Stool of newborns and infants: what is normal and what is pathology. Stool in newborns when breastfeeding What kind of stool does a 2 month old baby have?

In the first 2-3 days, a newborn's stool consists of a substance called meconium, which is black-green in color, thin and viscous. Then its color becomes yellow-brown. If the baby does not have stool within 2 days after birth, you should consult a doctor.

Stool in a breastfeeding baby

There may be several or even many bowel movements a day. In the first weeks, the newborn may have stool after each feeding. The color is usually light yellow. The consistency of a newborn's stool is usually similar to a thick puree soup or dough and is almost never too hard. In the first 2-3 months, the baby's stool occurs either often or rarely. For some children it happens every day, while for others it occurs only every other day or two. This can frighten a mother who is accustomed to believing that she should have a bowel movement every day. You have nothing to worry about if your baby is doing well. Feces of a child who was on breastfeeding, remains soft even if it happens after 2-3 days.

It happens that a child has difficulty squeezing out the feces accumulated over 2-3 days, and the consistency is like puree soup. I can only explain this by saying that the stool is so liquid that it does not create enough pressure on the inside of the anus. Usually, when solid foods are introduced into the baby's diet, stools improve. Check with your doctor, he or she may recommend solid food earlier. Two to four spoons of boiled prune puree will help your child. Laxatives are not needed in such cases. Avoid using laxatives or enemas regularly as your child will become accustomed to them. Try to get by with prunes or other solid foods.

Stool in a bottle-fed baby

At first, stool occurs 1-4, and sometimes 6 times a day. The number of bowel movements does not matter if the stool consistency is normal and the child is gaining weight well.

Feces of a child feeding cow's milk, can be light yellow or beige colour. However, in some newborns, the stool resembles soft scrambled eggs or pieces of cottage cheese in a liquid medium. If your baby is feeling well and gaining weight normally, then you have nothing to worry about.

The most common difficulty that arises with artificial feeding is a predisposition to constipation. In the first months, bottle-fed babies rarely have liquid, greenish or curdled stool. If you increase the amount of sugar in the formula, the quality of the stool will deteriorate. If the newborn's stool is characterized by the mentioned signs, it is necessary to show the child to the doctor as often as possible. Try to completely eliminate sugar from your child’s diet. But, if the child always has somewhat loose stools, but he is cheerful, gains weight well, and the doctor does not find any illness, then you can consider the stool to be normal.

Changes in stool

You are convinced that if the child is gaining weight well and his stool is always the same, then the consistency and color of the stool does not matter. But, if the stool changes dramatically in quality, you should consult a doctor. If, for example, the stool was viscous and then suddenly became thinner with pieces of undigested food and became more frequent, this could be a sign of indigestion. If the stool has become very liquid, frequent, greenish in color and has a different smell, then this almost certainly means an intestinal disease (diarrhea) in severe or mild form. If there has been no stool for a long time, and then unusually hard and dry stool appears, then sometimes (but not necessarily) this means the onset of a cold or other disease. The fact is that the infection not only reduces appetite, but changes intestinal function. Generally speaking, changes in stool color and frequency are not as important as changes in stool consistency and odor.

Loose stools often contain mucus, the presence of which confirms intestinal disease. Mucus gets into the stool if the child has a runny nose or bronchitis. Healthy newborns often produce a lot of mucus in the first weeks.

When a new type of vegetable is introduced into a child’s diet, some of it may pass into the feces undigested. If at the same time the stool becomes thinner and mucus appears in it, next time give him very little of these vegetables. Otherwise, continue to give the same amount or gradually increase the portions until the child gets used to this type of vegetable. Beetroot can turn your stool red. When exposed to air, stool may turn brown or green. It doesn't mean anything.

Traces of blood on the surface of the stool indicate that there are scratches on the walls of the rectum from too hard stool. Although this is not a disease, still consult a doctor so that your child can be treated for constipation in time. Constipation has a harmful effect not only on the physical, but also on the mental state of the child.

If there is a lot of blood in the stool, which is extremely rare, then the cause may be an abnormal intestinal structure or a severe form of diarrhea, or intussusception. Call a doctor immediately or take your child to a clinic.

In this article:

Immediately after giving birth, young parents face a lot of problems. It is necessary to accustom the baby to the breast, constantly change his diapers, give massages, bathe, monitor temperature conditions. On top of this is the struggle with drowsiness and despair caused by a lack of understanding of the reasons for the child’s crying.

Any change in the color of stool causes panic, but often it is not justified. Stool in newborns can change in appearance, degree of mass density, and smell almost every day; you should not get upset right away, because this may be a variant of the norm.

You should know how the stool of a baby who is breastfed and mixed or bottle-fed differs. The first weeks of life are characterized by a gradual change in the color and consistency of stool, which continues to change depending on the type of feeding, its frequency, and duration. The introduction of juices or purees into a child’s diet also has a direct effect on the baby’s bowel movements.

The color and smell of feces: what they should be

Image from http://ponos-x.com/

In a newborn, feces do not have any specific odor; they are black or have a greenish color. At the same time, the stool is liquid and viscous. The child often defecates, but this can only be noticed by looking into the diaper. That is why doctors recommend that during the first months when the baby cries, first check the cleanliness of the diaper, and only then start feeding. Original feces (also called meconium) consists of everything that the child swallowed along with amniotic fluid during the months of stay in the mother’s womb. The appearance of meconium in a newborn indicates the normal functioning of the newborn's intestines.

