A common question we get calls about in our office is “my baby hasn’t pooped in 3 days, what should I do?” This is a common problem in an infant from age 2 weeks to 2 months, breast fed or formula fed. A few things helpful to know include: how old is the baby, is the baby still eating, is the baby having fever, is the baby vomiting? If your baby is still eating and sleeping well and is under 2 months old we usually recommend to wait it out, likely their brains are trying to get the poop-anus connection worked out. As long as they are eating, thriving, not having fever or vomiting your infant can go up to 7 days without stooling. Let’s talk a minute about normal infant stool. If you breastfeed your baby, his/her stool will likely be yellow and seedy and may be very frequent. A formula fed infant may have pastier yellow or green stools. Now all of the sudden they are not stooling at all, then they are straining and the diaper smells of poop but you check…..no poop? What? They are fussy, straining, red faced, having smelly toots yet still…no poop? The next day rolls around and most new moms are getting really worried, they call their mom or trusted advisor and they say change your diet if you are breastfeeding or give you baby a little water (don’t ever give a baby under 2 months water unless advised by your pediatrician.) All day long you watch your baby strain and strain and nothing happens…you tell yourself if no stool tomorrow I will call the doctor. Day three you haven’t slept for worrying that something is seriously wrong with your baby though he slept soundly in between feedings and other then some smelly toots and a few moments of red-faced straining they are fine. You call and leave a message for the triage nurse after you have ‘googled’ infant constipation and decided your baby must have Hirschprung’s disease or some other rare condition. Instead of waiting for the nurse to call, you call the receptionist and make an appointment. Once you see the provider and they examine your baby and they reassure you that this is normal behavior for an infant and tell you your baby is fine. The best advice they can give you is to wait.
How can we wait, they should poop every day, right?
Yes, wait. The poop will come…it will be stinky and likely blow-out the diaper, so be ready. It might be on day 5 or not even until day 7.
What? Won’t they die if they don’t poop.
No, what your infant is trying to work out is the brain/anus connection. Up until this point when stool got to the anal sphincter it just came out, therefore we have frequent small stools. Now your infant is trying to work out the anus connection. When he pushes he is holding that anal sphincter just as tight as he can hold it, eventually he will figure out that he needs to ‘Let It Go’ (cue in the music, lol). Once she does “Let it go” you will feel better and so will she (though you may have a lot of stinky laundry to do.)
So when should you worry? What should you be watching for? It is not normal for an infant to have blood in their stool. It is also not normal for the stool to be small hard pellets. Also if your baby is in a lot of pain or having fever up to (100.5 F) rectally then you need to see your provider or call them more urgently.
Since this is our first blog post we don’t want to be too wordy. We will address more poop issues in the future, probably at least 2 or 3 more posts we can do to cover major issues we see with poop.
Until then don’t worry…. it all comes out in the end.