Stool frequency in a breastfed newborn. Stool frequency while breastfeeding. The color and smell of bowel movements: what should they be

Even in the maternity nurses and pediatricians ask mothers during the round how the process of emptying the intestines occurs in a newborn. The fact is that the stool in the baby is one of the most important indicators of the health of the child - moreover, as in those who are on breastfeeding, and those who are on artificial.

Why is it important to control stools in babies?

Why is it so important to control the baby's stool:

• it will indicate problems in the work of the gastrointestinal tract;
• it is possible to assess the level of nutritional value of the child;
• by some changes in the stool, it is possible to determine the development of pathologies of organs and systems that are not related to the digestive tract.

A child in infancy poops daily, and even several times a day - this allows even parents without medical education to quickly respond to changes in the stool, pay attention to this moment of the pediatrician or patronage nurse. Of course, for this you will need to master at least minimal knowledge about what a baby’s stool should normally be, what can be considered deviations from the norm, and in what cases it is worth calling a doctor. All this information is laid out in the presented material.

Remember right away - the norm for stool in infants is a relative concept. Someone has a child pooping 3-4 times a day, and the stool is a yellowish slurry, and some children defecate 1 time in 1-2 days and this is the norm for them. How do you determine how well it fits in? normal performance breast stool?

Bowel frequency

On the 2-3rd day of life, the transitional feces begin to pass from the newborn - it has a yellow-green color, it can also be dark green of a semi-liquid consistency, which is absolutely normal.

On the 4th-5th day of a child's life, a bowel movement schedule is already established, and the frequency of stool in children fluctuates in a fairly large amplitude - from 10-12 times a day to 1 time in 2 days. It is noted that most newborns poop either during feeding or after eating.

Note:if a child poops once every 2 days, but at the same time behaves calmly, the act of defecation passes without screaming and strong straining, then such a rhythm of bowel movements can be considered an absolute norm.

As the child grows, the number of bowel movements also changes - for example, if in the first 1-2 months of life the baby pooped 8-10 times a day, then by 4-5 months the number of bowel movements decreases to 5-6 times a day, and by 12 months - 1-2 times a day. It is noteworthy that if a child, still in infancy, pooped 1 time in 2 days, then this frequency of stool persists in the future.

The amount of feces in a bowel movement

This indicator depends only on the diet of the child. For example, in the first 2-3 months of a baby, he will have very little feces - no more than 5 grams per bowel movement, but by 12 months this amount will be increased to 100-200 grams per day (about 60 grams per bowel movement) .

In general, it is considered normal for a baby to have a stool when it is a mass of soft, mushy consistency. But even this indicator can be variable - for example, feces in the form of gruel with a small amount of lumps will also be considered the norm.

As the child grows older, the consistency of feces will also change - it will become more and more dense. But keep in mind - by 6 months of a child's life, the feces will already be completely formed, but will still remain soft.

Yellow with white lumps, dark yellow, yellow-brown, golden yellow and in general all variations yellow color for the feces of the baby will be the norm. But just keep in mind that as soon as the child is transferred to artificial nutrition or vegetable / fruit purees begin to be present in the diet, the color of the feces becomes darker, and by the age of 12 months the baby becomes dark brown.

Do not worry, and in the case of green feces in infants - this is also the norm, and green feces becomes due to the presence in it or biliverdin. You need to know that bilirubin with feces in infants can be excreted up to 6-9 months of age, therefore green tint chair in this age period may be considered the absolute norm. There is no reason to worry even in case of separation yellow stool, which then turns green - this means that bilirubin is released with stool in minimum quantities, in the air it simply acquires a characteristic shade.

If the baby is on an artificial or mixed feeding, then his stool will have a dark yellow or brown shade, the frequency of bowel movements will become less than on breastfeeding, constipation or diarrhea may occur periodically, flatulence with difficult gas discharge.

Note:if the baby is fed mixtures with iron content (this is usually practiced for anemia in newborns), then the color of the feces will be pronounced green. And if the child is fed not with special mixtures, but cow's milk, then the feces will be different oily sheen, bright yellow and "cheesy" smell.

