Stool stories
Welcome to the world of new parents, where the contents of your child’s nappy is endlessly fascinating and can reveal all kinds of interesting things about his lifestyle and health, writes Terésa Coetzee
WHILE YOUR WHOLE LIFE your mom might have told you that toilet matters should remain private, you’ll quickly come to realise that your baby’s stools play a big part in your and his little life. And that’s exactly how it should be, because the working of your baby’s gut tells you how healthy he is and if his body is functioning properly.
But remember: your child’s metabolism is as unique as he is, and the patterns of his stools will even differ from his brother’s!
ALL THE SMELLS AND COLOURS
Even in those first few days after Baby’s arrival, soiled nappies play a very important role. Your newborn baby’s stools are initially a sticky black or darkgreen colour because of meconium, a substance that built up in his gut while he was still in the womb.
As soon as your baby starts drinking milk, the meconium is excreted.
Colostrum (the very first milk your body produces right after birth) helps him get rid of the meconium quicker.
So, nurse baby as soon as possible after his birth, so that the milk can kick his body into action.
The colostrum almost functions like a laxative, and as soon as your milk comes in, the colour and texture of his stools will start changing. It will be brownish at first and less sticky. Remember, it’s a meconium build-up in his body that can cause jaundice, so it’s important that you feed at least 12 times in the first 24 hours. He should also not poo meconium for more than three days. If this happens, speak to your doctor.
The colour of your baby’s stools can vary depending on what you eat (if you’re nursing) or depending on the kind of formula he gets. A breast baby’s poo is usually yellow or green.
A newborn can have eight to 12 soiled nappies a day – it’s completely normal. Yet there’s no reason to be concerned should he only have one dirty nappy per day (with breast babies, it’s even normal to have one dirty nappy in 10 days).
If your baby is breastfed, his soft, watery stools initially make you wonder if he doesn’t have diarrhoea. The answer is no. Some breast babies’ poo just is this watery and is also characterised by small yellow-brown “mustard seeds”.
If your child keeps on having watery, green stools, he might only be getting foremilk instead of the more nutritious breast milk he should be getting if he suckles for a longer period of time. Make sure he drains one breast well before you move him to the other.
Many watery stools could also point to him being sensitive to some of the foods you’re eating or the medication you’re taking. Cut down on dairy products such as milk, cheese and yoghurt for at least three weeks, and see if it doesn’t have an effect on baby’s stools. After that, you can slowly re-introduce dairy products to your diet. If his stools become watery again, it’s better to get other sources of calcium and protein in your diet.
Breast babies’ stools don’t usually smell of anything.
Bottle babies’ stools are a little firmer than those of breast babies – one could almost compare it to peanut butter. If it’s
much harder than that, it might be a sign of constipation – better to go to the doctor.
Remember, some babies can go from a few bowel movements a day to a few days without any. It’s no reason for concern. Constipation is not determined by the number of times your baby has a bowel movement but by how hard and dry his stool is.
As soon as you start giving your baby solids such as rice porridge, the smell, colour and texture of his stools will start to change dramatically.
HELP! THERE’S BLOOD IN HIS NAPPY
Many hysterical parents have raced to the emergency room at the hospital after finding a little blood in their newborn’s nappy, just to realise later that baby swallowed a few drops from mom’s cracked nipple. (The crack in your nipple is perhaps so small that you won’t even see it.) This small amount of blood won’t do your baby any harm.
The blood could also come from a small tear or cut to your baby’s anus.
Help it heal by applying an antibacterial ointment.
If you continue finding blood in your baby’s nappy, go and see a doctor.
STUBBORN CONSTIPATION
Your baby’s unique pattern of poos and pees will depend on what he eats and drinks, how active he is, and how quickly he digests his food and gets rid of his waste products. Don’t worry – you’ll get to know his routine after a while. These might be signs that he’s constipated: ➤ He suddenly has far fewer stools than in the past. ➤ Three to four days pass between stools, and he’s obviously uncomfortable while he’s having a bowel movement. ➤ He has hard, dry stools that are difficult to pass, even if they happen regularly.
WHY DO BABIES BECOME CONSTIPATED?
Formula Babies who only drink breast milk hardly ever – if ever – get constipated. This is because breast milk has the perfect balance of fat and protein, so stools are almost always soft, even if your baby hasn’t had a bowel movement in a few days. If your baby drinks formula, it’s possible that something in formula makes him constipated. Ask the nurse at the clinic for advice about another kind of formula. (There are lots of rumours that the amount of iron has an influence on constipation. It’s false.) Introducing solids Don’t be surprised if your baby suddenly becomes constipated when he starts eating solids. Rice cereal (which is usually given first) has a very low fibre content. Dehydration If your baby gets too few fluids, he’ll start dehydrating, and his body will react by absorbing more liquid of whatever he eats or drinks – even the waste products in his gut. The result is hard, dry stools that are very difficult to pass. A medical condition Although it’s unlikely, your baby could be constipated because of a problem with his metabolism. He could even be allergic to some foods. Feel free to see a doctor if your baby has hard, very painful stools.
WHAT YOU CAN DO TO HELP?
Do exercises with your baby. Even a small baby’s legs can be “cycled” in the air. Put him on his back while you gently “pump” his legs. If your baby is crawling, you can encourage him to crawl short distances. Massage his belly. Measure three fingers under his belly button, and press firmly yet gently. Keep up the pressure until you feel a hard bit. Put pressure on his belly for about three minutes. Consider another kind of formula,
and chat to the nurse at your clinic about this change. Some babies also become constipated from soya milk. Sometimes a teaspoon of brown sugar dissolved in about 200ml of water ( boiled, then cooled) helps. Swop rice cereal for wheat or maize porridge for babies, or add a little prune purée to his porridge. Increase his fibre intake – as soon as he’s eating a variety of solid foods – by adding some bran to his porridge. Be careful with foods such as rice, bananas and cooked carrots because it could exacerbate constipation. Ask for a glycerine suppository from the pharmacy if your baby is badly constipated. But be careful not to use this too often, as his gut can become accustomed to it. Make sure he drinks lots of fluids. If your baby is older than two months, you can give him a little prune juice diluted 1:1 with water.
WHAT ABOUT NAPPY RASH?
Nappy rash is red and occurs on your baby’s bum but can even be seen in the folds of his legs or on his genitals. It can be dry or look like wet bumps and even form a crust.
If it’s not treated immediately, it could become infected. The infection can be caused by fungi (like when your baby is on antibiotics) and is usually red.
A bacterial infection can be linked to fever and pimple-like bumps or even yellow patches. Nappy rash can happen when a baby stays in a dirty or wet nappy for too long. The protective layer on the skin’s surface is literally broken down, so that the germs can attack the skin.
TREATMENT
✓ Leave your baby without a nappy, so that his bum can get some air. ✓ Use a good barrier cream every time you change his nappy. ✓ Antibacterial creams are available from pharmacies and can help for some rashes. ✓ Take him to the doctor if the rash does not get better after a few days. YB