Helpful Guide: When it comes to poo, what's normal?

Helpful Guide: When it comes to poo, what's normal?

Poo can come in an array of colours and consistency. There are various factors that affect the characteristics of baby poo:
  • Whether it is meconium or not : meconium is the first form of poo a healthy term baby will have shortly after birth (generally between 24-48 hours), while for preterm infants it may take longer to pass (NCBI, 2020).
  • The length of transit time in the intestines: a shorter transit time in the intestines leads to loose stool whilst a longer transit time leads to firmer stool. Longer transit time might lead to constipation (Lewis & Heaton, 1997).
  • Whether the baby is receiving formula or not: poo on formula might be firmer and less frequent, as well as more odorous compared to breastmilk poo. However, there are some formula ingredients that may affect poop consistency, see next bullet (NCT, 2020a). Green or darker coloured poo is more commonly seen in formula fed infants (NHS. Uk, 2020).
  • Specific formula ingredients: Infants fed formula without palm oil reported softer stool. (Padial-Juadenes et al., 2020). Additionally, infants who receive formula with HMOs have correlated shorter transit time and thus significantly softer stool (Scholtens, 2016).
Newborn, Week 1 (NCT, 2020)
Day(s) Colour Consistency Frequency
1-2 Dark green/brown/black also known as “meconium” Sticky initially 1+
3-4 Greenish Looser 2+
5-6 Yellowish* Loose 2+
*The faster an infant gets to the yellow poo stage, the more effectively a baby is getting milk. Typical poo of a breastfed baby after Week 1 (NHS.Uk, 2020b; Healthline, 2018; Healthline, 2016)
Colour Consistency Frequency
Earthy colours: mostly yellow but can be greenish/brown at times Soft, runny, might be grainy and/or seedy Typically at each feed, but after several weeks they might go less frequently
  • Breast milk poo will usually smell “sweet”
  • Some breastfed babies will skip a few days once they are a bit older (6 weeks+) (NHS.Uk, 2020b)
  Typical poo of a formula fed baby (in combination with breast milk or exclusively) after Week 1 (Nhs.Uk, 2020b; Healthline, 2018; Healthline, 2016)
Colour Consistency Frequency
Darker in colour: brown, green, tan Firm or runny* varied*, usually at least once a day
*Depends on the formula. See information in introduction
  • Formula poo is usually more odorous (Healthline, 2018; Healthline, 2016)
  • Constipation is generally marked by hard pebble like stool (Start4life, n.d.)
  • Regardless of frequency, as long as poo is soft then it’s a good sign (NHS.Uk, 2020b; Healthline, 2018; Healthline, 2016)
Colours to be be concerned about about after Week 1 (Healthline, 2016)
  • Black
  • White
  • Red
General notes:
  • Mucus: Mucus is commonly seen sometimes in baby poo. Mucus lines the intestines so sometimes it comes out in poo. Drooling by baby can also lead to some mucus in stool- the extra swallowed saliva can be irritating to the intestines and thus cause extra mucus production. There are other instances where mucus might be a concern, however, such as in the case of a suspected allergy (usually other symptoms accompany), consecutive diapers with a lot of mucus, infection, or other medical condition (FirstCry Parenting, 2020; WebMD, 2017)
  • Straining : Babies will often stain and turn red in the face when trying to poo, this is usually not a cause for concern as long as the consistency of the poo is soft and not firm (NCT, 2019; NHS.Uk, 2020c).
  • Introduction of solid food: A change in colour, consistency, frequency and smell is commonly seen when starting solids. One may even see some undigested food in poo (Babycentre, n.d.).
  References
  1. Skelly, C. L. (2020, July 26). Meconium - StatPearls - NCBI Bookshelf. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK542240/
  2. Lewis, S. J., & Heaton, K. W. (1997). Stool Form Scale as a Useful Guide to Intestinal Transit Time. Scandinavian Journal of Gastroenterology, 32(9), 920–924. https://doi.org/10.3109/00365529709011203
  3. NCT. (2020, December 10). Newborn baby poo in nappies: what to expect. NCT (National Childbirth Trust). https://www.nct.org.uk/baby-toddler/nappies-and-poo/newborn-baby-poo-nappies-what-expect
  4. NCT. (2020a, December 10). Common questions about newborn baby poo. NCT (National Childbirth Trust). https://www.nct.org.uk/baby-toddler/nappies-and-poo/common-questions-about-newborn-baby-poo
  5. Padial-Jaudenes, M., Castanys-Munoz, E., Ramirez, M., & Lasekan, J. (2020). Physiological Impact of Palm Olein or Palm Oil in Infant Formulas: A Review of Clinical Evidence. Nutrients, 12(12), 3676. https://doi.org/10.3390/nu12123676
  6. Scholtens, P. A. (2014). Stool characteristics of infants receiving short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides: A review. World Journal of Gastroenterology, 20(37), 13446. https://doi.org/10.3748/wjg.v20.i37.13446
  7. NHS website. (2020, December 7). How to change your baby’s nappy. Nhs.Uk. https://www.nhs.uk/conditions/baby/caring-for-a-newborn/how-to-change-your-babys-nappy/
  8. NHS website. (2020b, December 7). How to change your baby’s nappy. Nhs.Uk. https://www.nhs.uk/conditions/baby/caring-for-a-newborn/how-to-change-your-babys-nappy/
  9. Cherney, K. (2018, June 25). What Does Your Baby’s Poop Color Say About Their Health? Healthline. https://www.healthline.com/health/parenting/baby-poop-color#takeaway
  10. Rucoba, R. J. (2016, February 29). What Your Newborn’s Poop Tells You About Their Health. Healthline. https://www.healthline.com/health/parenting/newborn-poop#4.-Consistency
  11. Do you think your baby could be constipated? Find out what causes constipation and how to treat it. (n.d.). Start4Life. Retrieved August 3, 2021, from https://www.nhs.uk/start4life/baby/breastfeeding/breastfeeding-challenges/constipation/
  12. Khan, A. (2020, May 28). Mucus in Baby’s Poop - Is It a Concern? FirstCry Parenting. https://parenting.firstcry.com/articles/mucus-in-babys-stool-is-it-a-concern/
  13. Mucus in Your Poop: What It Can Mean. (2017, April 17). WebMD. https://www.webmd.com/digestive-disorders/mucus-in-poop-stool
  14. NCT. (2019, November 20). Constipation in babies: Q&A. NCT (National Childbirth Trust). https://www.nct.org.uk/baby-toddler/your-babys-health/what-watch-out-for/constipation-babies-qa
  15. NHS website. (2020c, December 7). How to change your baby’s nappy. Nhs.Uk. https://www.nhs.uk/conditions/baby/caring-for-a-newborn/how-to-change-your-babys-nappy/
  16. My baby’s poo has changed now that they’re on solids. Is this normal? (n.d.). Babycentre. Retrieved August 3, 2021, from https://www.babycentre.co.uk/x1051573/my-babys-poo-has-changed-now-that-theyre-on-solids-is-this-normal
Kendamil recognizes that per the World Health Organisation (WHO) breastfeeding provides the best nutrition and protection from illness for babies. As such, mothers should be given guidance and support on everything related to breastfeeding including information on lactation and an appropriate diet while breastfeeding. Mothers should be informed on the drawbacks to not breastfeeding and/or stopping lactation as well as be made aware of the financial cost to formula feed. If a decision to use formula is made, it is important to discuss correct formula preparation techniques and sterilisation.