Far from just being useless waste your baby expels; your baby’s poo may provide vital insight into his or her health. By knowing the normal and abnormal appearances of these substances, you can better monitor your baby’s well being and seek medical attention appropriately.
POO
In the first few days of life, a newborn’s stools (also known as meconium) are usually greenish-black in colour with a smooth and sticky consistency. Not passing stools within the first 24 hours of life is a concern as it is a sign of intestinal obstruction.
This will then change in the subsequent days to a transitional stool, which is greenish or yellow-brown with a grainy or seedy consistency. The frequency of stools may be very variable, ranging from as many as fifteen times a day to as few as once in a few days.
Normal breastfed infant’s stools are light yellow to bright green with a consistency that can be described as loose, runny, curdy, lumpy, seedy or creamy. The consistency, frequency and colour may vary from day to day.
Formula-fed infant’s stools are tan-coloured and usually thick like peanut butter.
As your child is weaned to solid foods, the stools may appear firmer and more greenish-brown. It is not uncommon to see pieces of food in the stool.
Other appearances
| Watery, frequent | Diarrhoea; causes include intestinal infection by a virus or bacteria, food intolerance or stress. |
| Hard, pellet-like | Constipation; more common in formula-fed babies, inadequate fluid intake and during weaning to solid foods. May be associated with blood streaks. |
| Dark green to black | Iron supplementation in infant foods and vitamins, often associated with constipation. |
| Green, frothy | In breastfed babies, nursing for short periods in each breast may result in more foremilk (sweet and thin) than hind milk (rich and fat) consumed. This improves by nursing for at least 20 minutes on each breast. |
| Orange | Foods such as carrots. |
| Red streaked | Bleeding in the lower intestine or anal fissures (tiny tears in the anus), cow’s milk protein allergy, ingested blood from mother’s cracked nipple. Intussusception is a serious condition where there is persistent or increasing blood in the stool mixed with mucus resembling red-current jelly. Needs urgent medical attention. |
| Black, thick (melaena) | Bleeding into the stomach or intestines. Needs urgent medical attention. |
| Pale or chalky white | Severe liver or bile disease. Needs urgent medical attention. |
Frequency
Exclusively breastfed baby’s stool frequency may suddenly increase or decrease. This is often normal, so as long as your baby is feeding, playing, growing and developing well, you do not need to be worried. As a general guide, a paediatrician should be consulted if your baby has not pass stools in a week.
With a better understanding of what is normal and abnormal in your baby’s poo, you can be more confident in caring for your precious one. If you detect any abnormalities as described above, a paediatrician should be consulted promptly so that a thorough evaluation can be made and appropriate treatment is given.
By Dr Eugene Han, Paediatrician, SBCC Baby & Child Clinic
Dr Han obtained his medical degree from the National University of Singapore. He is a member of the Royal College of Paediatrics and Child Health (UK) and an accredited Paediatric Medicine Specialist by the Singapore Medical Council. He was formerly a Paediatrician at NUH and a Clinical Tutor at the Yong Loo Lin School of Medicine, NUS.
This article was first published in The New Age Parents e-magazine.
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