Podcast: Breastfed babies and poo (Season 1 Episode 5)

No one talks about poo more than a new parent! 

No one talks about poo more than a new parent! So, what is normal when it comes to baby poo anyway? In this episode, we talk to Dietitian and International Board Certified Lactation Consultant (IBCLC), Joy Anderson, about what parents need to know about baby poo. Meanwhile, Andrea, Arianwen and Inez share stories of surviving 'poonamis' and baby poo that smells like old yoghurt. 

Information discussed in this episode:

• Signs baby is getting enough milk 
• Lactose-overload in babies
• Breastfeeding and food sensitivities 
• Diarrhoea and normal bowel motions of a breastfed baby 

Credits:

This episode is presented by Andrea Wild, Arianwen Harris and Inez Hanson. Featuring Joy Anderson. Special thanks to Sara Varatharajan. 

Show notes by Emma Pennell. Transcription by Eleanor Kippen. Produced by Belinda Chambers, Sky Mykyta, Jessica Leonard and Eleanor Kippen.

JOY: When they start eating solids, often parents notice bits of food appear in the nappy such as black specs from bananas and shells of corn kernels and peas. This is perfectly normal, and it doesn’t mean that the baby cannot or has not digested the food. So, they’re just things to keep in mind along the way.

[Music in background]

INEZ: Welcome to Breastfeeding … with ABA, a podcast brought to you with volunteers from the Australian Breastfeeding Association. Breastfeeding … with ABA is a podcast about breastfeeding made by parents for parents.

ANDREA: In this episode, we’ll be talking about what to expect when it comes to baby poo. From the frequency, to the colour, texture and smell. And some information from an expert on food sensitivity and baby poo, we’re going to let you know what’s normal. You’ll also hear some of our favourite poop stories, so you might want to make sure you’re not eating during this episode. You’ve been warned!

ARIANWEN: This podcast is being recorded on Aboriginal lands. The indigenous women of Australia have been living, working, breastfeeding and raising children successfully in this country for tens of thousands of years. Their skills and knowledge have been key to their health and survival. Indigenous women’s contribution to our history and continuing culture is often ignored. We would like to acknowledge and celebrate the first Australians, on whose traditional lands we are recording and you are listening. We pay our respects to the elders, past present and future.

ANDREA: In each episode you will hear from different mums from around Australia. My name is Andrea.

INEZ: And my name is Inez.

ARIANWEN: And I’m Arianwen, and we’re all volunteer counsellors with the Australian Breastfeeding Association.

ANDREA: To start with I’d like to introduce Joy Anderson, who is a breastfeeding counsellor and community educator with ABA. She’s also a lactation consultant and dietitian. And Joy has 2 children of her own who were born in the 1980s, and she also has 1 grandchild. Joy, thank-you so much for coming along to talk to me about baby poo. What we’d like to know from you, Joy, is what’s normal for baby poo? What sort of frequency should a parent look out for?

JOY: Well, if we look first at a newborn, they generally have a black sticky poo called meconium and the frequencies are not very great in those first few days. But we expect there to be some so that we know that the baby is clearing it, which means that the baby is actually getting some food as well.

ANDREA: And then further on during the early weeks, what sort of frequency would parents expect to see?

JOY: In young babies up to around about 6 weeks at least, generally they have 3 or more poops each day. If they have less than that, it’s a good idea to check they’re having enough breastmilk.

ANDREA: We’ll go into how to check if your baby is getting enough breastmilk in a moment.

JOY: Once they’re over that, around 6 weeks of age, they may have fewer each day, they may even go days without doing a poo. In these cases, usually once it does come, there’s like, a lot of it. But it’s very variable from that age. It can still be very frequent, or less frequent.

ANDREA: And sometimes I hear of babies only pooping around only once a week. Is that ok too?