In the period from 2 to 6 days from the date of birth, the baby’s stool may change its color to grayish or gray-green, and become thicker (the consistency of a semi-liquid ointment). This is typical for all healthy children during adaptation to a new way of getting food. From the second week, the stool becomes yellowish-mustard in color, sometimes brown with a faint sour-milk odor. The consistency of the bulk is liquid, with small white grains. Such stool indicates the normal functioning of the child’s gastrointestinal tract. The norm is a slight presence of mucus or a green tint with stable weight gain.

A variant of the norm is the case when the child’s stool is light-colored Brown or very dark brown. The presence of small greenish inclusions is allowed. In terms of consistency, there are two requirements for the contents of the diaper - it should not be liquid like water, and the feces should not be too dense. The smell may be pungent and unpleasant. This situation is typical for children who are mixed-fed. Similar indicators appear with the introduction of complementary foods.

It happens that pieces of undigested food are clearly visible in the diaper. If this occurs rarely, then there is no need to worry. Depending on the food you eat, your stool may turn orange or burgundy color. This is typical after eating carrots or beets.

Bowel movement frequency

At the age of up to 6 weeks, when breastfeeding, the baby has bowel movements 4-12 times during the day. With age, the frequency of bowel movements will decrease significantly. By two months, a child can delight his parents with fragrant stools both 4 times a day and 1-2 times every five days. These are standard indicators; a slight deviation in one direction or the other, provided that the color, smell and consistency comply with the norm, is considered acceptable.

Young parents sometimes confuse normal loose stools with diarrhea. Even if the child defecates once a day, but very copiously (even to the point of leaking feces from the diaper), there is no need to sound the alarm. In some children, the intestines work in such a way that bowel movements occur rarely, but in large volumes. This is not a pathological change. You should be concerned if bowel movements occur more than 12 times a day. In this case, the feces will not just be liquid, but watery; they will flow out from above, below, and along the sides of the diaper.

The absence of stool in a child for 4-5 days in a row, followed by successful bowel movements and with normal consistency of the mass, should not become a reason for changing the daily menu. This is a variant of the norm, and therefore excludes the possibility of any mechanical influence on the child in order to speed up emptying. Under no circumstances should you give your baby an enema, as this can cause a weakening of the normal reflex activity of the corresponding muscles. It is not recommended to try to help the child by irritating the anus with a thermometer or a bar of soap (although grandmothers will insist on using these methods).

What feces indicate pathology?

Cases when the baby's stool is of normal color, but it is too liquid or a little foamy, and has a strong sour-milk smell, requires increased attention from parents, especially when breastfeeding. If to the listed characteristics the presence of irritation in the anal area is also added, and the baby himself began to behave very restlessly, is capricious during meals and after it, and is underweight, this indicates a lack of hindmilk in the diet. It is higher in calories, not as sweet and contains the enzymes necessary to break down milk sugars. All this is not present in foremilk, so you just need to change breasts less often.

If there is a large amount of mucus in the stool, and the stool is green, yellow or brown, then you need to focus on the baby’s behavior and well-being. If this fact does not bother him, then medical help is hardly necessary. Most likely this is a consequence of a recent colds or a harbinger of teething. Medical advice should be sought if such symptoms persist for several days in a row.

Soft and very thick brown stool can be either normal or pathological. If your child has recently taken iron supplements, there is no need to worry. You should consult a doctor if you have not taken additional iron. Then an examination is necessary to rule out internal bleeding.

Urgent medical attention is needed if the stool is excessively watery and unpleasant smell, and the child gains weight poorly or even loses it. The reason may lie in allergies, poisoning or an infectious disease. Hard feces that come out in small parts with constant strong tension in the abdomen, accompanied by screaming and crying of the baby, indicate constipation. The reason may be in complementary feeding if it contains an ingredient that is not suitable for the baby, or in the mother’s incorrect diet.

Foamed green stool, which appears along with a specific “pop” and has a sharp sour odor, indicates pathology. If, in addition to everything else, irritation and redness appear around the anus, then you should immediately consult a doctor. Usually, with such symptoms, children stop gaining weight and are constantly capricious and behave extremely restlessly. The reason is lactose deficiency, both primary and secondary.

The appearance of blood in the stool, both liquid scarlet color and black blood lumps, should entail an urgent visit to the hospital. Most often, this is triggered by an allergic reaction to the protein contained in cow's milk; it can also be one of the symptoms of the development of bacterial infections. Based on the results of the examination, hemorrhoids or intestinal bleeding may be diagnosed. Both problems require immediate treatment. The case of digested blood lumps may indicate that the mother’s nipples are damaged, and the baby with milk swallows the blood oozing from cracks in the chest. For a newborn, this option is safe, although it is better to avoid such a scenario.

If intestinal problems are detected, you should seek medical help. This will help to diagnose pathological changes in the child’s body in a timely manner, accelerate the subsequent normalization of stool and restore the rate of weight gain. Doctors' basic recommendations often boil down to changing breastfeeding techniques.

Among them:

feeding should occur in a position that is comfortable for the mother and newborn;
It is important that the baby grasps the breast correctly and does not suck only the nipple;
in some cases, it is necessary to increase milk production by applying the baby to the breast more frequently and pumping after each feeding;
special attention should be paid to ensuring that the baby receives enough hind milk;
the duration of feeding sessions should not be artificially limited;
In the first months of life, you should not try to feed the baby according to a schedule; it is much better to do it on demand.

