EP 13: Decoding Diapers- Understanding Newborn Poop and Infant Nutrition

Newborn Poop 101: What’s Normal, When to Worry, and Why Baby Strains

Wondering if your newborn’s poop is normal? In this episode, I break down newborn and infant poop—what’s normal, what’s not, and when you actually need to worry.

As a pediatrician and registered dietitian, I walk you through what to expect in the first days and weeks of life, including the transition from meconium (black, sticky stool) to typical yellow stools, and how often newborns should poop. I explain why it’s common for stool patterns to change—and why growth, feeding, and overall symptoms matter more than any single diaper.

We also cover common parent concerns like:

• baby poop color (green, yellow, dark, pale)
• how often a newborn should poop
• baby straining to poop but stool is soft
• when poop frequency drops (even up to a week)
• mucus or blood in stool

I explain key red flags that may need medical attention, including poor weight gain and blood in the stool, and what those findings can mean.

You’ll also learn about infant dyschezia—a common developmental phase around one month where babies strain, cry, and turn red before passing a soft stool. I’ll explain why this happens and how to support your baby without over-intervening.

Plus, practical tips to make life easier (like preventing diaper blowouts and knowing when to size up).

If you’ve ever wondered, “Is this normal?” while staring at a diaper—this episode is for you.

Timestamps

00:00 Newborn Poop Intro
 00:19 Podcast Welcome
 01:11 Why Poop Questions
 03:55 Meconium and Early Days
 07:16 When to Worry
 08:23 Blood and Mucus
 10:12 Straining and Dyschezia
 13:24 Helping Baby Poop
 15:11 Poop Colors and Frequency
 17:40 Diaper Blowout Tips
 18:43 Wrap Up and Resources

NEW COURSE! "Read the Pattern: Feeding Your Baby 0–4 Months" — because a healthy relationship with food starts earlier than most people think. Course Link!