JOY: Yeah, if everything else is fine, and all the other signs are they are gaining weight, and they’re happy and healthy, as long as they’re having lots of, ah, wet nappies. And the poops when they do come are considerable in amount, then yeah, that’s fine.

ANDREA: Considerable in amount, there are a few cheeky slang terms for this type of poo – some people call it a pootastophe. Some people call it a poonami. Inez, Arianwen, what are your thoughts on these sorts of mega poos?

INEZ: The poonami, they always happen at the most inconvenient time. When you’re running late for an appointment and yeah … 

ARIANWEN: I always think it’s sort of mums’ law, isn’t it? If your baby hasn’t done a poo in ages, make sure you’re wearing a lovely outfit and make sure the baby’s in, you know, the favourite outfit from Grandma, ah, and be running late, cause then they seem to do a poo! [laughter]

INEZ: That’s the format for making it happen.

ARIANWEN: Yes! It’s kind of like washing your car will bring the rain on!

ARIANWEN: I did once have a poonami. As a new mum, I flew from London to Merimbula with a 7-week-old baby and we took off, from Singapore, and just as we were sort of leaving the runway, poo started seeping up the back of my son’s neck. And the poor air hostess was looking at it, and looking at the time allowed until we were able to take our seatbelts off. And it was quite a long time we had to sit with poo, sort of all over this 7-week-old baby.

ANDREA: Oh dear, right at the start of a long flight!

INEZ: That’s a huge poonami!

ANDREA: … Right at the start of a long flight!

ARIANWEN: I’d had some foresight, I had a couple of zip lock plastic bags with me, so I could just zip it into a plastic bag. But it’s just, it’s about 20 minutes until you can take your seatbelt off when you’re just taking off, so yes, that’s a long one.

ANDREA: So Joy, just circling back a little. When we look at wet nappies, how can we tell that a baby is getting enough milk?

JOY: Generally, they should actually pass urine at least 6 times a day. It’s a bit difficult when you’re counting nappies these days, because if you’re using highly absorbent, single-use nappies, sometimes a baby can actually do more than 1 wee in those nappies. But the urine should be clear, non-smelly, and if you can work out that they’re actually weeing at least 6 times a day, then yeah, that’s fine.

ANDREA: So clear wet nappies, not strong smelling, and I’ve heard it described as a sort of straw like, pale, straw like colour?

JOY: Yeah, clear, or very pale.

ANDREA: Yeah, the ABA advice is that if your baby is having at least 6 very wet cloth nappies, or at least 5 very wet disposable nappies in 24 hours, that’s a good sign. Along with all the other signs of lots of milk.

Speaking of colour, what about the colour of poo? What should parents look out for there?

JOY: In the early days, it’ll be black and sticky, and then as the milk comes in it changes to more of a greenish brown colour, less sticky, and then finally to a softer, watery mustard yellow. And most breastfed babies have mustard yellow and runny poos. Sometimes they’re green, and that can be quite normal. If you let the poo dry on the nappy, they can also look green. But normal poop can vary in colour, even if they are a different colour to what you expect, and the baby is otherwise well and gaining weight then there’s no cause for concern.

ANDREA: And what about the texture of the poo?

JOY: Well, the sticky poo to start with, but once the milk’s in and the poos have gone to that more breastfed, yellow, mustardy sort of colour, then they’re usually quite runny. They can actually be quite watery. They’re certainly not formed in any way.

ANDREA: So they’re not solid, they’re runny poos but they’re …

JOY: Yeah, they’re runny, yep.

ANDREA: When it comes to the smell of baby poo an exclusively breastfeeding baby often has poop that is not overly offensive in smell. Some people even describe it as smelling like freshly mown hay. But that’s not true for all babies.

ARIANWEN: I once asked my elder son if his little brother had done poo. And he went over and sort of smelt him and said, ‘Nope. He just smells like off-yoghurt’. And he was entirely breastfed, so I hadn’t been eating yoghurt, that was just the smell of his poos — sort of old yoghurt.

