Without doubt, one of the freakiest things to witness as a new parent, can be seeing the greenish-black sticky tar-like sludge called ‘meconium’ that is a newborn’s first bowel movements! But what the heck is it? And why does it occur only in the first few days? Then there’s also the mustard-like poos, diarrhoea-like poos and guacamole-like poos … all generally described as ‘normal’?? So how, with such weird and bizarre poos, can it be possible to truly know what is not ‘normal neonatal stools’? I’ll explain…
Meconium is the name given to the material at birth that has accumulated within a baby’s intestines while growing in the uterus (womb). It is thick, greenish-black in colour and is a mixture of bile pigments, salts, fatty acids, mucous, dead cells, uterine debris and swallowed amniotic fluid. This is what all newborns poo for the first few days of life. ‘Meconium Aspiration’ refers to when a fetus has poo’d inside the womb (due to hypoxic fetal distress), and then the baby inhales the amniotic fluid containing meconium. In up to 5% of births this syndrome is treated particularly seriously, as it can potentially cause newborn respiratory distress (rapid shallow breathing), pneumonia (lung inflammation) or pneumothorax (lung collapse).
It is normal for newborns to have their first meconium poo within 48 hours of birth, and this shows the colon (lower bowel) is open. Then at around days 3-5, as the newborn begins to drink milk, their poo changes into Transitional Stools which are a batter-like greenish-brownish-yellow, and this shows the entire gastrointestinal tract (stomach & intestines) are open. By days 4-6, their poo becomes a bright golden orangey-mustard colour. A young baby’s poo can be as small as a teaspoon of mush making a patch on a nappy the size of a large coin.
Colostrum is the name given to the initial milk breasts produce for newborns. Because their stomach and intestines have never digested food before, Colostrum is Mother Nature’s perfect gentle introduction that also ‘coats’ (lines) the gut walls, plus acts as a gentle laxative. Human breastmilk creates an intestinal environment designed to kill harmful bacteria and promotes growth of beneficial bacteria. A newborn’s intestines take about a hundred days to create competent protection against bacterial micro-organisms.
When an infant’s stomach begins to digest milk protein, it produces large amounts of the digestive enzyme Rennin, which converts infant milk into something resembling curdy, sour milk. So if your baby spits up a curdy substance, don’t think your milk has somehow ‘gone off’ – it is just partly digested.
Breastfed babies stools are soft, loose, bright yellow and inoffensive – that is, their poo doesn’t smell bad, and can actually smell sweet. This is because their body is able to digest every single amino acid (protein). In the early weeks a breastfed baby can poo up to ten times a day, but once breastfeeding is established (typically after 3-4 weeks) it can be normal for Bubs to poo somewhere between 4-8 times daily or just once every 2-3 days (even up to once every 7-10 days). It is rare for a breastfed baby to become constipated, and so long as their poo is soft and yellow, then a breastfed baby does not have constipation.
Babies fed artificial milk (formula) have pale brown, more curdy or solidish, formed stools that have the recognisable faeces smell – usually 1-2 poos daily. Formula-fed babies more commonly experience the discomfort of the small, hard, dry poo caused by constipation. If you believe your formula-fed baby has constipation, it is important you check this with your MD who may recommend giving your baby extra water.
Formula-fed babies are also statistically far more at risk of suffering from the potentially serious gastroenteritis. If your baby (formula or breastmilk fed) ever has diarrhoea with 6-8 hours of vomiting up all feeds, then you need to seek prompt medical attention. Gastroenteritis in infants should be treated as serious with under three-month-olds (especially with under one-month-olds). Young babies can rapidly go down-hill due to the dehydration caused by gastroenteritis (vomiting and diarrhoea), as it quickly imbalances their body’s electrolytes, which is very dangerous for young babies.
Babies occasionally passing loose moss-green watery or guacamole-like poos can be utterly normal. As way of explanation, the fat-emulsifying alkaline bile our bodies secrete from our liver into our small intestine via the gallbladder is green – so a greenish poo, means the poo contains high levels of bile – as a baby’s body is still learning to balance secretion levels. If the poo is consistently green then do seek medical attention. If a young baby has green poos and has vomited up all feeds over a 6-8 hour period, then again this is potentially gastroenteritis and needs prompt medical attention.
Watery acidic diarrhoea, even frothy, can be a sign of lactase deficiency (also known as lactose-intolerance). Especially if accompanied by a swollen bloated abdomen, excessive farting, rumbling stomach or in-pain crying. A mixture of constipation or diarrhoea-like poo (possibly containing blood), can be a sign of CMPA (Cows Milk Protein Allergy), especially if accompanied by snuffles, vomiting, nappy rash or in-pain crying. If your baby’s poo ever contains blood, or pus-like mucous, or is a bad-smelling poo from a breastfed baby – then these are also all reasons to seek medical attention.
Once your baby starts on solids at around six months, expect the poo to radically change, and reek of a more indelicate adult-like offensive odour! Then, as your baby grows into a toddler and is eating less mushy food, be prepared for the poo to sometimes contain food that doesn’t even look like it has been digested! From my observations, this seems to occur particularly with carrot, corn, peas and raisins. Also, beetroot can make poo look bloody and turn pee red; bananas can add black specks or black threads to poo; and liquorice can turn poo greeny-black.
Oh my word … such a divine topic!?!