Dirty Nappies: what is normal?

Maybe not the most pleasant topic! but all mommies are concerned about their little one's dirty nappies from time to time. this guide might help!

Early days: In newborn infants, a tarlike, dark green-black substance is passed with in the stools. This is perfectly normal and is the result of the accumulation of meconium in her intestines when she was still in die uterus. Take the passing of meconium as a good sign, as this indicates the normal functioning of the bowel.

Transitional stools: This describes the stools that are passed after most of the meconium is passed. It might still be green, or even yellow and slightly loose or contain mucous.

After a few days of having transitional stools, the frequency of passing will largely depend on what you feed your baby.

Breastfed: The stool may vary greatly including yellow colour, sometimes loose, watery stools, seedy consistency or even curdley

Formula fed: The stool will be soft but have better shape and form compared to the stools in a breastfed infant and the stools may be yellow, brown or slightly green.

Formula containing Iron or a vitamin supplements containing iron, may cause a darker green or black stool.

How often should he/she have a dirty nappy?

Some infants will have a dirty nappy after every single feed, where as one stool per week may be very normal and not unusual in many instances. This means that if your baby is not passing stools daily, it is not necessarily constipation

 Also remember that breastmilk is very well absorbed with little residue, resulting in fewer stools your baby’s stools and stool frequency will be different from day to day.

Constipation during infancy:

Constipation is very rare in the breastfed infant who receives a sufficient volume of milk. It is also very rare in formula fed infants who receives correctly prepared formula in adequate volumes (see correct instructions on the package of the formula as it differs between products)

True constipation is when the stools are very hard, and in small pieces or droppings and difficult for the baby to pass. If this problem persists, it is a good idea to consult a healthcare professional to exclude possible medical problems.

What causes it?

-          Too little fluid intake

-          Inadequate volume of milk

-          Over-concentrated formula feeds

-          Genetic tendency

-          Medical gastro-intestinal problems

Remember that your baby needs more fluid on a warm and humid day. Formula milk should be mixed as directed on the tin. Do not add more powder to the water than recommended, as this will over-concentrate the feed.

What can I do?

Make sure your baby has true constipation. Some babies normally have only 1 stool per week. As long as they are not rock hard, there is nothing to worry about. If still concerned, contact your dietitian or doctor

Hints and Tips:

-          Re-check the instructions on the formula tin. Make sure you are putting the cooled boiled water in the bottle first, and then adding the correct amount of scoops of milk powder.

-          Do not add extra powder or press the filled scoop of milk powder

-          Offer extra fluid. Water can be given (safe boiled and cooled water) to soften your baby’s stools

-          Do not add any sugar to your baby’s feed. This is sometimes advised to sooth constipation and is more detrimental than good

-          Try giving a small amount of well diluted prune juice (1 part juice, 2 parts water). Other juices might also be helpful but should not be given in the place of milk. Give this juice with a cup; this will lead to less contact with the teeth, which might be affected.

-          If your baby has started eating food, you can give pureed fruit and vegetables such as pear, apple, apricot, paw-paw, banana, prunes, carrot, pumpkin, lentils or potato. Remove any hard skins, as your baby will have difficulty digesting these. These foods contain fiber, which absorb fluids and helps to produce soft, bulky stools that are easier to pass.

-          Remember that just increasing fiber may cause problems. With increased fiber go increased fluids!

-          Use baby cereal or oat bran as a source of fiber together with pureed food. Oat bran will soften the stool and cereal adds bulk to the stool

-          As your baby progress to coarser food, you can offer coarser cereals, oats and whole-wheat finger foods such as brown bread, whole wheat rusks and crackers. Now you may also offer pieces of fresh fruit or vegetables.

-          Massage your baby’s tummy to stimulate movement or stretch and play with his/her legs to stimulate activity.

Too find out more, visit a healthcare professional such as a Dietitian, as many home remedies can do more harm than good in irritating and harming the intestines.