Dissecting Diaper Contents
The surprises start with your baby's first diaper change. When you peel off that cute little newborn-size diaper, you will be confronted with something that looks like sticky, greenish-black tar. This is your baby's first bowel movement, which is known as meconium, a mixture of amniotic fluid, bile, and secretions from the intestinal glands.
It will pass in the first 24 hours, and a few days later, the real stuff will arrive. "Don't expect infant poop to look anything like yours," Dr. Brown warns. "If you breastfeed, it will probably look seedy and mustard-like, and if you bottlefeed, expect something more greenish with the consistency of toothpaste," she explains.
Any variation on the colors yellow, green, or brown is normal. "The only colors that warrant a call to the doctor are red and black, which could indicate gastrointestinal bleeding, and white, which could represent liver disease and/or nutrient malabsorption," says Nanci Pittman, MD, a pediatric gastroenterologist and assistant professor of pediatrics at Mount Sinai School of Medicine in New York City. And since your infant is on an all-liquid diet, soft, squishy poops will be the norm for a while.
For most new parents, BM frequency is another fixation. I remember trying to calm down a friend who was alarmed that her baby hadn't made a diaper deposit in four days. Meanwhile, my own daughter seemed to go every hour on the hour for the first few months. Both extremes are perfectly fine. "For a breastfed baby, it can be normal to have only one bowel movement a week," says Dr. Pittman. "It can also be normal to have as many as one bowel movement with each feeding."
Bottlefed babies tend to average between one and four a day. Doctors point out that the most important thing to watch for is the consistency of the stool, not necessarily the frequency. If your baby seems uncomfortable and is filling her diaper with something that is thicker than toothpaste or that looks like logs or marbles, then she's probably constipated.
This problem occurs for several reasons. In babies under 4 months of age, it's usually because your child isn't getting enough fluids, so remedy the situation by encouraging her to drink more breast milk or formula. Some doctors recommend giving baby a little sugar water, as sugary substances can help to soften up stool.
In toddlers, the constipation culprit may be a fluctuating interest in food. Your doctor may recommend giving her a few teaspoons of prune juice or water. If she is straining with no results, Dr. Brown recommends inserting a rectal thermometer for a minute, which will stimulate the bowel to get moving. Pediatricians may also recommend a suppository to move things along.
On the other end of the scale, if baby's poop becomes thin, watery, or streaked with mucus and she's pooping a lot more often than usual, she probably has diarrhea. This can be caused by antibiotics; too much fruit juice; milk allergies (which are pretty rare); or gastroenteritis, a viral illness that results in vomiting and diarrhea.
If your baby has loose stools, "it's important to keep him hydrated with breast milk, formula, or pediatric electrolyte solutions," Dr. Pittman explains. But if you notice any signs of dehydration, such as dry lips, sunken eyes, or sunken fontanels (the soft spots on baby's head), call your doctor immediately.