ANDREA: So not too offensive. But maybe not newly mown hay?

ARIANWEN: Yeah, so not newly mown hay. But sort of off yoghurt. But I quite liked that you know, that this 5-year-old thought that this off yoghurt was an ok smell too. [laughter]

INEZ: Not a nappy that needed to be changed.

ARIANWEN: Yeah, no! So a bit of old yoghurt is ok, according to 5-year-olds.

[MUSIC]

SARA: My name is Sara, I volunteer for the Australian Breastfeeding Association, because I believe that all mothers should be supported in their breastfeeding journey. When I was a new mum, I came to the Australian Breastfeeding Association for advice and support. Not only did I receive this, but I was also welcomed as a new mum. Now I volunteer and hope I can support other mothers in the same way.

JESSICA: For more information on volunteering, please visit breastfeeding.asn.au and click on the volunteering tab in the menu.

The Australian Breastfeeding Association receives funding from the Australian Government.

[MUSIC]

ANDREA: Much later down the track after starting solids the poos change again at that point, don’t they?

JOY: Yeah, if a baby is having solids, or even if they’ve just been fed formula, then the poos can be a bit more brown, might be slightly more formed, more sort of adult like I guess, and more offensive in the smell, but they still should be quite soft.

ANDREA: What are some of the warning signs that parents might see in their baby’s poo?

JOY: As a newborn if they’re not going through that phase of the black sticky and then green, and going more mustardy over the first few days, that’s a warning sign. And then at any age, small infrequent poop can mean the baby needs more milk. And sometimes the poos get a bit sort of drier than they normally would be.

ANDREA: And if a baby has an illness, like if an older child has brought a gastro home and the baby has diarrhoea, how would the parents know?

JOY: First of all, if it’s a breastfed baby, it’s pretty rare for them to have diarrhoea. But if they were to be ill with it, the poos would be very, very watery, and there’d be a lot of them. They probably would smell different, and chances are you’d have other indicators that the baby is unwell. And you have to be very careful with babies because they can dehydrate very quickly, especially if they happen to be vomiting as well. In that sort of situation, you know, I think it’s imperative that you take the baby to a doctor quickly.

ANDREA: So that’s the point parents would be seeking medical attention for the baby, if the baby’s visibly unwell and if there’s vomiting and diarrhoea.

JOY: Yes.

ANDREA: Are there other instances when the poos might indicate that a baby needs medical attention?

JOY: I guess, I mean, constipation is the other end of the scale. Again, that’s pretty unusual in a breastfed baby. If they’re constipated, and this is nothing to do with the length between when they do a poo, this is, constipation is about how hard the stool is. So, in a baby, there’d be sort of like pebbles, small and hard and difficult to pass. More breastmilk will certainly help this and soften them up a bit. But if the baby is significantly constipated, then it would be best to check with the doctor. There may be other treatment they recommend.

ANDREA: So, if the parent is seeing small, formed, pebble like poos, and the baby straining, or seeming to find that difficult to pass, that’s the time to consult a child health nurse or GP?

JOY: Yes, yes.

Another one that may indicate that you need to go, well would indicate that you need to go and check with your doctor, would be if you see any blood or really huge amounts of mucus in the nappies. Now, the mucus will sort of look like raw egg white. A small amount of mucus is quite normal, it’s not just an all or nothing kind of thing, but if there’s a lot, and especially if there’s blood as well.

ANDREA: So, Joy, another thing mums might have heard of is lactose overload. What do we mean when we talk about that?

JOY: Often young babies, especially under 3 months drink sort of almost like too much milk. Often mothers have a lot of milk in those first few weeks, and in this case, the baby could be quite unsettled, but they’re gaining weight well. But if they have lots and lots of wet and dirty nappies, and sometimes they’re green and frothy and explosive, so it could mean that the baby has lactose overload. And often the mothers think that they don’t have enough milk, because the baby wants to feed all the time, they act hungry. If you’re thinking that this might be happening, then an ABA counsellor can provide some suggestions for how to resolve this.

