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How Often Should a Baby Poop? And Other Important Questions…

Last week, I wrote about BabyM’s nap strike. This week, we’re recovering from another kind of strike. BabyM went 7 days without pooping. I like to think I’m pretty laid-back about these sorts of things, but I admit to being a little worried – enough to do some research on it. So today on the blog, I’m going to write about baby poop.

I’m sort of sorry to bring this up, because I think it’s one of the worst parenting clichés – this idea that we become obsessed with our offspring’s bowel habits. But the thing about parenting clichés is that they’re often true. Part of caring for babies is keeping an eye on what goes in and what comes out. And by day 5 of BabyM’s poop strike, I starting searching both Google and PubMed for more information about normal poop frequency, how to tell if a baby is constipated, and what to do if he is. By day 7, when BabyM casually had his long-awaited bowel movement, I felt much more informed and relaxed about the whole situation.

How often should a baby poop?

This a surprisingly difficult question to answer. You can take two babies of the same age, both exclusively breastfed, and one may poop several times per day and the other may go once per week. That’s pretty fascinating to me, and it means that lots of different poop patterns can be normal.

For the first few weeks of life, you can expect several poopy diapers per day, and some babies will poop after every feeding. As babies grow and their guts mature, the transit time slows. By the second month of life, it is not unusual for babies to skip a day or two between poops, but again, there’s a huge range of normal here.1–3

There are some fun examples of comments about infrequent pooping in breastfed infants in the research literature. In a 1951 Lancet paper, Dr. Israel Gordon introduced his study of poop patterns in infants by noting the outdated belief that breastfed infants should always poop at least once per day and following with this comment:

“Those of the modern school such as Plaunder and Schlossman (1935), Williamson (1947), Ellis (1947), Watkins (1948), and Spock (1947) have discovered that it is not necessary for a healthy breast-fed infant to have bowel movements every day; but none of them has produced evidence that a number of normal infants have been studied or that the scatter with respect to age, and type of feeding, has been investigated. Large sections of the medical public, together with grandmothers and nurses, are still unaware, to the detriment of the child, of the normal bowel rhythm of infants. In fact, because of the popularity of Spock (1947) many modern mothers are better informed on the matter than their medical advisors.”4

Then there was this wide range of normal found in a 1988 study conducted in England:

“The frequency of defecation ranged from eight stools per day in breast-fed infants of 2 weeks to no stools passed for 27 days in a breast-fed infant between 7 and 11 weeks, who remained perfectly well, displayed no clinical signs of gastrointestinal or systemic disease and passed a vast soft stool at the end of this period. She had only 14 bowel actions during the first 16 weeks of life.”2

Although the baby described above might have been otherwise normal, this still sounds like a remarkable case. Most sources I found said that anything up to about a week between bowel movements could be normal. Beyond that, it is definitely worth talking with your pediatrician to be sure there isn’t an underlying cause.

Formula-fed or mixed-fed infants tend to poop less frequently than exclusively breastfed babies. Formula-fed babies also usually have a similar poop frequency across the first few months of life, while breastfed babies seem to poop with decreasing frequency from the first month until starting solids. Formula-fed babies are also more likely to have harder stools. Once solid foods are added, breastfed and formula-fed babies have a similar frequency of pooping, but the consistency of breastfed baby poop remains a bit looser.1,2,5,6

There are several possible explanations for the differences in poop between breastfed and formula-fed babies. Breast milk is more easily digested so may just have a faster transit time with less waste. Breastfed babies may feed more often, which means more frequent stimulation of the gastrocolic reflex that causes increased activity in the large intestine after a meal.7 Finally, human milk contains a ton of oligosaccharides that, unlike the other nutrients in milk, are not digested in the baby’s small intestine. Instead, they serve as prebiotics, passing on to the large intestine to be fermented by the gut bacteria. These human milk oligosaccharides may impact the frequency and consistency of breastfed babies’ poop by their effect on the gut microbiota, by stimulating gut motility, and by binding up water, an effect similar to dietary fiber.8,9

How does starting solid foods change poop patterns?

BabyM has been an infrequent (~2-3x/week) but dramatic pooper since he was about a month old, but I didn’t really worry until the last few weeks. He was exclusively breastfed from birth, adding small tastes of solids around 4.5 months. However, around 6 months, he showed a lot more interest in eating more solids, and when his solid food intake went up, his poop became less frequent and more solid, and he started straining more. These same changes that I observed in BabyM’s poop patterns upon eating more solid foods have been observed in the research literature as well. I’m sure most parents notice the same changes in their own babies.

