blood may indicate that your baby has small tears, a rectal fissures around the anus. This can be caused by your baby pushing or straining to remove the poo. This should resolve when your baby’s constipation resolves. If it doesn’t resolve after one or two poos contact a medical professional.
Bright green watery poo can indicate a foremilk/ hindmilk imbalance in breastfeeding babies. It can also indicate that your baby is receiving too much foremilk, which has higher levels of lactose. This can be caused by a number of factors such as being fed for short periods, changing breasts frequently during feeding, engorgement of the breasts or if your baby has a shallow latch at the breast. It is also an indicator that your breastfed baby isn’t feeding well. Your baby might be sensitive to medication that you are taking, or medication that he is taking. Your breastfed baby could also be sensitive to something you have eaten.
Babies with bright green poo can also have a rash or eczema. This can be a sign that your baby is ill or has an intestinal virus. It can also be an indicator of lactose sensitivity or intolerance in breast and bottle-fed babies. Lactose intolerance or lactose sensitivity are when someone has an inability to digest the sugar lactose. Babies with bright green poo tend to have cramping pains in their stomach, loose watery poos, pass more gas and have more bloating.
Black poo is urgent
After your baby passes the meconium as a newborn their poo should not be black in colour again, unless they are taking an iron supplement, which will turn their poo a dark brown/slightly black colour. Black poo is called melena, and is black, thick, and tar-like. In breastfead babies it will not be as thick as in formula fed babies. It is an indication that your baby’s poo may contain blood. This blood is dark in colour as it has entered at the upper part of your baby’s digestive system or intestines. It can indicate an illness, injury or allergy and requires urgent attention from a medical professional.
Chalky and white
Chalky, white, pale coloured poo can indicate a lack of bile. Bile is a digestive fluid that gives the poo its brown colour. It is made in the liver and stored in the gallbladder. If there is a bile obstruction or the liver is not producing bile, your baby’s poo will be this white pale colour. Chalky, white, pale poo requires urgent attention from a medical professional.
When to contact a medical professional
Contact a medical professional urgently if you are concerned about your baby’s poo or if your baby has additional symptoms like:
- Refusing breast, formula, or solid foods
- Reduced or dark coloured urine
- Blood in urine or poo
- White, pale poo
Breastfed and formula fed babies will poo quite differently. If you are breastfeeding and your baby’s poo changes colour, try to first recall what you have eaten, as different food pigments can alter your baby’s poo. Remember every baby is different; they will feed and poo differently too.
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