Complementary foods are considered a new type of food for babies, the digestive system will begin to adapt to it and produce specific enzymes for digestion. In the first days of complementary feeding, the mother may pay attention to the fact that undigested pieces of food and an increased amount of mucus appeared in the baby's feces. If such a change in the stool does not lead to a change in the well-being of the baby (the baby does not scream, the feces pass freely), then you need to continue to feed him, carefully monitoring the amount of feces excreted, the frequency of bowel movements and the nature of the stool.

There are some foods that can cause a laxative effect - for example, boiled carrots. Moreover, it is not even digested, but comes out unchanged with liquid feces. If the parents did not have the task of correcting the stool, getting rid of constipation in the baby, then with such “complementary foods” it is necessary to cancel the introduction of carrots into the child’s diet and switch to more gentle vegetables - for example, potatoes, zucchini. And if you introduce rice porridge into the baby’s diet, then the stool will certainly be fixed. It is necessary to take into account such features of the influence of various products on work digestive system so as not to worry and not to take any drastic measures at the slightest change in the stool.

In general, the following changes in the stool with the introduction of complementary foods are considered the norm:

• feces become more dense;
• stool color changes from yellow to brown;
• stool become heterogeneous;
• diarrhea or constipation may occur.

Knowing which baby stool can be considered the norm, it will be easy for parents to find out how healthy the baby is. If changes are detected that can hardly be called physiological, it is necessary to call the doctor at home and describe to him the full clinical picture- this will guarantee the timely detection of pathology and appointment effective treatment if necessary.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category

The stool of a breastfed baby is a cause for concern for the whole family. The bowel movements are carefully examined by mothers and grandmothers, and if random impurities were found in them, this is perceived as a deviation from the norm.

I would like to immediately reassure the worried parents: the child receiving mother's milk, can be any character of the chair. And it depends more on the diet of the mother. So, if a nursing woman ate too many fruits and vegetables, the baby's feces may acquire a greenish tint.

If the newborn is calm, sucks his mother's breast with pleasure, does not pull his legs to the tummy and steadily gains weight, parents should not worry.

The nature of the stool in the baby changes depending on what his mother ate.

In the first 2-4 days after the birth of a child, meconium, or original feces, occurs. Meconium is a dark, viscous, greasy mass, it consists of desquamated cells of the intestinal epithelium and swallowed amniotic fluid. The original stool appears 8-10 hours after birth.

If the original stool does not appear within a day, a surgeon's consultation is necessary. Perhaps the passage of feces occurred in the womb, which is observed with oxygen starvation baby during pregnancy. In other cases, the absence of meconium may indicate congenital pathology intestines (atresia or narrowing of its lumen).

After the start of feeding, meconium is replaced by transitional stools, which have various color shades- from mustard to yellow-brown. Transitional stools often contain small lumps, mucus. Often there is liquid feces. The appearance of transitional stools is associated with the settlement of the infant's intestines with beneficial bacteria. This character of bowel movements persists for up to 10 days, the frequency of excretion is up to 10 times a day. The color of the transition chair does not have of great importance, except for the admixture of blood in the feces. However, single streaks of blood should not cause concern, most often they are the result of a small crack in the rectum.

In the future, the baby's stool on breastfeeding becomes yellow, of a homogeneous consistency, semi-liquid, with no pungent odor sour milk. During the neonatal period, diapers get dirty almost after each feeding, and the amount of feces is from a teaspoon to a tablespoon.

Sometimes the chair can be allocated 1 time per day, in other cases, bowel movements may be absent for several days, and both of these options are not a pathology.

If you suspect that the baby is constipated, analyze his behavior: constant crying, whims and other manifestations of discomfort may confirm your assumption

Some moms start to panic if there is no stool for one or two days. The "grandfather" methods of stimulating the intestines are used - a bar of soap, a thermometer or cotton swab. It can be dangerous to carry out such manipulations. After all, soap is an alkali, and when a small piece is introduced into the rectum, a burn of the mucous membrane easily occurs, and subsequently inflammation of the intestine.