Why does this happen? Simply put, you’re shifting from a liquid diet to a diet with more solid foods, and that causes the stool to bulk up. Gradual introduction of small amounts of solid foods and some water to drink can help ease this transition, but it can still be an upset to a baby’s system. With the introduction of solid foods also comes shifts in infants’ gut microbiomes, which can alter poop patterns.9,10

The changes in defecation patterns that come with starting solid foods are a good reminder to pay attention to fiber and fluid intake from the start to avoid issues with constipation (more on this in my next post). Starting solids is the first common trigger for constipation in childhood.11 (Other common triggers later in childhood include potty training and starting school.) So, when BabyM didn’t poop for 7 days, was he constipated?

How do you know if your baby is constipated?

Because of all the things we just discussed, normal frequency of pooping is really variable so on its own is not a good indicator of constipation. Most health professionals use something called the Rome III criteria to diagnose “functional constipation” in infants and children [PDF]. Functional constipation just means that it has continued for a while and has no evidence of an anatomic or biochemical cause. The Rome III criteria lists the following factors for infants and toddlers, and if at least two of these are present for one month, then your child might be diagnosed as functionally constipated:

  • 2 or fewer defecations per week
  • History of excessive stool retention
  • History of painful or hard bowel movements
  • Presence of a large fecal mass in the rectum
  • At least one episode of incontinence after being potty trained
  • History of large-diameter stools that may obstruct the toilet.

(Those last two factors are obviously not relevant to infants.)

Although the first item on the list is stool frequency, this is not the most important one. The most important indicator of constipation is probably the one that is most likely to cause discomfort in your baby: hard poops that are painful to pass. Note that grunting and straining to pass a soft stool can be normal for a baby, as the muscles and nerves required for pooping are still developing strength and coordination. But if stools are hard and painful to pass, then a baby might start avoiding pooping. That’s when you get into the real problem with constipation, and you definitely want to avoid this.

Because there’s so much subjectivity in these indicators, one of the most important considerations is probably what your baby’s previously normal pattern was and how it has changed. So if your baby normally passes a soft stool just 1-2 times per week and goes 7 days without a bowel movement, that’s probably nothing to worry about. If your baby normally poops once a day and goes 7 days without, then you should be worried. Regardless, it never hurts to bring up your concerns with your pediatrician. They’re used to reassuring parents about poop patterns, and they’ll be able to tell you if there is anything to worry about.

In BabyM’s case, I started to worry a little when he hadn’t pooped for 4-5 days. That was a bit unusual for him, and I knew his increased intake of solids could make him constipated. I started paying closer attention to his diet and offering more poop-promoting foods. In my next post, I’ll give lots of tips on how to help a constipated baby.

I’ve over-shared about my baby’s poop patterns today with the hope that this is helpful to other parents. What was your experience with your baby? It’s not a random or scientific sample, but it would be interesting to see how much variability there is among readers’ babies. There are few public forums where it’s considered socially acceptable to talk about poop, but consider this a safe space!

REFERENCES:

  1. Tunc, V. T., Camurdan, A. D., İlhan, M. N., Sahin, F. & Beyazova, U. Factors associated with defecation patterns in 0–24-month-old children. Eur. J. Pediatr. 167, 1357–1362 (2008).
  2. Weaver, L. T., Ewing, G. & Taylor, L. C. The bowel habits of milk-fed infants. J Pediatr Gastroenterol Nutr 7, 568–71 (1988).
  3. Hertog, J. den et al. The defecation pattern of healthy term infants up to the age of 3 months. Arch. Dis. Child. – Fetal Neonatal Ed. (2012). doi:10.1136/archdischild-2011-300539
  4. Gordon, I. Bowel rhythm in the healthy infant. It’s suggested relationship with chronic constipation. Lancet 257, 1203–1205 (1951).
  5. Quinlan, P. T., Lockton, S., Irwin, J. & Lucas, A. L. The relationship between stool hardness and stool composition in breast- and formula-fed infants. J. Pediatr. Gastroenterol. Nutr. 20, 81–90 (1995).
  6. Duyan Camurdan, A., Beyazova, U., Ozkan, S. & Tunc, V. T. Defecation patterns of the infants mainly breastfed from birth till the 12th month: Prospective cohort study. Turk. J. Gastroenterol. 25, 1–5 (2015).
  7. Stewart, M. L. & Schroeder, N. M. Dietary treatments for childhood constipation: efficacy of dietary fiber and whole grains. Nutr. Rev. 71, 98–109 (2013).
  8. Scholtens, P. A., Goossens, D. A. & Staiano, A. Stool characteristics of infants receiving short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides: A review. World J. Gastroenterol. WJG 20, 13446–13452 (2014).
  9. Voreades, N., Kozil, A. & Weir, T. L. Diet and the development of the human intestinal microbiome. Front. Microbiol. 5, (2014).
  10. Thompson, A. L., Monteagudo-Mera, A., Cadenas, M. B., Lampl, M. L. & Azcarate-Peril, M. A. Milk- and solid-feeding practices and daycare attendance are associated with differences in bacterial diversity, predominant communities, and metabolic and immune function of the infant gut microbiome. Front. Cell. Infect. Microbiol. 5, (2015).
  11. Sood, M. R. Prevention and treatment of acute constipation in infants and children. UpToDate (2015).
31 Comments
  1. Sarah #