Transcript

Dr. Liz Daniels 0:00

Let's talk about poop, specifically newborn poop. The thing, you now have more pictures on your phone than your wedding day, and you're asking Chad GBT about it, like a forensic scientist. We're gonna give it the time it needs today, so listen all the way through to the end so you don't have to text these pictures to your doctor. Wink, wink. Welcome to the Nutrition for the Early Years podcast with Dr. Liz. Your guilt free guidance for feeding your family. This podcast is for folks who are creating better nutrition for their kids, but are tired of the whiplash of nutrition claims and diet culture influence. You're reading labels, paying attention to ingredients, but you still doubt yourself and for good reason. Food goes deep and often we fear making costly mistakes that as parents, we hope to prevent. If you're ready to explore the ins and outs of your child's actual nutrition needs and nourish the whole child from the inside out. Hang with me, Dr. Liz Daniel. I'm a board certified pediatrician, plus registered dietician, and we're gonna dig deep into real deal nutrition, science, honest, talk about barriers to health and real stories that I help address. So let's dig in. All right. Howdy guys. Welcome back to the Lunchbox Reformation with Dr. Liz. This week we are talking about, as promised. Poop. I can hear my boys in the background going poop. I have three boys and they love these kinds of conversations, but actually today we're talking about not just any poop we're gonna talk about. Poop in the beginning, like baby poop. Okay. And how long can they go without pooping or how much is too much and what color is the right color? And all of those things. And then we're gonna talk about when they like really seem to be acting as if they're dying when they poop. Okay? So I like this topic because it's one that I get. Like even our most experienced, educated, thoughtful parents, it is like a question that I get all the time. Even doctors ask, asking doctors questions. I have other like surgeons that, you know, aren't pediatricians that'll ask questions about these. 'cause like, it's, it's confusing and there's so much out there, like, oh, you have to interpret this by their poop and, okay. Here's the bottom line. You should listen to the whole thing, but the bottom line is most of the time. It's still normal. Okay. What is considered normal poop is really broad. So we're gonna talk today about infant poop, all of those things. If you have a newborn or if you are about to have a newborn, I want you to save this episode. And I mean, just go ahead and hit subscribe if you haven't already, but like, save this episode because I guarantee. You are gonna have a question and you're gonna think, Hmm, should I text my doctor pictures of my baby's diaper? And the answer is most likely going to be no. If you have this podcast, we get pictures like in our, you know, portal through our patients like all the time. And I don't, like, I really don't make many clinical decisions based on a diaper. I don't know many pediatricians that do. It's the history and it's the weight gain and the growth and the symptoms that you're experiencing that are gonna lead me to help navigate one particular thing with your diet or your formula or your breast milk or whatever, it's often not gonna be what's in the diaper. I know it's a surprise tone. I like to tell my family is like, you know, poop is really not a report card of how you're feeding your baby or attention that you need to be having in some different direction. It's just is their digestion and their, it's their poop, it's their waist, and it changes because as they grow what their body needs is going to shift as well. So in the beginning day of life, one. Bear in mind that the large intestine, as you've been growing this baby in your womb, really isn't like, they're not pooping. They shouldn't be. That's why we do emergency C-sections if we need to, but they, they really aren't pooping. They're collecting dead skin cells and tissue and, you know, some components within the colon, but they don't ever poop until they're born. And so. The first poop that's in there is just that old sticky black tarry called meconium. And in the first few days of life, that's gonna transition over to cd, usually pretty yellow soft bowel movement. And that transition takes place because they're actually getting nutrition from the mom if they're breastfed and they're only getting a little bit of colostrum in the beginning. And it, there's a delay in mom's production of milk. There's gonna be a delay in the bowel movements, most likely for the baby. What I mean is that day one, we expect at least one bowel movement. Day two, we expect at least two bowel movements. Day three, we're typically gonna see three, and then sometimes. There's a quiet waiting period, and I have a lot of families that get really worried. They'll come in for their newborn visit on day of Life, four or five and be like, we haven't had a bowel movement in over 24 hours. And we really wanted to call the emergency line, but we, we weren't sure and it's okay. Now, the first question I'm gonna ask isn't. When was their last poop? My first question that I'm gonna ask is, how are they growing and what are they eating and how much are they eating? Because in the very beginning, most likely if you're delivering in a hospital, they will not discharge you if you haven't produced a bowel movement. And this really matters because what we're looking for is the rare kid who has something called Hirsch Sprungs. Where the nerves that help innervate the colon, like the large part, the distal part of the colon, um, that connects to the rectum, doesn't have the wiring in it. So they don't have the stimulation, the neurologic stimulation to create a bowel movement. And it can be very dangerous and it can be very serious. But if they're producing a bowel movement, then you're in a pretty good place. There are some nuances here. So you know, for what it's worth, we still like to pay attention to that process and what's going on. But I think the take home here is that if you've passed meconium and you're in the transition period waiting for that new stool to come