Pooping is normal – but what is normal is sometimes confusing, especially when it changes over the lifetime. Questions about normal baby stools are some of the most common ones we get, so here’s some information on what’s normal and when to call the pediatrician.
To watch the video of Dr. Bhogte talking about Infant Poop and Constipation, visit our website HERE.
What should it look like?
First and most importantly, stools should always be soft – think peanut butter or dough consistency, at the hardest. In fact, in newborns, they are often quite liquidy. This can be normal (I’ll talk more about the frequency of stools per day below). A hard or formed stool is never normal for a baby.
How often should my baby stool?
Newborns – should stool at least once in the first 24 hours of life, and usually about once a day for the first few days of life – this shows us their digestive system works. This early stool is called meconium, and is quite dark, hard and tarry. This stool will change over the first few days of life to the softer stool. But, there is a huge range of normal after the first few days of life – anywhere from once per day to once per feed! That might mean 12 poopy diapers per day! Significantly more than 1 poop per feed is concerning for diarrhea.
After the first week, infants should poop anywhere from once every feed, to once every 48 hours.
Over the next 1-3 months, you may see stools gradually spread out even further, even to once per week – as long as they are soft, that is ok.
So, What is constipation?
Constipation is a hard poop, at any age, OR going more than 2 days without stooling in the first 1 month of life, or 1 week without stooling if they are older than 1 month of age.
A quick note on straining: Straining does not necessarily indicate constipation in a baby, IF the stool that comes out is soft. A baby’s digestive system is still developing – including the muscle coordination between when they tighten and push with their abdominal muscle to poop, and when their rectum relaxes. This is called infantile dyschezia. It is not a problem, it is a normal developmental process. You’ll notice they push and push and push, and get red in the face, and then gas (or soft poop comes out). It looks uncomfortable, but it is normal, and it will pass (no pun intended).
What can you do to help your baby if they are constipated?
Less than 1 month of age
Call your doctor to possibly have your baby seen
1-6 months of age
(before solid food introduction)
Try 1 oz of pear, prune or apple juice daily *
After solid food introduction
Try 1 oz of pear, prune or apple juice *
Try a serving of baby food pureed prunes once daily
When to Call the Pediatrician:
Please call us to speak to a Triage nurse, and possibly schedule an appointment to have your child seen if:
- If your baby is breast fed in the first month of life not stooling every 1-2 days OR suddenly has a decrease in the number of stools (which could be a sign of declining or inadequate milk supply)
- If your baby is under 1 month of age and having hard stools
- Your baby is over 1 month of age, and stools are hard despite trying 1 oz pear, prune or apple juice per day* for a few days
- Your baby, in consultation with your doctor, has been introduced to solid foods and is having hard stools despite trying 1 oz pear, prune or apple juice and/or pureed prunes daily for a few days
- Your baby isn’t feeding well, or isn’t making good wet diapers (at least one every 8 hours)
- Your baby is having a small amount of blood on their stools (please call us emergently if your child has a large amount of blood in their stool)
- IF YOU ARE CONCERNED, please call us – you know your child best, and if you are concerned, we should check them out.
*I know – we usually do not recommend juice. BUT, the natural sugars in juice are a nice natural laxative, so 1 oz can be used as a medication in this scenario. Please do not give it for any other reason at this age.