What Goes in Must Come Out!

Breastfed Babies and Their Bottoms

By Lisa A. Goldstein

When you become a parent, you might find yourself obsessed with personal hygiene – not yours, but the baby's. You'll walk out the door with your hair looking like it's been electrocuted, but your baby will be snot-free and in a clean diaper.

Your heightened sensitivity to Baby's hygiene and personal care may lead to panic attacks when your breastfed baby seems to be having too many bowel movements – or not enough. To avoid the stress, here's a handy primer.

The first thing to expect is that initially, both bottle- and breastfed babies will pass rather unique first stools, called meconium. These stools are thick, sticky and greenish black, says Maureen Brown-Ginsberg, a registered nurse and International Board Certified Lactation Consultant at Women & Infants Hospital of Rhode Island. Baby will likely have one to two stools on the first two days of life. Around the third day, you'll see transitional stool, which is greenish brown and will be softer. Two a day is typical for this time.

During day four, Brown-Ginsberg says there will be a color change to a mustard yellow color. Baby will probably have three stools on days four and five. The seedy, mustard-colored stools will continue from day six through the first four to six weeks. Four a day is average.

"These numbers are the minimum we'd expect to see," says Brown-Ginsberg. "Many breastfed babies have bowel movements with each feeding, [about] eight to 12 per day. [The] odor is not offensive [and] is milder than that of stools of a formula-fed baby."

Between 4 to 6 weeks of age, the pattern can change to less frequent bowel movements, Brown-Ginsberg says. The quantity per movement will be greater, though. "Some breastfed babies can have a bowel movement every few days or even once a week," she says. "As long as it remains soft, it is not constipation."

The first month of baby's life is the most difficult, as you're both learning breastfeeding and the milk supply is being established. During this period, frequent, yellow bowel movements are reassuring. Brown-Ginsberg advises if the diaper count isn't meeting your expectations to check your baby's weight gain.

She also suggests exploring the whole breastfeeding picture – comfort with latch, frequency of feeding, presence of engorgement and so on – to determine if breastfeeding phone support will resolve the problem or if a visit with a lactation consultant is needed.

After about 6 to 8 weeks, "most breastfed infants have a bowel movement at least every other day, and most have one to three bowel movements per day," says Dr. Colin Rudolph, professor of pediatrics and chief of pediatric gastroenterology, hepatology and nutrition at Medical College of Wisconsin and Children's Hospital of Wisconsin. "As infants grow older, and especially as other foods are introduced, infants have fewer bowel movements that are more formed or pasty."

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