Irritating the outer hole with a thermometer or other object, you can injure the delicate intestinal mucosa of the baby.

Constipation in newborns during breastfeeding is quite rare. More often this happens with "artificial" ones, since the baby's digestive system is not always able to digest the milk mixture. Constipation is indicated not only by the absence of stools, but by dry, hard stools.

Changing the mother's diet will help normalize the nature of bowel movements. So, the inclusion in it of porridge from buckwheat or oatmeal, boiled vegetables, one-day kefir and whole grain bread has a positive effect on the baby's stool.

Another cause of constipation may be impaired intestinal motility, spasm of the external sphincter. At the same time, it is difficult to discharge not only feces, but also gaziki. The child becomes restless, often "knocks" his legs, cries piercingly. These symptoms are indicative of intestinal.

Accurate administration can improve the situation, sometimes medicines are prescribed by a doctor - suppositories with glycerin or Microlax microclysters.

Green chair

Greenish stools in a breastfed baby are a variant of the norm. Baby feces contain bilirubin, which turns green when exposed to light. This situation can persist up to 8 months of age. If there are no manifestations of an infectious disease (temperature, watery stool, anxiety of the baby, refusal of food), then green color bowel movements is not a pathology.

White lumps in stool

Sometimes whitish lumps are found in the baby's stool, which resemble curdled milk or pieces of cottage cheese. The appearance of these elements indicates insufficient digestion of breast milk.

As you know, babies have a poorly developed enzymatic system, and if you regularly overfeed a child, breast milk cannot be completely processed by his body. Often white lumps appear when frequent application to the breast or changing from one mammary gland to another in one feeding. The appearance of undigested lumps indicates that the baby is receiving more nutrients(proteins, fats) than he needs.

If this phenomenon is accompanied by a weak weight gain, enzymatic preparations may be prescribed by a doctor.

loose stool

Appearance liquid stool may be a sign of an infectious disease. Unfortunately, some mothers neglect to boil bottles and pacifiers, and babies also like to pull objects into their mouths, which contributes to infection. The following symptoms indicate an infection:

• temperature increase;
• loose stools that resemble appearance some water;
• baby anxiety;
• pathological impurities in the feces - blood, a large number of slime and greens;
• frequent regurgitation;
• vomit;
• weight gain stops.

If these symptoms appear, you should call your doctor as soon as possible. Because the infection leads to dehydration of the crumbs, the situation can become critical. Self-medication in these cases is extremely dangerous!

Loose stools can be a symptom of lactase deficiency. At the same time, the stool acquires a sharp sour smell, foams strongly, and on the diaper around the feces, wet spot. The attending pediatrician will have to deal with all this, however, it is worth noting that true intolerance to milk sugar (lactose) is quite rare. It is allowed to refuse breastfeeding only with the established diagnosis of lactase deficiency, in all other cases it is unjustified and will harm the baby.

What should be the feces (stool) in newborns and infants. How do the properties of feces depend on the nutrition of the child? In what case does a change in the nature of the child's stool indicate an illness?

In the first year of a child's life, the functions of the digestive system have not yet been fully formed, and therefore, the feces (stool) of newborns and children of the first year of life has a number characteristic features. The analysis of feces in children of the first year of life also has some features that are important to consider when trying to establish a diagnosis of dysbacteriosis or digestive disorders. The properties of a baby's feces depend on the nutrition he receives, so the normal stool of children who are breastfed is very different from normal stool children receiving artificial feeding.

Features of the analysis of feces in newborns

The first feces, which departs approximately 8 to 10 hours after the birth of a child, is called meconium. Meconium is a mucous plug that contains a small number of cells lining the intestines of the child, as well as tiny drops of fat and a yellow-green pigment -. Meconium is usually a sticky, thick, odorless substance that is viscous and dark green in color. The characteristic color of meconium is given by a pigment - bilirubin, which is formed during the breakdown of erythrocytes (red blood cells) of a child. As a rule, meconium is sterile, that is, it does not contain germs.

Normal discharge of meconium in the form of greenish-black mucus in a total amount of up to 100 g continues for another 2-3 days after birth.