in. This is where the conversation is gonna go. Your pediatrician's gonna wanna know how much they're eating, how often they're nursing. Is it comfortable with the breast? Are they gaining weight in the days after you get discharged from the hospital, we expect that a baby is going to lose some weight. Typically you're expecting to lose up to about 10% of their body weight in the first five days of life. They usually reach the lowest point at day of life five, and then it slowly increases back up and typically they're regaining back up to their birth weight by two weeks. Now, there are some exceptions to that, but hopefully you've seen your pediatrician by Day of Life five already, and you are getting the attention you need and the support you need to navigate that. Moving past the first two weeks, what I often am noticing is that families will be concerned about green poop. Normal. What about really dark poop? Normal. What about poop? With every single time they like sneeze or eat normal? What about a week without a bowel movement? Also normal and. That's frustrating for parents when you feel like you need some kind of indicator or reminder that everything is okay. But remember that in the first month of life, they are maturing tremendously and their, their digestive tract is maturing tremendously. And so their stools are also going to reflect that. So what I like to share with families are sort of my guardrails for when I'm worried, number one. I'm worried about their poop. If a baby is having trouble gaining weight adequately, I'm worried about a baby's poop if there's blood in it now. About the blood. Typically when we see blood in the diaper, it's little flex mixed in with the poop. I don't typically see big globs or clots of blood. That is more urgent. Probably should require some attention, but sometimes we'll see blood mixed in with the like regular soft poop. And that can be a sign of something called cpro allergy. It's not an emergency room visit for most babies. It's really just an office visit. We wanna see what's going on. We wanna see the baby, we wanna talk through it with you. But it's not usually something that requires going to the emergency room. Now, that said, the first thing I'm gonna do if there is blood in the diaper is look at the baby's bottom and make sure that there's no fissure or there's no tearing on the skin, and we kind of go from there. You can have hemorrhoids in babies and you can have fissures as well, which is where they're straining really hard and they kind of just tear the skin a little bit on the outside and, and then, you know, after that, then I would say if the baby's a little bit older and we're not really having blood in the poop anymore, maybe we have a little bit of of mucus in the stool, and that is worth some conversation. Again, it comes down to growth and if it's repeated or just a one-off when babies get sick. Sometimes they can actually get mucus like from their cold and all of that kind of stuff, and it will be swallowed and actually end up in their poop. So not always a red flag. Um, and then I'll get families ask about like, okay, what about like hind milk versus four milk? If their poop is really green, is it just because there's hind milk and do I need to be feeding them longer? Again, I would ask, how's our growth? How are we doing overall, not just a single diaper? Then we get a little bit older and say we're about a month old. This is usually what happens at a month. And I have a family who will let me know that, oh my gosh, we are really struggling with poop. I really think that we have constipation or something. And what they'll tell me is that. The baby will bear down and strain. They'll get red in the face. They'll arch their back. They'll scream, they'll kick, they'll cry. Everything's gonna be so dramatic for like 10 minutes, and then all of a sudden they poop and it's soft. Like you were totally expecting a rock to come out of their diaper. And it is soft. Wait, what and no. The answer is not giving them more laxatives or doing rectal stimulation. A lot of times you don't need to do that. If the poop is soft, then the issue is, is really likely not actual constipation. Our definition of constipation is really gonna come down to the consistency of the bowel movement. If the baby has actual, what seemed like rocks coming out in their diaper, it's worth a phone call to talk through your doctor and kind of make sure that they're getting enough support. And again, we're looking back at growth and we will also want to think about what kind of milk they're getting and navigate that with you. So little babies, by and large, shouldn't have true constipation where they're having like rabbit. Pellets. You know, like that shouldn't be happening. If it is, it definitely warns a conversation. Okay, so I wanna go back to this like weird straining behavior, and it's kind of a phenomenon that we see often at about a month of age. And it's called DYS keysia. I know funky name DYS is basically pelvic floor dysfunction. So consider that. The baby, since they haven't had to actually practice creating a bowel movement in the womb, that's something that is a skill. Likewise, they haven't had to actually like coordinate their arm movement intentionally or even focus their vision, like all of their muscles are there, but they haven't really been functioning in and working in the same way. They have to really develop that muscle tone after they've been born. So the pelvic floor is really pretty impressive. It's a bunch of muscles that take a lot of coordination and they're generating pressure by doing that. So they're bearing down on their esophagus, they're letting their stomach get really rock hard, and they're trying to create pressure to generate a bowel movement. This is actually development. We wanna see them hold their head up. We wanna see them roll over to their side. We wanna see them start to get their butt up in the air and do that swimming motion. And guess what? Pelvic floor coordination is actually part of that development too. And it characteristically is gonna happen about a month. And if you're super lucky and your baby just seamlessly does this without even noticing, then super