    Great post! My daughter was mixed-fed (mostly breast) and she had always popped about once per day after the first month or so. She is 19 months now. She did get constipated once she started solids, poor thing, So I’ll be looking forward to your next post to try to prevent that with my second! I am also interested in the babyM sleep post when it’s ready!

    Like

    July 16, 2015
  2. My first was a very constipated baby- by the time he was a toddler he was on a daily regime of prunes and oat bran! Fortunately no medical advice was needed and he liked prunes and thought it was a delicious snack. I gave the baby (Sweetpea) some prune last week as she also had the same experience: 6 months old, suddenly VERY interested in food and then clearly very uncomfortable. But all was well post-prunes! I’ve given them all probiotics on occasion too-with a fine disregard for dosing accuracy, I usually open a capsule and give them a fractional dose. Naturally I can’t recommend this but they all three have had no ill effects. 🙂

    Like

    July 16, 2015
  3. P.S. he is super extra cute.

    Like

    July 16, 2015
  4. My son (10 months, breastfed) has always been a prolific pooper. He was one of those poop-after-every-feeding newborns; with solids, he’s slowed down to 1–3 bowel movements a day. Very rarely, he’ll go a day without pooping—and when he does, it means watch out for the mess next time!

    Like

    July 16, 2015
  5. My daughter pooped frequently in her first couple weeks of life, then started pooping hardly at all (coinciding with lack of weight gain). We started supplementing with formula a few weeks later on our doctor’s recommendations since it was pretty obvious by then that she wasn’t getting enough to eat. Then she started pooping again, fairly regularly, usually once a day. We found that different types of formula varied the kind of stool she made (the free nestle stuff we tried resulted in stinky bright green poop), and then when we started introducing solids around 5.5 months, things changed again. Right now, at nearly two, she tends towards pooping every other day (though it’s often daily), and often the pooping day includes a couple of bowel movements. She has been constipated a few times and is especially prone to that when we travel, so we try to make sure she gets lots of fluids and plenty of fiber. Her system was discombobulated enough by travel once that a can of prune juice did pretty much nothing. Then the next week, after we were home, I gave her some more prune juice to encourage her system back to normal, and half an hour later, I was regretting it. Right now, it’s been a day or two since the last time she pooped, I give her some high-fiber toast or some fruit and yogurt and make sure she’s drinking water, and that usually does it.

    Like

    July 16, 2015
  6. Alison #

    Both my kids got constipated from rice cereal. Eliminating it and using oatmeal in its place helped but the best solution we found was to ignore cereal and start with fruit and veggies instead. Their iron got a smidge low by a year but was fine by 15 mo without supplementing.

    Like

    July 17, 2015
    • Yes, rice cereal can do this. Using a whole grain oatmeal or barley cereal is a good option to still get baby the added iron but also fiber. I’m currently mixing a little oatmeal into pears.

      Like

      July 20, 2015
  7. mt #

    When my son was a newborn, it took a while–about 7 days–for his gut to “get going.” He didn’t poop for the first week he was home from the hospital, but our pediatrician said this was perfectly normal for brand-new babies. I think we had taken our son in on the 5th poop-less day, and the doctor said to give it another 4-5 days, as everything else seemed normal. After the long-awaited poop, our son was very regular, going several times per day.

