Is my baby’s poo normal?

Many parents worry their baby has constipation because he does not poo every day or as much as other babies. In many cases this is very normal behaviour.

• Babies usually aren’t considered constipated unless they have gone more than seven days without a poo and when they do poo it’s hard and looks like ‘rabbit pellets’.

• Breastfed babies poo less than bottle-fed babies because breastmilk is so well digested.

• Breastfed babies over three months can often go four days without a poo. As long as his stools are soft and he doesn’t seem uncom-fortable when passing them you have nothing to worry about.

• Both breastfed and formula-fed babies given a set amount of milk each feed can appear constipated because they are not drinking enough to push the poo out. Increasing his milk intake could solve your baby’s constipation. You should always offer your baby the breast until full once your milk has come in and remember to offer him more milk if your baby drains his bottle.

• Grunting and groaning while passing a stool doesn’t mean your newborn baby is constipated. But if he poos less than once a day and his stools are hard, he probably is constipated.

In a baby who has started solids, symptoms of constipation may include irritability, abdominal pain (which as a parent you will not know your baby is suffering from so you can just guess he is suffering from abdominal pain) and gastric discomfort, a hard abdomen which softens after a bowel movement, blood-streaked stools (usually due to rectal fissures caused by passing hard stools) or hard-to-pass, pellet-like stools.

Treating constipation

In many cases I have found that constipation is a signal that a baby is hungry – there is not enough food being given to push through his digestive system. If your baby is constipated, the first step is to make sure you are feeding him until he is full.

If you are breastfeeding, check that you offer him both breasts at each feed. If bottle-feeding, ensure you are not limiting him to a set amount; there should always be some milk left in the bottle at the end of a feed.

When feeding solids be sure to offer two courses at each mealtime and three times a day once solids are fully established.

If your baby is still having trouble with constipation, the following remedies may help:

• Babies under sixteen weeks: Offer up to 30 ml of cool, boiled water from a bottle in between the milk feeds. If this is not making any difference, try adding a teaspoon of brown sugar to the water.

• Babies on solids: Add 60 ml of prune juice to his food. [Note: do not feed your baby prunes before nine months unless he is constipated as it may cause diarrhoea.] If your baby’s constipation doesn’t clear up with these home remedies, contact your GP.

There is a very rare condition where a baby suffers from a tight anal sphincter muscle. A symptom of this problem is the baby cries a lot and strains with every bowel movement, but when the stool comes it is soft.

Not all GPs have come across this condition, so if you think your baby may have it you should see a paediatrician. There is a very simple procedure to correct it.

Green poo is normal

Many parents become alarmed when they go to change their newborn baby’s nappy and find a green poo.

To date I have not discovered the reason for this colour but with breastfed babies the colour of poo can vary according to what the mother has eaten.

Some breastfeeding mothers notice their baby doing green poos after they have eaten a lot of lollies.

But experience has shown me that green poo comes and goes causing no present or future problems. Whether you are bottle-feeding or breastfeeding and your baby’s poo is green, but he is gaining weight, don’t worry too much.

If his poo is very runny, talk to your GP to rule out an infection. If you find any trace of blood in your baby’s poo, you should contact your GP.

Green poo in a formula-fed baby can be a sign that your baby is simply excreting the additional iron from the formula that he does not require.

LACTOSE INTOLERANCE

Lactose intolerance occurs when a baby doesn’t have enough of the enzymes required to break down the lactose (a form of sugar) in breastmilk or formula. The intolerance can also be a temporary side effect of a tummy infection.

Classic symptoms of lactose intolerance include an unsettled baby who is not sleeping well and has constant, watery diarrhoea.

I often hear mums say that their baby is lactose intolerant so they are going to give up milk and other dairy to remove lactose from their breastmilk to try to solve the problem. I find this odd as cows don’t eat dairy but there is still lactose in their milk, so it’s obviously something that occurs naturally in milk.

If you think your breastfed baby is lactose intolerant, I recommend you first teach him to self-settle as his crying may be due to being over-tired while the watery poo is normal for him.

If the problems persist, I recommend you put him on a lactose-free formula for 48 hours. But you will need to express just before his regular feed times to keep up your milk supply.

If your baby becomes more settled it could indicate there is something in your milk that is upsetting his tummy and you can either try an elimination diet or continue with the lactose-free formula.

If you decide on the latter, after four months on the lactose-free formula you can try weaning to a regular formula. If you do decide to try an elimination diet, I recommend you do this under the supervision of your doctor or dietician.