babies’ bowel actions in the early months, before any supplemented milk is given or solids are introduced, have a typical pattern. For the first few days after birth meconium stools are passed – this is a sticky dark green/black substance that has filled the intestines while the baby was in the womb. Almost every nappy will be soiled with this, sometimes more, sometimes less, as the early mother’s milk, called colostrum, has a laxative effect to help clear the system of this sticky stool. Over the first three days, the colour gradually changes to become lighter and soon it will be the usual mustard colour of a normal breastmilk stool. Meconium is best cleaned with cotton wool balls dipped in baby oil.
Once breastfeeding is established, from about three days after birth, a typical stool is mustard-coloured, the consistency of a soft paste, almost without any odour and certainly not at all unpleasant smelling. A normal stool contains little whitish ‘seeds’. Almost every nappy will be soiled, sometimes just a smear, sometimes a huge amount. This is not diarrhoea and is no cause for concern. The digestive system is just maturing and this will soon settle. Frequent stools continue for about six to eight weeks. Thereafter, if the baby is still exclusively breastfed, stools will become far less frequent, sometimes occurring as seldom as once in seven to ten days. If the stool is still soft, this is not constipation. A constipated stool is always hard, dry and irregular.
Parents are often convinced their babies must be badly constipated in this phase as it seems so unlikely that a baby can pass a stool so seldom and still be healthy. Remember, though, that breastmilk contains very little waste matter and so there is little to pass through the colon. Babies often seem to be in discomfort when not passing a stool more regularly, but take into consideration that they are very aware of their digestive systems and make very dramatic faces from the rumblings on the inside! This does not mean that they are in pain – you will soon be able to tell the difference, so enjoy this unexpected benefit of breastfeeding!
There are some variations of this normal pattern that parents might need to know more about:
•It is normal for a newborn baby’s stool to contain a little blood sometimes. This is usually just a reaction to the mother’s hormones and will soon settle. You need only see a doctor if bleeding is substantial or persists.
•Baby’s stool might also reflect mom’s diet and medicines. Iron supplements and green veggies can cause green stools.
•Babies with allergy tendencies often react to dairy and grain products and other commonly allergenic foods by passing mucus with their stools. This can range from just a little to quite a lot of frothy mucus. If this occurs, nursing mothers should avoid these products.
•If the baby has been on medication, the stool may also change, mostly becoming looser.
•If the stool of an exclusively breastfed baby is malodorous and he is very windy or crampy, evaluate your diet carefully and make the necessary changes. If the problem still persists, see the doctor.
•Should your baby become jaundiced, you will notice that his urine stains the nappy a darker colour than that to which you have become accustomed. This is simply the pigment called bilirubin, which the kidneys are helping to excrete, and is not a cause for concern.
•When Mom takes an iron supplement, her baby’s stools may be tinged a green-brown and tend to be far firmer or even a bit constipated.
Formula babies’ bowel action
Formula-fed babies’ stools are usually brown and pasty, and are mostly passed once to twice daily. However a small baby will seldom demonstrate a pattern to its bowel action, apart from the motion accompanying feeding. In time you might detect a pattern, but a regular excretory routine cannot be forced. Green tinges can be due to iron added to the formula milk powder and are not a cause for concern unless accompanied by constipation.
The following deviations need attention:
•Constipation is quite common if the formula milk does not agree with Baby. These stools are pellet-like and painful to pass. At times a little diarrhoea-like stool might seep past the constipated stool, and should not fool one.
•Should you notice rather substantial quantities of mucus in the stool, it might be an indication that your child is sensitive to the formula. Alternatively, it might be a passing symptom of an, as yet, immature bowel. Should it persist and seem to cause discomfort in your baby, consult your practitioner.
•Some babies’ stools are passed explosively, others almost unnoticeably. Formula adjustments are sometimes required, but only if you see that your baby is uncomfortable. Homeopathic remedies like Rescue Digest and the tissue salt Mag phos may also provide distinct relief, as can massaging Baby’s lower abdomen and back.
•Green, watery stools are a definite cause for concern and if they persist after one or two episodes, have your practitioner check your baby. This is especially true if accompanied by fever and if your baby is disinclined to feed.
The best way to clean a baby after a soiled nappy is simply to wipe off most of the pasty matter and then dunk the baby’s buttocks in a basin of warm water and clean with baby soap.
CARING FOR BABY’S SENSITIVE AREAS
There are many questions about Baby’s sensitive areas and how to care for them: Baby’s eyes, ears, nose, mouth, fontanelle, genitals, nails and belly button. This guide will see you through every stage, ensuring that Baby is perfectly cared for.
Head
Many parents are concerned about the soft spots on a baby’s head and wonder if they will not hurt their babies when washing hair or cleaning the head. As long as you do not press on these areas, especially the large anterior fontanelle, all will be well.
To clean Baby’s head routinely, simply wipe down with a warm, damp facecloth. If Baby has a thick shock of hair, or perspires freely on the scalp, you might need to do so once or twice daily, or wash his hair with gentle shampoo at each bathtime.
Some babies have cradle cap, which is a thick, sticky, yellow layer on the scalp and sometimes the eyebrows. The cause is not totally clear, but it is not serious, nor does it trouble Baby. Moms don’t like the look of cradle cap of course, and fortunately there are a number of self-help solutions to be found in this guide.
Eyes
Many babies awake with their eyelids stuck together and thick mucus accumulating in the inner corner of the eye. There is seldom need for concern. For the first two to three months of life, clean Baby’s eyelids regularly if crusty by dipping cotton wool balls in boiled, cooled water and wiping from the inner corner of the eye outwards. Use one cotton ball for the upper lid and a fresh one for the lower lid of each eye to prevent infection.
From three months use a separate facecloth for Baby’s face and eyes, but it is no longer necessary to pay special attention to the eyes unless there is chronic blockage of the tear ducts.
Ears
Baby’s ears are self-cleaning and one should not try to reach into the external ear canal to remove wax, as delicate structures could be harmed. If using a cotton bud, clean only the shell of the ear. Always use a cotton bud with an extra swollen tip to prevent penetration of the canal. When washing Baby’s hair, block the ears with the thumb and middle finger of your hand holding the head, to prevent water from entering the ear canal.
If Baby has a profuse or malodorous discharge from
