Infrequent stooling in newborns

Is my newborn baby constipated?

Healthy newborn babies are not constipated, so if your baby has not produced a stool (poop) by 24 hours, see your health-care provider. Some normal babies take up to 48 hours for their first stool, and premature babies may take a little longer. Infrequent passing of stools in the first few days may be a sign the baby is not getting enough colostrum or milk. Rarely, babies may be prevented from passing stools because of an anus that isn’t formed properly, a bowel abnormality, a low thyroid hormone level, or another health problem.

A) Normal delay in the first stool

Healthy babies have fairly predictable stooling patterns. The first stool is greenish-black and has a tar-like consistency. This stool is called meconium. Most babies pass meconium on the first day of life.

Some normal babies take up to 48 hours for their first stool (poop) (Okoro 2013). Normal premature babies may also take a little longer (Bekkali 2008). However, infrequent passing of stools can be a sign of a problem. Talk to your health-care providers if your baby has not passed a stool by 24 hours.

B) Infrequent stooling caused by poor feeding

Infrequent passing of stools in the first few days and weeks after birth may be a sign that the baby is not getting enough colostrum or breast milk (Shrago 2006).

Newborns who are not getting enough milk may:

  • Not produce stools.
  • Produce fewer stools than expected.
  • Have small stools.

They may also have stools that are green for five or more days after birth.

Newborn babies are not constipated. If your baby is not stooling enough, has abnormal stools, or is showing other signs of not getting enough milk, please see your health-care provider and have your baby assessed and weighed.

C) Infrequent stooling caused by infant illness

There are some relatively rare conditions that prevent babies from passing stools at birth or shortly thereafter. These include:

  • An anus that is not properly formed (imperforate anus)
  • A bowel blockage caused by:
    • Meconium
    • The bowel not being continuous or being narrow
  • A bowel that does not have enough nerves to allow it to function properly (Hirschsprung’s disease)
  • An abnormal spinal cord
  • A low thyroid hormone level
  • Cystic fibrosis

References

Bekkali N, Hamers SL, Schipperus MR, et al. Duration of meconium passage in preterm and term infants. Arch Dis Child Fetal Neonatal Ed. 2008 Sep;93(5):F376-9

Okoro PE, Enyindah CE. Time of passage of First Stool in Newborns in a Tertiary Health Facility in Southern Nigeria. Nigerian Journal of Surgery : Official Publication of the Nigerian Surgical Research Society. 2013;19(1):20-22

Shrago LC, Reifsnider E, Insel K. The Neonatal Bowel Output Study: indicators of adequate breast milk intake in neonates. Pediatr Nurs. 2006 May-Jun;32(3):195-201