ANDREA: And you can find a link to an article about lactose overload in the show notes.

Are there any signs of food sensitivities that might show up in a baby’s nappy?

JOY: Yeah, sometimes food sensitivity can irritate a baby’s gut and they can have mucousy poop, and sometimes even streaks of blood. But generally, a bit more mucus than they’d normally have in their poop. And this is because the gut, when it’s irritated, it produces more mucus. I mean, it normally has mucus because it lets the contents slide by, but when it’s irritated, it tends to produce more, and you might see that in the nappy. Even bits of blood, tiny little bits of, stringy bits or something that looks red. That can also just indicate irritation, it’s just a little bit more severe. But the good news is once the irritation ceases, the gut will heal up quite quickly and there will be no long term effects on the baby.

ANDREA: And so can that occur in a baby who’s exclusively breastfed? Those foods that are typically …

JOY: Yes, because the milk, because the foods can come from the mother’s diet and go through the milk to the baby. So, if the baby has got a sensitivity, then yes, they can react to that.

ANDREA: If a parent is concerned about food sensitivities in their baby, where can they seek help?

JOY: I think their first port of call should be their GP. Because some of the things that you see with babies with food sensitivities can be caused by other things, so a doctor would need to rule out those things, and give the baby a good check over. If the doctor can’t find anything else, and feels that the baby is otherwise healthy, then a dietitian who has a special interest in this area of food sensitivity and babies can certainly help mothers with designing an elimination diet and making sure their diet’s got everything in it that they need. And help the mother to work out what it could be. This is much better than mothers trying to just take a stab in the dark, and trying to guess and then start eliminating foods because it’s very difficult to do, and they could end up with diets that are deficient.

ANDREA: So, to finish things off Joy, you’ve prepared your top 3 things you think parents should know about baby poo. What are they?

JOY: Normal babies often grunt and make faces when they pass a poo. This is very common, it doesn’t mean they’re constipated or in pain. Because constipation, as I mentioned, is only really about the consistency of the poo, not the frequency, or not what the baby does or looks like when they pass a bowel motion. So that’s sometimes parents wonder about.

Another one is that it’s a good idea to change a baby’s dirty nappy as soon as possible, because they can get nappy rash if the poo is sort of like held against their skin.

And finally, when they start eating solids, often parents notice bits of food appear in the nappy, such as black specks from bananas, the shells of corn kernels and peas. This is perfectly normal, and it doesn’t mean that the baby cannot or hasn’t digested the food. So they’re just things to keep in mind along the way.

ANDREA: Thanks so much to Joy, Arianwen and Inez for joining me to discuss all things baby poo.

INEZ: For more on this topic, you can go to the ABA’s website at breastfeeding.asn.au and check out the show notes for a link to this episode’s blog post which contains further links and information.

ARIANWEN: To speak to a breastfeeding counsellor, call the National Breastfeeding Helpline on 1800 686 268, or you can also use LiveChat via our website breastfeeding.asn.au.

INEZ: To find your local ABA group, visit our website where you’ll find loads of information and a link to join the Association as a member. You also might like to join our Facebook group Breastfeeding with ABA. Make sure you answer the joining questions so we can add you quickly.

ARIANWEN: A word about sponsorship advertising: In each episode you’ll hear about other ABA services and products that we think could help families. We’re a not for profit, member organisation. We’re a charity, so we need to look for income to support our activities, so you may also hear about non-ABA products and services that we’ve carefully chosen because they are consistent with our goals and aims. You can feel reassured that advertising on our platforms will always be compliant with the World Health Organization Code on marketing in this area. We want this podcast to be a resource that any new parent can find and come back to, because these issues are timeless.

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Thank-you for listening!

END

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