Always carefully examine the contents of your baby’s diaper - this will make it possible to promptly respond to any pathological change. But you shouldn’t panic at the slightest discrepancy with the norm.

Useful video

A child’s stool is one of the most important indicators of health. Already in the maternity hospital, during the rounds, doctors always ask mothers whether the baby has pooped. How and how much the child poops will continue to be of interest to local pediatricians and nurses– during home visits and during examinations in the clinic. In this article, we will consider everything about the stool of infants, since this is an extremely important component of the life of young children, and we will consider not only the stool of children who are breastfed, but also those who receive artificial nutrition.

Why is it so important to pay attention to how your baby poops? The frequency of bowel movements and the main characteristics of stool (quantity, color, presence/absence of impurities, consistency, smell) make it possible to assess, first of all, the functioning of the child’s gastrointestinal tract. In addition, they can be used to draw conclusions about the baby’s nutrition (including whether he has enough breast milk); changes in stool characteristics may indicate the presence of diseases in other organs and systems. Of no small importance is the fact that defecation in children occurs regularly (usually daily), most of the properties of feces can be easily assessed visually (during examination), and therefore, for attentive parents, any changes in stool do not go unnoticed.

But what to do if the regularity or quality of stool changes: call a doctor, treat it yourself, or don’t worry at all - everything will go away on its own? How should a baby normally poop, and how does stool change during different periods of its life?

About the norm and its variations

The frequency of stool in infants varies from 10-12 times a day to 1 time every 4-5 days.

Norm is a relative concept. I’m always surprised when I hear “a baby should poop 3-4 times (2-5 or 1 or 10 times, it doesn’t matter) a day with yellow mush.” Remember, your child does not owe anything to anyone. Every baby is an individual from birth. How he will have bowel movements depends on many factors - and on the degree of maturity of his digestive system, and on the type of feeding, and even on the type of delivery, and on concomitant pathology, and on many other reasons. The main guidelines for determining the individual norm specifically for your baby are the child’s good health, regularity, painlessness of bowel movements and the absence of pathological impurities in the stool. Therefore, below I will give not only averaged normal indicators, but also extreme values of the norm and its variants, depending on the influence of various factors.

Frequency of bowel movements

After the passage of meconium (original stool of a viscous consistency, brown or black-green color), from 2-3 days the child experiences transitional stool - dark green or yellow-green, semi-liquid. From 4-5 days of life, a newborn establishes a certain rhythm of bowel movements. The frequency of bowel movements varies within quite significant limits: from 1 time every 1-2 days to 10-12 times a day. Most babies poop during or immediately after eating - after every feeding (or almost every one). But stool once every 2 days will also be a variant of the norm - provided that it is a regular stool (occurs every two days), and the act of defecation itself does not cause anxiety or pain to the child (the baby does not scream, but only grunts slightly, feces pass easily , no excessive straining).

As the child grows, he begins to poop less often: if during the newborn period he had stool on average 8-10 times, then by 2-3 months of life the baby poops 3-6 times a day, at 6 months - 2-3 times, and by year – 1-2 times a day. If, from the first days of life, the baby pooped once a day, then usually this frequency remains the same in the future, only the consistency changes (the stool gradually becomes formed from mushy).

Amount of feces

The amount of feces is directly related to the amount of food consumed by the child. In the first month of life, the child poops very little - about 5 g at a time (15-20 g per day), by 6 months - about 40-50 g, by one year - 100-200 g per day.

Stool consistency

The norm for newborn babies is a soft, mushy consistency. But even here, fluctuations within the normal range are quite acceptable - from liquid to fairly thick gruel. Ideally, the stool is homogeneous, evenly smeared, but it may be liquid with lumps (if a child pooped in a diaper, the liquid component is absorbed, slightly staining the surface, and a small number of small lumps may remain on top).

How older child, the more dense his stool becomes, representing a thick mush by six months, and by one year it becomes practically formed, but at the same time quite soft and plastic.

Color

Yellow, golden yellow, dark yellow, yellow-green, yellow with white lumps, yellow-brown, green - each of these colors will be normal for a newborn's stool. After breastfeeding ends, the stool becomes darker and gradually turns brown.

Green feces

Please note that greenish, swamp green, yellow green color a – variants of the norm, and the green color of stool is due to the presence of bilirubin and (or) biliverdin in it. Bilirubin can be excreted in feces for up to 6-9 months, that is, a greenish color to the stool during this age period is quite normal. In newborn babies, the transition from yellow to green stool and back is especially noticeable during physiological jaundice, when maternal hemoglobin breaks down and bilirubin is actively released. But even in the subsequent days and months of life, until the intestinal microflora is fully established, the presence of bilirubin in the stool, which gives the stool a green color, is acceptable.

It is also quite normal for the stool to be initially yellow in color, but after a while it “turns green” - this means that the stool contains a certain amount of bilirubin, which is initially invisible, but upon contact with air it oxidizes and gives the stool a green color.

On the other hand, if a baby (excluding a child with ) has never had green stool before, and suddenly the stool becomes green or streaked with green, it is more likely that there will be either a functional digestive disorder (due to overfeeding, the introduction of complementary foods, etc. ), either a lack of milk in the mother, or some kind of disease in the child (intestinal infection, etc.).