What diseases are detected in the analysis of meconium?

Research Meconium is milestone detection of some congenital diseases of the child's digestive system. An important indicator is the time of discharge of the first meconium (normally, the first portion of meconium is excreted in the first 8-10 hours of a child's life). Delayed passage of meconium for more than 24 hours after birth is called meconium ileus and may be a sign of the following diseases:

1. is a hereditary disease characterized by increased production thick mucus body glands (including intestinal glands). Meconium in this case becomes too viscous and is not able to stand out.
2. Anomalies in the development of the intestine (overgrowth of the intestinal lumen - atresia, narrowing of the intestinal lumen - stenosis, etc.) are the cause of delayed meconium discharge. Treatment in such cases consists in the surgical restoration of intestinal patency.

Features of the feces of a child of the first year of life who is breastfed.

At breastfeeding The baby receives all the necessary nutrients, vitamins and minerals with milk. In addition, mother's milk contains enzymes that allow the baby to absorb the maximum amount of nutrients from mother's milk.

Fecal frequency in breastfed babies changes with age:

• In the first month up to 10-15 times a day
  
• In the next 4-5 months 2-5 times a day
• After 6 months 1-2 times a day or less
• After a year 1 time per day or 1 time in two days

false diarrhea

Once again, we draw the attention of readers to the fact that liquid, frequent stool in infants receiving breast milk, this is completely normal phenomenon. Such stool should not be considered as diarrhea or a symptom. In the letters of our readers, there are often such expressions as "a child who has been breastfed since birth has had diarrhea ... numerous attempts have been made to treat them, but to no avail, while stool analysis shows the presence of dysbacteriosis." This situation can be commented as follows:

It is perfectly natural that a child who receives only liquid and easily digestible food passes liquid feces. Approximately the same chair will be in a perfectly healthy adult if he begins to eat only milk. After the introduction of complementary foods, the liquid feces of the baby will immediately begin to thicken and become the same as in adults, only after the child begins to receive exactly the same food as adults.
The fact that dysbacteriosis is often determined in children of the first year of life can be explained by the fact that the intestinal microflora is formed sufficiently for a long time. We do not recommend treating dysbacteriosis in cases where the only symptom of the suspected disease is liquid feces. Treatment should be resorted to only if there are obvious and severe symptoms of dysbacteriosis: allergies, lag in body weight, severe bloating after 6 months.

False constipation

Due to the fact that breast milk is digested and absorbed almost completely, in some children, after 6 months, stools can become very rare (once a week or less). If at the same time the child feels normal, can empty his intestines on his own without crying and anxiety, such a schedule for fecal excretion should be considered normal. No treatment from this case not required.

Also quite often, in children of the first months of life, some temporary difficulties are observed with the release of feces, which causes considerable concern on the part of parents, who immediately begin to actively stimulate the release of stool in the child with enemas, laxatives, gas pipes and even soap (!).
IN similar cases attention should be paid to the consistency of the child's stool: if the stool is soft, no treatment is needed, since the difficulty in defecation is obviously not due to the fact that the stool is too dense, but to the fact that the child has not yet learned to control bowel function well. We also note that persistent attempts by parents to stimulate defecation in a child with soft chair can only exacerbate the problem, as they deprive the child of the opportunity to train his intestines correct work. The use of enemas and laxatives is allowed only as an ambulance in cases where the child cannot remove dense feces. If a child has chronic formation of hard stools and the accompanying difficulty in defecation, he should be seen by a doctor and treated for constipation.

Features of the feces of a breastfed child

The feces of a child who is on natural (breast) feeding is an unformed mass of golden or yellow-green color, with a sour smell. Often, even with the same mother's diet, the color of the baby's feces changes from yellow to green, which should also not cause concern.
The reaction of feces to the content of bilirubin is normal in children is positive up to 6-8 months of age. Bilirubin gives feces a greenish tint green chair(feces) in a child under 8 months who is not accompanied by other signs of illness (fever, blood in the stool, restlessness of the child) should not cause any concern and does not require any treatment.
At infants after 8 months of life, bilirubin in the feces is practically absent, since intestinal bacteria turn it into stercobilin. Until the age of 8 months, the intestinal microflora is not sufficiently formed to completely convert bilirubin into stercobilin.