    One bout of constipation occurred when we started solids. Our son loved avocado, and it because it’s so easy to prepare, he ate a LOT of it, but it resulted in some hard stools. So we reduced the avocado and increased the proportion of sweet potato and spelt cereal in his diet, which got things back on track pretty quickly.

    More recently, we’ve struggled with poop holding during toilet training. This is more frustrating. Our son would hold poop for days to avoid an accident, but then sometimes the dam would break, and we’d have a mega mess on our hands (plus a very upset little one). We were set back by a not-terribly-helpful daycare environment (they just weren’t very encouraging or supportive in this area even though otherwise they were fine), but that’s behind us. We’re making progress again, and our son is getting the idea that pooping in the potty is more about listening to his body than avoiding accidents.

    Like

    July 17, 2015
    • So glad you’ve gotten past the poop-holding, MT. That’s very challenging, and it can cause so many problems! We’ve had to work on that a bit with Cee too.

      Like

      July 20, 2015
  8. maggie #

    My pediatrician called rice cereal “baby gut glue” and suggested that we started with mixed grain baby cereal; which worked well for us because we have no history of allergies. He also suggested pear juice in small amounts when she stopped pooping regularly. We did have a 7 day poop strike. We noticed that the longer gaps between bowel movements also seemed to correspond to growth spurts. She is 6 now, and still goes for a few days without bowel movements when she is growing.
    Our experience is that almost every baby has what my family calls a “gurgle, gurgle, pop” – a bowel movement that you can hear coming and is so dramatic that you end up cleaning the backs of their ears and just throwing out the onsie.

    Like

    July 17, 2015
    • Ha! That’s a funny description, and I know what you mean:)

      Like

      July 20, 2015
  9. Aw the joys of parenting!!

    Like

    July 17, 2015
  10. My exclusively breast fed baby boy (now almost 2 years old) pooped a lot in the first few weeks of life, then completely changed and only pooped once a week. I knew this was normal, but it was still disconcerting, especially to the grandmothers! lol!

    Like

    July 17, 2015
  11. sheridanj2015 #

    my daughter became constipated around the time that I changed from exclusively breastfeeding to adding formula throughout the day when I would go to work. I truly believe that she responded to different types of formula differently (the ones with lower iron levels worked better for her) and even now that she is 2, she is still can get constipated if she consumed too many iron-rich foods. It’s all about moderation with her! Great and well-written article! 🙂

    Liked by 1 person

    July 17, 2015
  12. You did not over share the poop information. I was pretty much sailing in the same boat last year!

    Like

    July 17, 2015
  13. Alison #

    This has been super helpful! Especially the comments on rice cereal so thank you for sharing. My wee one is 22 weeks old and breast fed, but having some interest in food for around 4 weeks now. Her bowel movements were slowing down before she had any solids (from twice/three times a day to every other day). However since she showed a big shift of her enjoyment of food, bowel movements ticked down another notch to twice a week with a big change in consistency (todays was super sticky). It hasn’t worried me too much, but she’s been loving the rice cereal so I might try and swap that out and see if it helps her go a little more frequently.

    Like

    July 17, 2015
    • Yep, try a whole grain oatmeal or barley, and definitely work in the fruits and veggies, too! More on that in my next post!

      Like

      July 20, 2015
  14. Anya #

    Thanks for this post, Alice. I am definitely one of those parents obsessed with their babies’ poop 🙂 Have you come across any information on the possible link between ‘transit time’ and infant eczema? I noticed a pattern with both of my babies. My now-4-year-old used to go very infrequently while exclusively breastfed and once went for 20 (!) days without a bm. Her eczema would always flare up before a big bm. My 6.5 months old baby went every 3 days before she started solids and is now going every 1-2 days.

    Like

    July 19, 2015
    • I haven’t come across info on this, but this is an interesting observation. I’ll keep an eye out for studies that might relate to your experience.

      Like

      July 20, 2015
  15. NeuroBioMom #

    My son is a non-pooper. He is now 15 weeks old and poops on average once a week, since birth. I was also worried, of course, but my (German – we live in Bavaria) paediatrician said it was fine. She said that for fully breastfed babies anything goes, unless they are visibly in pain, their belly feels hard or bloated and their poop is hard or in any way abnormal. This was thankfully never the case for our boy: when he poops (always an exciting celebratory moment!) it’s a modest amount.
    I have to add that this little boy is enormous (born 11 days overdue, 10lbs, 22″), currently at the 97th percentile for length, and very strong (holding head up from the start, rolling over both ways since 3 months, and sitting relatively stable when propped in a high chair).
    I think he just uses every ounce of milk (we supplement with 100ml of formula at night since 2 months of age) and nothing is left too poop out!?