Smell

In a breastfed baby, the stool has a peculiar, slightly sour smell. In artificial babies, the feces acquire an unpleasant, putrid or rotten odor.

Impurities

In general, any impurities in the stool - undigested food particles and other inclusions, blood, greens, mucus, pus - are considered pathological. But the period of newborns and infancy are exceptional periods; here even pathological impurities can turn out to be quite normal. We have already talked about greenery and found out why green can (although not always) be a variant of the norm. Let us now look at other impurities in the child’s stool.

Normally, a baby may have the following impurities in their stool:

White lumps– are caused by the immaturity of the baby’s digestive system and enzymes, which is why the baby does not fully absorb milk (especially when overfed). Provided the child is in satisfactory health and has normal weight gain, these inclusions can be considered normal.

Undigested food particles– appear after the introduction of complementary foods and are explained by the same physiological immaturity of the gastrointestinal tract. Usually the stool returns to normal within a week; if during this time the baby’s stool character does not return to normal, complementary feeding is most likely introduced too early and the baby is not yet ready for it.

Slime– mucus is constantly present in the intestines and performs a protective function. Its appearance in small quantities in breastfed children is a variant of the norm.

What impurities should not be in a baby’s stool:

pus;
blood.

Their presence is a dangerous symptom, and if even small amounts of pus or blood appear, you should immediately consult a doctor.

Changes in stool depending on the child’s nutrition

Breastfed baby's chair

An excess of carbohydrates in the diet of a nursing mother will lead to increased fermentation processes in the baby’s intestines, intestinal colic, rumbling, frequent, loose, foamy stools.

The nutrition of a breastfed baby and the way the mother eats will determine the baby's stool. If the mother follows the basic nutritional rules for nursing women and limits the diet from excessively fatty foods and sweets, the baby’s stool usually meets all the criteria of the norm - yellowish, mushy, without impurities, regular, homogeneous. If there is an excess of fat in a woman’s menu, breast milk also becomes fattier, making it more difficult to digest, and therefore the baby may experience white lumps in the stool. A diet rich in easily digestible carbohydrates often leads to increased fermentation processes in the child’s intestines, and is accompanied by frequent, loose, sometimes even foamy stools, accompanied by rumbling, bloating in the abdomen and intestinal colic. With severe bloating, constipation may occur instead of loose stools.

Certain foods in the diet of a nursing mother can cause diarrhea in the baby, which manifests itself not only in the form of diarrhea, but also in the form of changes in stool - it becomes liquid, with mucus.

When a nursing mother lacks milk, the baby's stool first becomes viscous, thick, then dry, green or grayish-green, crumbly, passes in small quantities, or persistent constipation occurs.

Mixed and bottle-fed baby's stool

Compared to infants receiving mother's milk, bottle-fed babies poop less frequently (in the first months of life - 3-4 times a day, by six months - 1-2 times a day), their stools are denser, putty-like consistency, dark yellow in color, with an unpleasant putrefactive or sharp sour smell. With a sudden transition to artificial feeding, when changing the usual formula, stool retention (constipation) is possible or, on the contrary, appears.

Feeding formulas with a high iron content (for prevention) may be accompanied by the release of dark green stool due to the presence of unabsorbed iron.

When feeding infants not artificial adapted mixtures, and with natural cow's milk, various problems with stool are even more often observed: chronic constipation or diarrhea. The feces of such children are usually bright yellow, sometimes with greasy shine, with a “cheese” smell.

Changes in stool due to the introduction of complementary foods

Complementary foods themselves, which are a completely new type of food for a child, require the active work of all departments digestive tract and enzymes. In most cases, children do not fully digest the first complementary foods, and undigested particles are passed out in the stool; they can easily be seen in the baby’s feces in the form of heterogeneous inclusions, grains, lumps, etc. At the same time, a small amount of mucus may appear in the stool. If such changes are not accompanied by the child’s anxiety, vomiting, diarrhea and other painful symptoms, there is no need to cancel complementary feeding - its introduction should be continued, very slowly increasing the single portion of the dish and carefully monitoring the baby’s well-being and the nature of the baby’s stool.

Certain complementary foods, for example, vegetables with a high content of plant fibers, can have a laxative effect - stools become more frequent (usually 1-2 times compared to the norm for of this child), and feces sometimes represent a slightly modified dish. For example, mothers note that they gave their child boiled carrots, and after 2-3 hours he pooped with the same carrots. When the initial goal was not to stimulate the baby’s bowel movements (the child did not suffer from constipation), it is better to temporarily postpone the introduction of the product that caused such a reaction, moving on to more “tender” vegetables (zucchini, potatoes) or cereals.

Other dishes, on the contrary, have a fixing effect and increase the viscosity of stool (rice porridge).

All this should be taken into account and correlated with the child’s digestive characteristics when introducing complementary foods.

In general, the introduction of any complementary foods to healthy children is accompanied by an increase in the amount of stool, its heterogeneity, changes in smell and color.

Pathological changes in stool and methods of treatment

Now let's look at what changes in the regularity of bowel movements or in the quality characteristics of feces are abnormal and indicate digestive disorders, diseases or other pathological conditions.

Abnormal bowel movements

There are three possible options: constipation, diarrhea or irregular bowel movements.