So, the analysis of the feces of a breastfed baby is normal:

• yellow-green stools, mushy or liquid
• positive for bilirubin (before 6-8 months of age)
• has a sour smell and slightly acidic environment (рН = 4.8-5.8)
• infant stools may contain white blood cells (blood cells designed to fight infection), as well as mucus and visible undigested milk clumps
• intestinal flora is not fully formed

Features of the feces of a child of the first year of life, who is bottle-fed

At healthy baby located on artificial feeding, feces have some differences compared to the feces of a child receiving mother's milk:
The color of the feces of a bottle-fed baby is pale yellow or light brown, has an unpleasant odor and is more alkaline (pH = 6.8-7.5)
The consistency of the stool is pasty (if the child is receiving liquid formulas) or semi-solid if the child is receiving solid foods.
The stool test for bilirubin is also positive until 6-8 months of age.
At microscopic analysis Feces of a child of the first year of life are found single leukocytes and a small amount of mucus.
Feces depart 1-2 times a day, in greater quantities than with natural feeding.

Waste diseases in children infancy, causing change fecal analysis:

1. Celiac disease is a disease that is characterized by a deficiency of a special enzyme that promotes the absorption of gluten, a substance found in wheat flour, oats, rice, rye and barley. The disease manifests itself only when the child is introduced to complementary foods containing foods with gluten (various cereal cereals, bread, cookies). Undigested gluten causes allergic reaction organism, resulting in intestinal inflammation. Symptoms of celiac disease are: frequent stools (up to 10 times a day) of light yellow color, with bad smell, anxiety of the child, lack of weight gain, etc. Analysis of the feces of a child with celiac disease: feces contain a large amount of fat (steatorrhoea).
2. - a disease in which the child's body does not produce enough lactase - an enzyme that promotes the absorption of lactose (a carbohydrate in breast milk). Lactase deficiency manifests itself in the first days of feeding a child breast milk: the stool is quickened (up to 10 times a day), the stool is watery, has a sour smell, the child is restless, cries, does not gain weight. In the analysis of feces, a large amount of fat (steatorrhoea) and lactic acid are determined - a substance that is formed from milk lactose under the influence of intestinal microflora.
3. Cystic fibrosis is a hereditary disease. With cystic fibrosis, the glands of the body produce a viscous secret that makes it difficult for all organs to work. In the intestinal form of cystic fibrosis (the predominant lesion of the digestive system), the child's feces have a viscous consistency, a grayish color, an unpleasant odor, and “glistens” due to the presence of fat in the feces (steatorrhoea). An analysis of the feces of a child with cystic fibrosis reveals a large amount of fat (steatorrhoea), at an older age, with the introduction of complementary foods, muscle fibers (creatorrhoea), connective tissue, and starch. All these substances in the feces indicate a lack of digestion of food.
4. Acute and chronic is an inflammatory bowel disease that is usually caused. The stool of a child with acute enteritis is semi-liquid or liquid, contains a lot of mucus, sometimes contains blood. Microscopic examination of the feces of a child with acute enteritis reveals a large number of leukocytes (white blood cells), as well as an increased fat content (steatorrhoea). In chronic enteritis in a child of the first year of life, an increased content of fat is found in the stool, as well as important trace elements(calcium, phosphorus, etc.)
5. taken from the site

By the contents of a baby diaper, one can judge the quality of the baby's digestive system; regular bowel movements (at least once a day) are considered the norm for a newborn baby. Analysis of the state of the stool allows you to identify incorrect bowel function and promptly provide assistance to a fragile body.

What should be the chair of the baby at different ages?

The ideal stool for a newborn baby is a uniform yellow consistency without additional inclusions, however, such feces are observed exclusively in artificially fed babies, since in this case the baby receives the same mixture, which, accordingly, is digested in the same way. It is quite another thing - children who are breastfed. In this case, the stool may have additional lumps and mucous layers, it may be different color, since the condition of the bowel movements is affected by the foods that the mother ate.