    Like

    July 22, 2015
  16. Carole Leff #

    Great article! I have a 14 month old granddaughter and seem to be obsessed with her poop schedule. If she goes more than a day, I freak out! Her poops always seem to be pretty dramatic which always makes me nervous…she stands very still with lots of grunting and sometimes crying out! Poops range from hard to soft! I think it’s all pretty normal, as she eats a variety of foods and drinks whole milk. I try to stress with her parents that more water is good too! I guess I had all these issues when raising my 3 kids, but don’t remember worrying so much! lol Thanks for all the comments above…very helpful!

    Like

    August 29, 2015
  17. I breastfed my babies and they both would sometimes go up to two weeks without defecating. At first I was always worried that I might be eating something that was causing them to be constipated, but they never showed signs of it. Figured it they did not go for more then two week I would call in, they would usually go just as i was thinking about calling the nurse. My first would go on average once a week, but my second so far is every two weeks or so. Thanks for posting this. Its got a lot helpful and reassuring advice to us mothers who worry incessantly about our babies bowel movements.

    Like

    September 16, 2015
  18. C.line #

    I have a 14 mo old girl, and she’s been formula fed since birth due to my milk never came full-on. But she gets as much as she can from me, but I’m also a full time working mom. Ever since she caught a stomach bug at age 9mo, her poop consistency had been a roller coaster. There are days that she’s normal-daily soft stools passed, but there are times that she seems constipated- hard stools. She was introduced to solids and whole milk at age 12mos, and her poop had been crazy. I worry. She is a drinker, so water is not a problem.. her diaper must be changed within 3hrs. She eats oatmeal and a fruit (she prefers 1/2-3/4 a banana) with 2oz of milk. Then it’s naked chicken with another fruit or veggie for lunch, yogurt for snack, and a little bit of whatever we eat for dinner. She doesn’t eat solids much at night. She does drink her formula at bedtime and when she wakes up in the morning. But her poop will either be hard or soft… there’s no telling, and she poops every other day. Her pediatrician says to give her more fiber containing foods and water. I have, but doesn’t seem to be enough.

    Like

    September 21, 2015
  19. This is seriously driving me insane right now. My newest little one is 10 months and has become a really infrequent pooper since he started solids. I try to be so careful with not giving him things to block him up and try to give him things to help him go like prunes and none of it seems to make any difference. But the poop that comes out doesn’t seem problematic anyway. And weight gain is not a problem at all!

    My older child was an infrequent pooper and it ended up being a big problem for him and he dramatically dropped on his growth chart so i can’t help but worry.. I hate how much I worry about poop.

    Like

    December 3, 2015
  20. Mummel #

    Thank you for this post. Our little boy is exclusively breast fed and averages a poo once or twice per week. He’s almost four months. He’s gone 10 days between poos but today set a record of 20 days! He has been fighting his first cold but otherwise been perfectly normal. It’s such s relief that it came! My husband is a doctor and was going to intervene at 21 days 🙂

    Like

    December 5, 2015
  21. Valerie #

    I wanted to know how much pooping is to much, my child goes up to six times a day is that to much.

    Like

    February 26, 2016
  22. tony tony #

    my baby boy goes for seven days without poopy bt passes out some air every now and then am so worried coz he is 2months old plz help me

    Like

    April 15, 2016
  23. my baby is 4 month old. he pass motion only once in a day and pass urine only 5 to 6 times a dax. he is born before 34 weeks is there any problem

    Like

    April 15, 2016
  24. Dr nida #

    I hv a baby boy 4 months old now.he passed meconium within 2 hrs of his birth.during purpurium he passed stool daily.after that he is passing stool after 10 days.sometimes 7 days sometimes after 11 days.he is on breastfeeding.plz help me.really worried

    Like

    April 24, 2016
  25. Daza #

    My baby does her poop after 7 to 9 days only everytime.she is turning three months on 8th of july.And the poop is soft as babies do.Most impotantly she is breastfed only.

    Like

    June 29, 2016
  26. Vicky #

    My baby girl is pooing every 2days she is 12 days old is that normal

    Like

    July 4, 2016

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