Constipation

Constipation includes one or more of the following symptoms:

delayed bowel movement – for 2 days or more; for a newborn baby, constipation can be considered the absence of stool for 24 hours, if previously he pooped several times a day;
painful or difficult defecation, accompanied by screaming and straining of the child; frequent ineffective straining (the child tries to poop, but cannot);
dense consistency of feces, “sheep” stool.

The main causes of constipation in infants:

mother's lack of milk;
irrational feeding (overfeeding, incorrect selection of formulas, feeding with cow's milk, early introduction of complementary foods, lack of fluid);
low physical activity;
immaturity or pathology of the digestive system;
concomitant diseases (pathology of the nervous system, etc.);
organic causes (intestinal obstruction, dolichosigma, Hirschsprung's disease, etc.).

Help with constipation

In case of acute constipation in a baby, regardless of the reasons for stool retention, defecation should be established. First, you can try to help the baby in this way: when he strains, trying to poop, bring your legs bent at the knees to his tummy and lightly (!) press on the tummy for about 10 seconds, then do a light massage of the abdomen clockwise around the navel, repeat the pressure . If auxiliary measures are ineffective, it is recommended to use children’s glycerin suppositories or give the child a microenema (“Microlax”). If there are no baby laxatives in your home medicine cabinet, you can perform a cleansing enema with boiled water at room temperature (within 19-22°C) - for a child in the first months of life, use a sterile (boiled) syringe of the smallest volume. You can also try to stimulate bowel movements reflexively by irritating the anus (by inserting the tip of a syringe or gas tube into it).

Sometimes difficulties during bowel movements are caused by a large amount of gases in the baby’s intestines - this is quite easy to understand by the way the baby cries when trying to poop, his tummy is swollen, rumbling can be heard, but gases and feces do not pass away. In such situations, abdominal massage and leg adduction are also used; you can simply try placing the baby on his tummy, carrying him in his arms, placing his stomach on your forearms. Warming the tummy makes it easier to pass gas (and subsequently stool) (the mother can put the baby on her stomach, face to face; apply a heated diaper to the stomach). From medicines enough quick effect To eliminate colic, simethicone preparations are given (Bobotik, Espumisan, Subsimplex), herbal remedies are used to improve the passage of gas (dill water, Plantex, fennel decoction, Baby Calm).

For recurring constipation, it is not recommended to constantly use reflex irritation of the sphincter with a tube or use cleansing enemas - there is a high probability that the child will “get used to” pooping not on his own, but with additional help. In the case of chronic constipation, it is necessary, first of all, to establish its cause and, if possible, eliminate it. Treatment of chronic constipation in infants should be comprehensive, including correction of the mother’s diet or selection artificial mixtures, competent, timely introduction of complementary foods, daily walks, gymnastics, massage, and, if necessary, additional water. Medications (Lactulose, etc.) are prescribed less frequently.

Diarrhea

Diarrhea is understood as frequent (2 or more times compared to the individual and age norm) bowel movements with the release of liquefied stool. Diarrhea does not include the constant release of small amounts of feces (lightly smearing the surface of the diaper) during the passage of gases - this occurs due to the physiological weakness of the anal sphincter, and as the child grows, feces stop coming out when gases pass.

The table below shows the most likely causes of diarrhea in infants.

Cause	Signs	Treatment options
Reaction to	Loose stools up to 10-12 times a day; feces without pathological impurities (there may be a small amount of mucus); moderate increase in body temperature (up to 38-38.5°C); swelling and redness of the gums; salivation.	Feeding on demand; sufficient amount of liquid; use of antipyretics if necessary; use of local products (teethers, dental gels).
Acute intestinal infection	Diarrhea to varying degrees severity (from moderate diarrhea to severe diarrhea); stool is liquid, may be watery, foamy, with flakes; pathological impurities are often detected - streaks of greenery, mucus, pus, streaks of blood, particles of undigested food; increased body temperature; frequent vomiting; symptoms of intoxication (lethargy, pallor, refusal to eat).	Calling a doctor; treatment with drugs such as Smecta or Polysorb; Soldering the baby with boiled water 1 tsp. In 5 minutes.
Lactose intolerance	The stool is liquid, foamy, yellow; sour smell; frequent colic.	If symptoms are moderate, no help is required. In case of obvious violations, consult a doctor; enzymes are prescribed; less often, a transfer to lactose-free mixtures is required.
Functional digestive disorder (overfeeding, early introduction of complementary foods)	Clear connection with food intake; stool is liquid, copious, yellow, possibly with an oily sheen, white lumps; stool is only slightly increased or normal; Possible single vomiting after eating or regurgitation.	Correction of diet: when breastfeeding, control the frequency of breastfeeding; with artificial feeding - calculate the volume of feeding depending on the weight of the child (done by a doctor); if complementary foods are introduced, temporarily abandon them.
Taking medications	Connection with taking medications (antibiotics, sulfonamides, antipyretics). When treated with certain drugs (including antibiotics containing clavulanic acid - amoxiclav, augmentin), diarrhea develops immediately due to stimulation of intestinal motility. Long-term antibiotic therapy can cause dysbiosis and, against this background, diarrhea.	Consultation with a doctor. It may be necessary to discontinue (replace) the drug or additionally prescribe probiotics.
Intestinal dysbiosis	Prolonged diarrhea or irregular bowel movements without fever, other symptoms are possible (lethargy, poor appetite, poor weight gain, etc.). This is confirmed by laboratory testing, but it should be borne in mind that stool analysis for dysbiosis is not indicative in infants under 3 months of age: during this period, the child’s intestines are just being populated by normal microflora.	Treatment is carried out as prescribed by the doctor.