A study of the baby's feces will help to identify possible nutritional deficiencies in a timely manner, so every mother should know how the baby's stool should look at different ages:

• in the first three days, the baby poops in a black-green mass, such a stool is called meconium. It consists mainly of amniotic fluid, which the baby ate before birth;
• starting from the 3rd day until the end of the first week the stool can be gray or gray-green, while the liquid consistency of the mass is considered the norm. Such feces show that the baby receives enough milk and it is successfully digested by the body;
• from the second week of life to 3 months the child should poop up to 10 times a day (sometimes there will be as many bowel movements as there were feedings), while the stool will be yellow or mustard color, has a sour smell. This testifies to adequate nutrition and normal bowel function;
• from about 4-5 months the baby's feces should be brown or brown interspersed, such a mass has an unpleasant pungent odor. This is the norm for a baby who is starting to receive complementary foods, main characteristic- the stool should not be hard, the consistency should resemble putty;
• after six months, the feces of a newborn may have an unusual shade, the reason is the vegetables and fruits used as complementary foods. For example, beets give the mass a bright red color, carrots turn the stool orange, and greenish streaks may appear due to zucchini in the diaper.

Constant monitoring of the state of bowel movements will prevent all kinds of stomach upsets and protect the child from unnecessary discomfort.

There is no single definition of how many times a child should poop per day, however, for newborns of the first month, from 4 to 12 bowel movements per day are considered the norm. Over time, they will become more rare, but up to a year, the baby can walk “in a big way” several times a day.

What does unusual stool in a baby mean?

An unusual color or texture of feces in a newborn baby may indicate the causes of discomfort for the crumbs:

• green stools with a sour-milk smell it will not necessarily be a harbinger of the disease, if the child is gaining weight well and does not experience discomfort, such a state of feces may be a common reaction to foods eaten by the mother;
• if the feces are liquid and have a foamy structure, while around anus irritation is often noticed, the cause may be an excess of anterior sweet milk in the mother. The way out of the situation will be the preliminary decantation of the initial fluid from the chest;
• bright yellow or green mucus-streaked stools can have three explanations:

1. the child received a viral infection due to infection with SARS or other infectious diseases;
2. a common reaction to teething;
3. insufficiency of enzymes in an organism that has not yet been formed;

• if the baby poops in a dark brown dense mass, this may be a consequence of taking iron supplements, but if additional medications were not prescribed, it is worth reviewing the diet and slightly reducing foods containing such a mineral;
• bright green foam chair should alert you if the baby behaves restlessly and gains weight poorly. Most often, this situation manifests itself due to;
• hard feces in a newborn baby is an anomaly, and it does not matter at all what color it is. Constipation occurs due to the introduction of unsuitable foods into the diet, to eliminate discomfort, you should find out exactly what such a reaction occurs to, which can be done by eliminating the ingredients;
• if baby long time pooping diarrhea, this may be a consequence of dysbacteriosis, the best option would be to contact a doctor to prescribe suitable medications;
• feces with bloody elements- Very alarm symptom. The cause of this imbalance may be an allergy to milk, an infection, or intestinal bleeding. If you find this type of stool, you should immediately consult a doctor.

Causes of stool disorders in newborns

Most often, stool in infants is not disturbed due to bacterial infection, the cause of disruption of the digestive system in most cases is the incorrectness of breastfeeding.
The main mistakes of the first months of breastfeeding:

• late application- the child should be attached to the breast in the initial minutes after birth, even if he does not immediately eat, this contributes to getting used to breastfeeding;
• should eat when he wants to, since each organism requires a different amount of nutrition, and is also adapted to an individual regimen;
• early introduction of complementary foods- how many foods to introduce into the baby's diet, the parents themselves decide, however optimum time start of application adult food the first half of life is considered, until this time the stomach is simply not able to digest anything other than mother's milk;
• excessive fluid in the body- this is obtained in the case of "drinking" the child with water, teas and juice.

Proper organization of breastfeeding will help to avoid possible problems, therefore, in no case do not refuse the opportunity to feed your baby with natural milk.