Infant poop may seem odd, but it may not be as complicated as you think. The varying colors and textures usually aren’t cause for concern.

Story by: Kim Huston on February 25, 2021

Baby poop can be a source of concern for new and veteran parents. If you’ve spent time searching for information about specific colors or textures to understand if it’s normal or abnormal, this is for you. We’ll walk through what’s normal, what’s not, and when to call your pediatrician.

Newborn poop: Passing meconium during the first few days

Newborn feces that is passed during the first few days of life is unique — it can look like motor oil or tar. Doctors refer to this as meconium. It is composed of cells, amniotic fluid and other materials ingested in the womb, as well as mucus a baby’s bowels produce. It also contains bile produced by the liver. The meconium is black, thick and contains mucus. Babies usually start excreting the meconium in the first day of life; it can be passed even during delivery. Babies can pass the meconium for days, and it often transitions to more of a black-green color before taking on the colors and textures of traditional baby feces.

Baby poop: Breastfed vs bottle-fed

Stool can vary quite a bit from the time a baby begins feeding from breast or bottle until beginning solid foods. It’s important to note that there is no one definitive way a child’s stool should look. In most cases, even if you think it looks weird, it’s likely normal.

“Stool that children produce, from a newborn to toddler age, is nothing like the stool adults produce,” said Marian E. Morris, M.D., pediatrician with Norton Children’s Medical Group – Novak Center. “It garners a lot of questions from parents. It’s important to remember that even if it looks odd, the reality is that more often than not, it’s usually OK.”

Dr. Morris suggests that parents pay attention to four attributes of a baby’s stool:

• Color: Baby poop actually can be any shade of yellow, orange, brown or green, but is most often a shade of mustard yellow. In general, “fall” colors are OK, except for red. Red, black or white stool should prompt a call to your pediatrician for evaluation. Common causes of red stool can include swallowing blood from a mother’s nipples while breastfeeding, straining to pass stool or diaper rash. However, red stool also could indicate bacterial infection, or gastrointestinal issues such as bleeding polyps. White stool may be caused by the absence of bile, which is what gives stool color. While white, red or black stool should be checked out by a pediatrician, it does not necessarily mean a serious issue.
• Consistency: A child’s stool varies based on whether they are fed by breast milk or formula. Babies fed breast milk have stool that is considered as loose, thin and grainy — think cottage cheese or grainy mustard consistency. It can be confusing to some, as the loose nature may cause parents to think it is diarrhea. Formula-fed babies tend to have more “formed” stool, but it still will be mushy, despite being better-formed. However, if your child’s stool is more liquid or runny than normal, it could be diarrhea. If your child experiences several watery stools in a row, call your pediatrician, as dehydration easily can occur in babies and infants. On the other hand, if a child’s poop is hard, resembles small rocks or pebbles, and/or you witness your child straining (some straining is normal), the child may be constipated. Should you notice that stools seem like they’re made of jelly or contain mucus more often than not, you should bring that up with your pediatrician. It may indicate a milk protein intolerance, infection or potential intestinal issue.
• Frequency: There is a wide range of normal for how often a child will pass stool. Breastfed babies can have a wider range of frequency than formula-fed ones — it can be normal for them to go from once every five days to five times a day. Formula-fed babies can go one to three times a day, generally. It’s common for babies to go after feeding, no matter whether they are bottle-fed or breastfed. That is thanks to gastrocolic reflex, which is when the digestive system becomes more active when you eat food. If your child is going more often and with urgency, it could indicate diarrhea. Additionally, if a child has not passed stool in a number of days and has other symptoms of constipation, such as a distended belly, crying or straining without passing stool, they could be constipated. Call your pediatrician should you suspect diarrhea or constipation.
  If your child experiences periods of straining and possibly turning red in the face that last 10 to 30 minutes before passing a soft stool or no stool, it could be a condition called infant dyschezia. In this condition, a child has not yet developed the coordination of two skills needed to pass stool easily: a relaxed pelvic floor and an increase of intra-abdominal pressure (bearing down to pass stool). Straining is the child’s way to try to bear down to pass the stool; it may look somewhat uncomfortable, but is not dangerous. This condition usually lasts for a week or two when a child is 1 to 2 months old, and usually resolves itself as the child develops. No treatments are needed for this condition.
• Volume: The amount of stool your child may pass can vary based on how frequently they go. A baby could pass several small amounts through the day or have just one larger bowel movement. It’s important to note that if a child passes large volumes of stool often or small amounts irregularly, it could indicate an issue with diarrhea or constipation.

Solid foods bring changes to infant’s stool

Children usually begin to eat solid foods around 4 to 6 months old. At this time, parents may begin to notice changes in a child’s stool. At this point, a child’s stool color often can vary by what a child eats. Green vegetables can give a green tint; sweet potatoes or blueberries can cause stool to appear orange, or a tint between blue and purple. However, as when a child is breastfed and bottle-fed, you always should call your pediatrician should you notice red, black or white stool.

The introduction of solid food will change consistency, frequency and volume of stool as well. Stool likely will become denser and have more shape, but still should be soft. Stool should not be hard or like pebbles. Seeing small chunks of food such as corn is also normal. It’s also likely that parents will notice that kids may start pooping less frequently but have more regular number of stools from day to day. However, call your child’s provider should you notice frequent diarrhea or if a child hasn’t passed stool in a week.

Take action

Should your child’s stool have more than a scant amount of blood, you may want to take them straight to the emergency department.

Other signs that should warrant urgent care in addition to diarrhea and constipation can include:

• Child hasn’t had a wet diaper in 12 hours
• Fever
• Vomiting
• Lethargy
• Stops feeding or eating
• Child looks ill