Irregular bowel movements in infants

Irregular stool is an alternation of constipation with diarrhea, or an alternation of normal stool with constipation and (or) diarrhea. The most likely causes are poor feeding and intestinal dysbiosis. Irregular bowel movements can be a manifestation of chronic constipation, when after a long period of absence of bowel movements a large amount of liquid stool appears.

If you have irregular bowel movements, you should first of all pay attention to the child’s nutritional pattern. If errors in nutrition are excluded, there is no overfeeding, and the baby receives food according to its age, then you need to consult a doctor for further examination and treatment.

Changes in stool quantity

A decrease in the daily amount of feces in infants is observed mainly with constipation and fasting - in both cases, the feces are dense, difficult to pass, dark yellow or yellow-brown in color. Abundant stool is possible due to overfeeding. Constantly passing large amounts of stool, especially unusual color, with a strong unpleasant odor, requires mandatory examination of the child (to exclude enzymatic deficiency, intestinal diseases, etc.).

Changes in consistency

Feces become denser with constipation, dehydration and lack of food; liquid – against the background of diarrhea for any reason.

Color Changes

As we have already discussed, the color of feces infant is highly variable, and most often the color changes do not pose a danger - with some exceptions - the baby's stool should not be colorless or black.

Black color is an alarming symptom and may be a sign of bleeding from the upper gastrointestinal tract, and black stools should always rule out bleeding first. In addition to black stool (melena), bleeding may be accompanied by pallor, lethargy of the child, and often vomiting mixed with scarlet blood. Black stools are also observed when blood is swallowed in case of nosebleeds.

However, there are also completely harmless reasons for a baby passing black stool:

taking iron supplements;
Ingestion of blood by the baby during sucking due to cracked nipples in the mother.

Pathological impurities

There should never be any admixtures of pus or scarlet blood in the baby’s stool (even streaks of blood) - if they are detected, you should immediately seek medical attention. medical care. Pus can appear with inflammatory (infectious and non-infectious) diseases of the intestines, blood - in case of bleeding from the lower parts of the digestive tract, with severe infectious diarrhea, with fissures in the anus, etc.

When to see a doctor immediately

Blood in a baby's stool is a reason to immediately consult a doctor.

Immediate seeking of medical help (calling an ambulance) is necessary if the baby has at least one of the following symptoms:

Black stools (not associated with taking iron supplements).
Scarlet blood or streaks of blood in the stool.
Diarrhea with high temperature, vomiting.
Raspberry jelly stool - mucus comes out instead of stool Pink colour- a sign of intussusception.
Colorless stool combined with yellow skin and eyes.
A sharp deterioration in the child’s well-being: lethargy, pallor, monotonous screaming, incessant crying, etc.

Not only the above, but also any other “incorrect” changes in your baby’s stool, for which you are unable to find an explanation on your own or are not sure of their causes, require consultation with a pediatrician. It's always better to play it safe and discuss any warning signs with your doctor.

Which doctor should I contact?

If your child's stool changes, you should contact your pediatrician. After diagnostics and tests, the doctor can refer the parents and child to a consultation with a gastroenterologist, infectious disease specialist, allergist, endocrinologist, surgeon, or hematologist.

One of the main problems of parents of babies is the child's stool. Parents always think that it is their child who is doing “this” in a completely different way than required, and they are ready to go through hundreds of studies in order to find non-existent problems. Two problems - constipation and diarrhea - are sometimes caused by parents themselves. However, absolutely normal “major results” of a child’s life activity are often considered a problem. To be able to distinguish normal stool from problematic stool, you need to know the norms. Let's talk about them.

Infant chair

Chair in children different types food varies significantly in quality and type. Therefore, you cannot compare the contents of diapers for a baby and an artificial baby. Due to fully digestible nutrition of ideal composition, infants very rarely have problems with stool only in the case of real illness. By definition, breast milk cannot cause any digestive problems. However, it is these children who have the most imaginary problems.

The biggest questions are raised by the number of bowel movements a child has: usually from 8-10, almost after every feeding, with a volume of about a teaspoon, to once every 5-7 days, but in a larger volume. This phenomenon is called physiologically rare stool; it occurs due to the almost complete digestibility of breast milk - there is simply no “waste” left.

It is quite acceptable to have watery stools, with yellow coloring and interspersed with white lumps, stool when farting, and a mushy mass. For a baby up to 6-7 months, stool with mucus, lumps, pieces and even greens is quite normal - this is the formation of microflora and the work of enzymes - there is no need to get involved with “therapeutic” measures in this process. If, with any type of stool, the child is cheerful and healthy, smiles, farts well, eats and sleeps, gains height and weight - this is normal phenomenon and the child has no problems with bowel movements.

What not to do

Many parents, when the baby does not have stool, try to look for constipation in the child and begin to treat it with barbaric methods. I advise you to first try all the “treatment” methods on yourself, and then apply them to your child. It is forbidden to induce stool by inserting a bar of soap into the rectum, cotton swabs, the tip of a thermometer or other foreign objects!