cool. That's awesome. Celebrate it. But if your baby is actually having to visibly show you that they're learning to use their pelvic floor, that's okay. And you don't necessarily need to do that for them. I like to teach families. I think a lot of families know about bicycles and that's, that's totally fine to do and if that works, cool. But what I like to do is hold the baby with, you know, their legs sort of in a bicycle motion, sort of compressed up to their belly. But I like to hold them with their back on my chest. We're both, you know, walking around, facing outward, looking at something and I'm kind of pulling their knees up into their belly, giving them a nice big hug and snuggling them and rocking side to side because gravity will help to push that, that gas out or that poop out. Along with some of that compression, you are literally raising your legs up in a baby form of Squatty potty. Okay. And, and so, you know, that is really helpful. By the way, if you're postpartum, you should have a squatty potty. Okay. It really does help reduce some of the pressure that you need to generate. I know it sounds gross, but try to picture, if you're like ever trying to like poop and you're flat on your back, like it takes a whole lot of pressure to do. It's not easy, and so you're just helping them out mechanically. Then as they get older, they figure it out, they poop without much trouble, and they kind of move on and it's not a big deal. Dys Skii is pretty common. We see it in a lot of babies and they just get over it. So the good news here is that as a parent, no, you're not missing something major that you need to be fixing. It's more about understanding that developmentally that. Normal and they actually do figure it out, and you don't really have to do anything to help them with it again, except if there's blood in the poop that we need to talk about. If they truly have constipation that are hard stools that we need to talk about, if they're not growing weight, we need to talk about that, but the rest poop happens. Then I often get questions from families about what about different colored poop? Especially like the pale poop. I get questions all the time about the poop is like, it's like white or it's like peanut butter texture. That's okay. What about being really pale? Now, pale would be a colic stools, and truly a colic stools is associated with jaundice where you're like yellow and you are circulating the bilirubin and it's not coming out in the poop to make it brown. Um, we would have other signs that this was going on, like we're vomiting, we are having belly distension, or we are getting yellow like in our eyes or our skin. That's not gonna be an isolated weird poop. If it's an isolated weird poop, it's okay. So for what it's worth, the whitish poop is usually just fine. Okay. And then if you're on the other side of the spectrum and you have a breastfed baby, that really doesn't poop very frequently. Um, sometimes we need to do some support in navigating this, but really I think the takeaway here is that growth is really our baseline metric that really helps us interpret if we need to be worried about the poop. And then there's some other parameters around that that we talked about. Interestingly, when you think about age, it's kind of cool, like typically. In the first couple of weeks of life, we're gonna have a lot of poops, and then it slowly decreases from like somewhere between average of five poops a day and a newborn to mine. Were always like 13 by the way, but like that to. Really like two to three for a one to three month old who was breastfed and then about one to two stools a day for formula Fed babies in his first few months of life. And then by the time you make it to three months, we're actually even less than that about like one every other day, or even like every day. Just once a day is pretty common for a lot of three month olds. And then by the time you get to feeding solids. That's gonna change pretty dramatically depending on what's going on in the diet, and that's okay. So it's just pretty interesting that you know, you're gonna be seeing so much change with poop. And I like these conversations because I think that understanding the why really helps get rid of some of the fear so that when your baby grows and those patterns change, you can be aware of it, but not be afraid of it. Okay. And then here's my final couple of pro tips. Okay. My husband stayed home with our three kids for 13 years as a stay at home dad. Okay. Major way to go. This was especially during the time where it was like not cool to do this, and in this scenario he learned some amazing pro tips that I'm gonna pass on to you. If you are, um, not aware already, you will learn that your baby is ready to size up on your diapers when poop starts shooting up their back. We used to call these PO explosions in my house and this is when it gets a little too tight around their waist and all of a sudden now you have this like one little opportunity for it to come up the back. That's when you know it's time to size up. And then if you're changing diapers, please, please, please don't forget to pull the ruffles out on the side of the diaper where their thighs are. If you don't, you're giving the diaper an opportunity to leak. So you'll thank me later if you didn't already know that. Now I just think that these conversations are good. It's okay if you're really still worried, but listen to this before you send your doctor a picture of your diaper. Okay, so if this episode is helpful and you want some more tools that help make feeding decisions feel clear and less overwhelming, head on over to my website@newsstorynutrition.com or reach out to me on Dr. Liz News Story, nutrition. I'll respond. I'll talk. We'll be friends, and you can also find me on Instagram. I'm at Dr. Liz News store Nutrition. I am excited to encourage you along your feeding and growth journeys with your kiddo. At the end of the day, I find that when parents are confident and when they feel calm and centered, it really does help their kids tremendously. I just wanna encourage you that you're probably already doing more than you know, so hope you're doing well. Enjoy and we'll see you next week.