How often should a breastfed baby poop? A guide for parents - Evidence Based Babies
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How often should a breastfed baby poop? A guide for parents

Baby poop. Yes, it’s icky, and under normal circumstances it’s not really something adults care to discuss. Once you become a parent though, it’s something you’ll have to adjust to quickly as babies tend to poop, quite a lot. You’ll soon ask the very same question of how often should a breastfed baby poop? Stool tells us a lot about a baby’s milk intake and a baby’s health.

If you’re a soon to be parent, a new parent or a first-time breastfeeding parent, you need to know what’s normal and what’s abnormal when it comes to how frequently your baby has a bowel movement. How many diapers and how often they have soiled diapers will tell you what you need to know.

A baby’s bowel movements and how many bowel movements they have in the early days and early weeks of life, tells us many things, including whether your baby is getting enough breast milk. If they’re not having the expected number of bowel movements, especially if they’re not gaining the expected weight gain, could be a warning sign of insufficient milk intake or even signs of medical conditions.

How often should a breastfed baby poop?

Day 1

In the first 24 hours, your baby should have no less than 1 wet and 1 or more soiled diaper. Some babies may poop more and that’s normal.

You can expect the first stool to be a black, sticky and tar-like substance. This is called meconium and it’s just a mixture of amniotic fluid, skin cells and everything else your baby may have swallowed in utero.

Day 2

On day 2 your baby should have no less than 2 wet and 2 or more soiled diapers.

These stools will still mostly be meconium stools, but it will be less sticky and dark brown to black in color.

Day 3

On day 3 your baby should have no less than 3 wet and 2-3 or more soiled diapers.

By now you will start seeing a clear difference in both the consistency and the color of the poop as the meconium is starting to work out of the baby’s digestive tract. This is what’s known as transitional stool. You can expect these stools to be brown to green in color.

Day 4

On day 4 your baby should have no less than 4 wet and 2-4 or more soiled diapers.

You can expect these diapers to become even lighter in color. You may start seeing the yellow color to come through if it hasn’t already. These stools will be green to yellow in color.

Day 5

On day 5 your baby should have no less than 5 wet and 2-4 or more soiled diapers.

By day 5, it is expected that all meconium has cleared, and the stool will now be mustard yellow in color and may have white seedlike flecks.

Day 6

From day 6 until around 4-6 weeks of age, it is expected that your newborn should have at least 5-6 wet and 2-4 or more soiled diapers during every 24 period.

4-6 weeks to 6 months

Around the 4-6-week mark, some babies may have a change in their bowel movement pattern, they may have fewer and less frequent bowel movements than before. Some babies may start going longer without having a bowel movement. Some babies may continue going multiple times a day, others may start going every few days while others may even go as long as 10 days between bowel movements.

No one really knows why this happens. Some experts believe that it’s due to the milk composition changing around that age. Others believe that even though this is such a common occurrence, it’s not necessarily normal, and not being regular could be because of many different factors such as a lack of probiotics, medication use in either mother or child and many other reasons.

Unfortunately, studies lack when it comes to babies’ bowel movements and how frequently they should have one. So, the best practice recommendation is that as long as your baby is healthy, gaining weight and growing as expected and their stool is soft once they do have a bowel movement and they’re not constipated when they go infrequently, it’s perfectly fine.

Infrequent stooling is one of the most common reasons why babies receive unnecessary laxative medications. Make sure that you don’t mistake constipation for normal infrequent stooling.

6 months

Around 6 months of life with the introduction of solid foods, babies’ stools will once again change. Seeing as they’re no longer exclusively breastfed, their stools will reflect that.

In the beginning, when they’re still eating very little, you may not notice much of a difference. But their stool will eventually become firmer in consistency, and colors may vary depending on what they eat.

Firm poop should not be mistaken for constipation. Food will cause firm but soft bowel movements, constipation on the other hand will cause hard or pebble like and uncomfortable stool.

Diarrhea in breastfed infants

Breastfed newborns’ bowel movements are known to be explosive sounding and very soft and somewhat runny, which is different from explosive watery diarrhea Some newborns may also have a soiled diaper after every single feeding and even more frequently. Many parents mistake this soft and frequent stool for diarrhea, but it’s completely normal in breastfed babies.

If their stool suddenly increases by quite a bit, is much looser than usual or even watery, and lasts for at least three bowel movements, it could be a sign of diarrhea. It will probably have a different and possibly foul smell and it may contain mucus or blood. Your baby may also have other signs and symptoms of illness such as a diaper rash, overall fussiness and a fever.

If at any time you suspect diarrhea in your breastfed baby, consult with an International Board Certified Lactation Consultant (IBCLC) and a healthcare provider who is well experienced and knowledgeable in working with breastfed babies as soon as possible. Diarrhea in newborns can be very dangerous due to how quickly they can dehydrate. Diarrhea is usually due to illnesses or could be a sign of infection which should be treated promptly.

Signs of dehydration

– Less than the recommended amount of wet diapers
– Less than the recommended amount of dirty diapers
– Showing signs of dehydration, such as dry lips, sunken eyes or a sunken fontanelle
– Sleepiness or lethargy
– Losing weight

Constipation in breastfed infants

Exclusively breastfed babies (receiving no other food or drink other than breastmilk) usually don’t get constipated. Breastmilk is higher in the protein whey than the protein casein and therefore, it’s much easier to digest and works like a natural laxative.

Constipation in exclusively breastfed infants is extremely rare and is usually due to not exclusively breastfeeding, medications (including drops such as colic drops and other over the counter drops and medications) or a medical condition.

Signs of constipation

– Hard or dry stool is usually the biggest sign of constipation
– Babies may refuse to eat due to discomfort
– Making strained faces while trying to have a bowel movement. This should not be mistaken for infant dyschezia, which is just your baby learning how to poop with their underdeveloped digestive system.
– Crying and appearing uncomfortable. This can also be a part of infant dyschezia which is completely normal in infants.
– A hard or distended belly
– Stool that contains blood

Important notes

There is a wide range of normal when it comes to newborns and their bowel movements, some babies may have very frequent bowel movements, where others may have fewer bowel movements. A baby’s bowel movement will change in color and consistency during the first week as their stool transitions, around the 4-6-week mark, and it will change again when they start solid foods.

Some babies may only have 2-4 diapers a day in the first 4-6-weeks, other babies may have a dirty diaper after every single feeding, both are normal. Infrequent stools in the first 4-6 weeks may indicate insufficient milk intake and should be assessed immediately.

After the first month, your baby may stool less frequently than usual. As long as they’re happy, healthy and growing as expected, you have nothing to worry about.

If at any time your baby is having less than the recommended amount of wet and dirty diapers, it’s important to contact an International Board Certified Lactation Consultant (IBCLC) or healthcare professional to assess your baby and ensure that they’re getting enough milk.

Be sure to always do lots of skin-to-skin care. Feeding responsively is always a good idea, the best idea. This will reduce the risk of your baby not drinking enough breastmilk.

Additional information and resources:

Defecation patterns of the infants mainly breastfed from birth till the 12th month: Prospective cohort study

The bowel movement characteristics of exclusively breastfed and exclusively formula fed infants differ during the first three months of life

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