The introduction of soap into the rectum causes irritation and chemical burns mucous membrane of the rectum, this causes sharp pain in the child, and inflammation of the rectum disrupts its normal functioning.

Inserting thermometers and sticks into the rectum leads to mechanical injury and disruption of the intestinal sphincter apparatus, which can lead to disruption of the coordinated functioning of the intestines and the formation of true constipation. All artificial stimulants suppress the natural urge to defecate, and children stop going to the toilet “in a big way” on their own, only with stimulants. For reflex defecation to occur, it is necessary to create a certain pressure of feces in the lumen of the rectum, which will send an impulse from the rectum to the brain and open the sphincter. It may take several days for the volume to accumulate.

In addition, you should not supplement your child with various drops, teas and infusions - espumizan, smecta, plantex, dill tea - you should not, unless absolutely necessary, interfere with the process of physiological formation of intestinal microflora and the formation of enzyme activity.

How is bowel function established?

After the baby is born and the first cry, its microflora is formed - the baby receives it from the air, from the skin of the mother’s perineum and chest, and this microflora begins to populate the intestines. In the first two to three days of his life, he empties his intestines of meconium - dark, olive color a mass similar to glue or plasticine. These are the remains of intestinal epithelial cells and digested amniotic fluid for nine months of pregnancy. When amniotic fluid is swallowed, the baby trains its digestion to work after birth. Meconium has virtually no odor; it is very difficult to wash off diapers and the butt. In the first three days it should completely go away and then the nature of the stool will change.

The stool begins to liquefy, becomes more frequent, and heterogeneous inclusions appear in it - liquid, mucus and whitish lumps; its color is also heterogeneous - there may be areas of dark color with yellow fragments, whitish and colorless, watery. Bowel movements may occur six or more times a day. This stool is called transitional, and it means the colonization of the intestine with microflora and the inclusion of enzymes in the digestive process. As the intestinal sections colonize, the stool may take on different kind and coloring due to irritation of the intestinal wall by microbes and the formation of intestinal immunity. In about one to two weeks, the stool begins to return to normal - it becomes homogeneous, mushy, yellow in color, occurs less frequently and ceases to contain impurities and mucus. This is facilitated by exclusive breastfeeding - if the baby is not given pacifiers, bottles or additional food and drink. If this is present, the correct physiological stool will take longer to form.

From the moment lactation is established and the microflora in the intestines settles down, the baby begins to go to the toilet with “mature” stool - this is a bright yellow homogeneous paste with the consistency of thick sour cream with the smell of cottage cheese. This indicates good absorption of milk, although its frequency can vary from several times a day to once every 5-7 days. Such rare stools are normal during breastfeeding. At the same time, the baby’s health is excellent if he has enough milk and there are no additional supplements or supplements. At the age of 2-4 months, there are usually from 15-20 to approximately 50 grams of feces per day. With the introduction of complementary foods, stools begin to take shape, become less frequent and change in character.

Artificial Chair

Typically, stool in bottle-fed children has a thicker consistency, darker color (from greenish to brown), and occurs from several times a day to once every one or two days. If bowel movements occur less frequently, the formula most likely causes constipation or you are not giving your child enough water. On average, children on IV poop 1-2 times a day, the amount of feces is about 30 g. Due to the predominance of rotting processes, the stool contains E. coli and bifid flora, there may be some mucus and whitish crumbs; this indicates that the baby has not yet fully absorbed the fats of the formula, or you have overfed him.

With the introduction of complementary foods, the stool thickens and begins to form into a soft sausage or mush, the color becomes dark brown, there are no impurities in the form of blood or mucus. The frequency of stool is 1-2 times a day.

This is the stool that should ideally be and which reflects the full functioning of the intestines. But there are variants of deviation from the norm that are not considered a pathology, but are very frightening for parents. Then moms and dads demand immediate action from the doctor, which is unnecessary and can only do harm. But how can we understand where “this” came from in the diaper?

Variants of norm and deviation

Often, white lumps similar to curdled milk are found in a child's stool. With good or excessive weight gain, they indicate some excess supply of milk or formula; This happens when a child receives breastfeeding on demand. This is a good sign: there is more than enough milk, it’s just that some amount of protein and fat does not have time to be processed by enzymes and comes out unchanged - a milk residue is formed. But if, with a large number of lumps in the stool, the child does not gain weight well, this usually indicates a deficiency of enzymes (primarily the liver and pancreas), that is, the intestines cannot cope with the digestion of food. In this situation, the doctor may prescribe enzyme preparations during intestinal maturation.

Often, the stool may have a thinner, even watery consistency with foam, be splashy or have a watery edge on the diaper, and have a sour smell. Sometimes such stools pass when gas is released - in small portions. The stool is yellow or mustard color, not changed. This condition is called milk imbalance or transient lactase deficiency. If a child receives a lot of milk, rich in milk sugar (lactose) and liquid, then lactase, an enzyme of which there is still a limited amount in the child’s intestines, simply does not have time to cope with the entire amount of milk sugar received. Then part of it enters the intestines and is fermented by microbes into gas and water - this is how excess gas formation and active metabolites appear - including lactic acid, which irritates the intestinal walls and causes increased peristalsis and loose stools. If washing is not thorough enough, irritation of the anal area may occur - it is necessary to use a protective cream. Correcting the situation is quite simple - there is no need to “save” milk, it is necessary that the breasts are always soft. Then the baby will receive hind milk, low in lactose, but higher in calories.

