New moms will attest that having a newborn can be a fulfilling and frustrating experience at the same time. After the nine months of pregnancy and attendant issues and body changes associated with childbirth, comes the major task of taking care of another precious, tiny, human being. Taking care of a newborn can be very challenging as new mothers often wonder what is normal, and what is not normal; and might be confused when to take the baby to a doctor or when to just observe the baby. One of the issues which can be very confusing is when the newborn is not ‘pooping’ but just passing gas. It is important to understand the difference between a newborn and bigger child to answer this question.
Normal bowel movements of newborns
The digestive system of a newborn is not very mature at birth. The coordination between the muscles and intestines needed for smooth bowel movement is usually not fully developed at birth. This may make it confusing when you are nursing a newborn. The quantity and consistency of the newborns stool is greatly dependent on what the child is fed with.
First of all, most normal newborns SHOULD pass stool within the first 24 to 48 hours after birth regardless of if they are fed or not. This stools confirms the patency of the digestive tract of the child and is called meconium. It is often dark greenish or black and thick. This stool marks the introduction of your newborn to the human activity of passing stool or ‘pooping’.
Depending on whether your newborn is breastfed exclusively or given formula, their stool frequency, colour, and consistency will differ. Many newborns have at least 1 or 2 bowel movements a day. This may increase to up to 5 to 10 times a day by the end of the first week. Your baby may even pass a stool after every feeding. This usually reduces when the baby gets more mature as they get older.
Sometimes in breastfed children, the frequency of stooling maybe once every few days. This is because newborns can digest breastmilk very well. Subsequently, there is little left over after digestion, hence there may be nothing to ‘poo’ until after a few days. The colour is often a transition from dark green to yellow until it becomes completely yellow and ‘seedy’. The stool ranges from soft to watery and seems to contain ‘seeds’. This is perfectly normal for a breastfed child.
A formula-fed child will have firmer ‘poop’ with a stronger odour. The colour also ranges in shades of tan to brown. If your baby is formula-fed, you should be more mindful of the consistency and frequency of the stools. The stool should not be too hard like pellets or consistently very watery. These may be signs to see a doctor.
When newborn not pooing but passing gas
If your newborn is not pooing but passing gas happily and is exclusively breastfed, you should not be worried as constipation is very rare in breastfed babies. Colostrum contained in breastmilk also acts as a laxative and ensures proper bowel emptying.
Formula-fed babies tend to swallow more air while they feed, so they are often a lot gassier than breastfed babies.
So if your baby is passing gas, and is feeding well, and happy but not passing stool often, just relax, chances are that it will resolve on its own as the digestive system matures further. Also note that some babies are just gassier than others, and it is nothing to be worried about.
Constipation in newborns
Constipation, however, can occur sometimes especially in formula-fed babies. It is estimated that constipation affects about 0.7% to 29.6% children across the world and accounts for a lot of office visits to the pediatrician. If the frequency of pooing is much reduced to less than once a week, the stool is very hard or pellet –like, your child maybe constipated.
What to do
If you think your newborn child is constipated, you can start modifications like adding a water after formula feeding or a little fruit juice if your baby is up to 2 to 4 months old. You may also need to adjust your diet if you are breastfeeding or change the formula. Other measures like giving your baby a warm bath, gently moving their legs while they are lying down as a form of exercise, gentle circular massage of the stomach may also help to relieve constipation.
You should also watch out for associated signs of severity. These signs are delay of more than 48 hours in passing meconium, very hard, pellet-like stools, streaks of blood in stools, explosive stools, abdominal distension, irritability, poor feeding, vomiting, and failure to gain weight.
You should visit your pediatrician immediately if constipation continues despite home measures or you notice the above associated symptoms as there are other more serious causes of constipation which may require urgent treatment.