By Helen, Nutritionist and registered dietician
I’m often asked for advice about bowel habits - one of the occupational hazards of being a dietitian I guess! Babies’ stools can vary from day to day in the same baby and between different babies, so what is normal for one baby is not for another. There are generally differences in stool consistency and colour depending on whether you are feeding your baby breastmilk or formula, but there are no strict rules on what is ‘normal’ - what is important is to understand what is normal for your baby and not to spend your time worrying and comparing with others.
From around 4 weeks of age, babies pass stools on average 3 times a day, but this can range from once every 2-3 days up to 6 times a day. At the time you introduce some ‘solid’ meals, usually at around 6 months of age, the digestive system adapts and your baby is likely to poo less frequently and the consistency will become more like yours (thicker and usually darker and smellier too). At the age of 1 year, the average is 2 poos per day. It is worth remembering that stool size, colour, texture and frequency reflects what has recently been consumed so the colour of your baby’s stools will vary depending on what food you are feeding them. But if you notice a definite change, such as poos becoming very smelly, very watery or harder (particularly if there’s blood in them), you should talk to your doctor or health visitor.
Constipation is very common when you start complementary feeding (‘weaning’) and is quoted as affecting up to 30% of ALL children under the age of 5. If a parent comes to me saying that their baby is not passing frequent stools (less than 3-4 times a week) and the stools are hard, often pellet-like, and baby appears to be in some pain, it’s likely they are constipated. I usually advise parents to offer sips of water with meals and to also try including some fruits such as stewed apples, pears or other soft fruits with their meals to help rehydrate and relieve constipation. Another question I’m often asked is if babies can have wholewheat pasta or breakfast cereals, porridge or wholemeal bread to increase the amount of fibre in their diet and to help with constipation, but the amounts of these should be kept fairly small and not given every day as they can be a bit bulky for babies.
Other things you can try are a warm bath which can sometimes help relax babies and relieve constipation, as can baby massage. Also, I often suggest that parents try lying their baby on his/her back and move their legs in a bicycling motion – this can often help get things moving! If these home treatments have not worked, or if your baby appears to be in a lot of pain or discomfort, I would recommend you visit your GP. They may suggest a laxative, probably lactulose, or other medications, but only try this with their guidance.