However, often when similar situation the diagnosis of lactase deficiency is unreasonably made, which does not reflect the true picture. Lactase deficiency is manifested by poor weight gain, which cannot be corrected even with normal breastfeeding. This is a congenital defect of the enzyme or its severe deficiency (although over time the enzymes can mature). There is often an excess of lactose (milk sugar) in mother's milk - this is a genetic feature or a consequence of an unbalanced diet. The diagnosis is confirmed by analyzing stool for carbohydrates, and, of course, monitoring the child’s well-being. And with dietary restrictions and lactase administration, the condition normalizes. There is no need to rush to switch your baby from breast milk to lactose-free formulas - lactose is necessary for the body, therefore, breastfeeding even with lactase deficiency and introducing an enzyme to digest lactose would be correct.

The worst thing for parents is the presence of “green” in the stool, which causes panic or thoughts of the most terrible diseases. In fact, in the vast majority of cases in children early age(up to about 4-6 months) is the norm. In the first months of life, a lot of bilirubin (a breakdown product of hemoglobin) is released with feces; it oxidizes to a greenish tint in air. Hence the “romantic” admixture of greenery. Sometimes it happens that a mature stool is not established in any way and the baby’s stool long time has an unsightly appearance: with greenery, lumps and threads of mucus. This happens when the baby is malnourished, inactive sucking and other problems - hungry stool. Another reason for such stool is the predominance in a woman’s diet of raw fruits and vegetables with a lack of meat, during hypoxia during childbirth. Then the mucous membrane takes longer and more difficult to restore, and the enzymes mature later.

What should mom do?

First of all, you need to remember the rule - if nothing bothers the child and there are no painful manifestations, he has the right to any stool. Even infants can have a long period of stool formation due to difficult childbirth or the establishment of full breastfeeding. The body is a complex system and everyone has an individual development program; you cannot force everyone to fit a single standard. If a child gains at least 500 g per month, urinates well and often, and there are no painful manifestations, this means that this is his normal stool, no matter what impurities are in it, and there is no need to interfere with the delicate process of adjusting the intestines.

Medicinal correction measures must be used if the child is experiencing severe pain, he screams and presses his legs to his stomach, and the stomach itself is tense; if he develops rashes, itching and has problems with weight and height. It is necessary to consult a doctor, conduct an examination and scatological examination of stool, and adjust the mother’s diet. But stool testing for dysbacteriosis is an absolutely unnecessary and non-indicative test; conducting it is practically pointless.

What should you really be concerned about?

You should immediately call a doctor or ambulance if the child has loose stools (mucoid or with pieces) in the presence of fever, vomiting or feeling unwell- these are signs of an intestinal infection, and this cannot be the norm. No medications, except maybe smecta, should be given to the child - self-medication in such cases is deadly, dehydration and convulsions may occur.

It is also necessary to pay attention to the retention of stool in a child on IV for more than 2 days - this indicates constipation and may indicate the need to change the formula or feeding regimen. It is also necessary to pay attention to stool retention in infants with rare urination and highly concentrated urine.

In addition, the appearance of a stool in a baby or artificial baby that resembles a dense sausage or “sheep’s balls” requires the intervention of a doctor - these are also manifestations of constipation that require correction.

Particularly dangerous is the appearance of blood, scarlet or coagulated, in the stool. Sometimes small streaks of blood appear when farting with straining due to a crack in the anus. However, these should be isolated and very rare phenomena. The constant presence of blood in the stool can be caused by a number of diseases: allergies and problems with the rectum, infectious diseases and even malformations of the anus.

Mothers watch their baby's stools with special attention. At 2 months, digestion cannot yet be called stable. Therefore, the baby’s stool can be either rare or frequent.

What should the stool look like when breastfeeding?

At the age of 2 months, the baby’s digestion is not yet particularly established, so stool may be frequent or rare. And a child can defecate as many times as he has eaten. At the same time, some babies poop several times a day, while others “suffer” for 2-3 days. Such phenomena greatly frighten mothers, because it seems to them that diarrhea or constipation has begun.

A 2 month old baby should have frequent bowel movements.

Don’t panic if your baby’s bowel movements are too frequent, because at this age, a frequency of up to 4 times a day is considered normal. And if the baby feels well and is not capricious, then he does not have diarrhea.

But if the stool is suspicious, for example, there has been a sharp change in consistency and odor, or there are admixtures of mucus or blood in it, then you should seek medical help. In addition, you should show your baby to the doctor if the stool is too hard and the baby suffers from constipation. Although the latter is quite rare, because mother's milk does not cause stool thickening.

Normal stool with artificial feeding

The feces of a two-month-old baby fed formula are denser and harder. And babies often have constipation. This happens if you do not adhere to the recipe and prepare a more concentrated mixture or do not give the child enough water. Otherwise, babies can defecate up to 5-6 times a day. And if the child feels well and gains weight normally, then there is no need to attach great importance to his stool. At artificial feeding The color of babies' stool is quite dark. In addition, the stool may have a sour smell.

Stool with mixed nutrition

If a mother does not have enough milk and feeds her baby with formula, then he often has problems with bowel movements. This is due to the fact that such nutrition is quite difficult to balance. Therefore, if your baby’s stool is too hard, then try to prepare him a thinner porridge. In addition, you should ensure that your child drinks plenty of fluids.