It's common for parents to worry about their baby’s poos. They might worry about their colour, consistency and frequency.
A reduction in the frequency of poos in children and adults often indicates constipation. It's therefore only natural for parents to worry if they notice their baby pooing less.
The good news is that it's rare for exclusively breastfed babies to be constipated.
What is normal when it comes to breastfed babies’ poos? How often should they be pooing? When should you see a doctor?
Here are 7 things you should know about constipation and breastfed babies’ poos.
#1: Constipation Is Hard Poo
It's common for babies to make strange grunting noises or appear to be straining. These things do not mean your baby is constipated.
#2: Exclusively Breastfed Babies Tend To Poo Often (At Least In The Early Weeks)
After the first few days, most exclusively breastfed babies have at least 3 poos every 24 hours (at least for the first 6 weeks). This is one indicator that a baby is getting enough breastmilk. Some exclusively breastfed babies poo much more often than 3 times every day.
#3: Infrequent Poos In Early Weeks Could Indicate Insufficient Milk Intake
If an exclusively breastfed baby does fewer than 3 poos every 24 hours, within the first 6 weeks or so, it could indicate her intake is inadequate.
However, if she is feeding and growing well, has plenty of wet nappies and the poos she does are large, she is likely to be getting enough breastmilk.
Nonetheless, if you're concerned, it's a good idea to get your baby checked by your health care provider.
#4: Oligosaccharides Might Be Why Breastfed Babies Tend To Poo Often And Not Get Constipated
Oligosaccharides are the third most abundant component of human milk. They serve as an important anti-infective factor (by acting as a decoy for pathogens). They are also prebiotics (food for the good bacteria) and a form of insoluble fibre.
It’s probably because of these oligosaccharides in breastmilk that breastfed babies poo so often. This is because poo is mostly made up of bacteria. Bacteria in a baby’s gut thrive on oligosaccharides. Breastmilk has a lot of oligosaccharides, meaning the bacteria in a breastfed baby’s gut grow in number and absorb water. Result: breastfed babies do regular soft poos.
And, because oligosaccharides are insoluble fibre, the process of pooing speeds up .
#5: It's Common For Breastfed Babies To Poo Less Often After About Six Weeks
After the age of about 6 weeks, it’s not uncommon for breastfed babies not to poo every day. Some babies continue to poo several times a day while for other babies it might happen every few days or so (and maybe even every 1-2 weeks).
If you're worried, or if there has been a sudden change in your baby’s poo frequency, check with your health care provider or an IBCLC.
#6: Common Doesn’t Necessarily Mean Normal
Just because it’s not uncommon for breastfed babies not to poo every day, particularly once over the age of 6 weeks, this doesn’t necessarily mean it's ideal or normal.
Jennifer Tow, an International Board Certified Lactation Consultant and holistic practitioner, believes “it is absolutely not normal for babies of any age to have fewer than several significant bowel movements per day. Not per week! Per day.”
She believes the reason why some breastfed babies, aged around 6 weeks or so, stop pooing so often is because the baby and/or mother have suboptimal gut flora. This might be due to the use of medications (e.g. antibiotics), or the mother’s poor diet.
For example, there might be a change in the oligosaccharide composition of a mother’s breastmilk. “When the mother's gut is not healthy, she passes compromised flora to her baby. It’s highly likely that mothers with compromised guts also have breastmilk containing different HGOs [human milk oligosaccharides] than mothers with healthy guts,” Jennifer says.
According to Maureen Minchin, author of Milk Matters: “Basically, what a thriving breastfed baby does within a wide range is what’s normal. And if frequency changes or volume decreases, it won’t be any one ingredient in milk that makes the difference. It will be an interaction between complex ingredients and the ever-growing and developing structures of the baby’s body, and the microbiome they produce and are produced by. Yes, some bugs need oligos, others different ingredients. It's the balance that counts.”
More research is needed into why some babies seem to poo less often than others.
#6: Once Solids Begin, Constipation Is Possible
Once solids foods are introduced to your breastfed baby, there will be changes in her poos. They will have a stronger smell (often more potent), different colour (the colour of the solid food) and consistency (often less runny). It's common to find bits of undigested foods (e.g. vegetables) in her nappy.
Once solids have started, it's possible for your baby to experience constipation. If this happens, it’s a good idea to speak with your health care provider. The suggestion might be to ease off foods that tend to be constipating, and to increase the frequency of breastfeeds.
#7: See Your Health Care Provider If You Think Your Baby Is Constipated
If you think your baby might be constipated, it's important to seek advice from your health care provider. Although constipation is rare in an exclusively breastfed baby, there are a few medical reasons that could cause it. For example, constipation could be a sign of a food sensitivity in an exclusively breastfed baby.