Poop Problems When Starting Solids

One of the things new parents find most surprising is how focused they are on their child’s poop. Whether your child struggles with constipation or diarrhea, poop problems can add another layer of stress to starting solids (looking for more information on baby led weaning vs purees? Read this).

First off, know that there will be changes to your child’s poop. We expect that. Their digestive system has a lot to learn. There are ways to help them through the transition and make it more comfortable for everyone.

Expected Changes

Consistency:

For most kids, poop will start getting more firm. This makes sense given they are going from a liquid diet to one containing solids. Some kids will have runnier poop for a while as their body is getting used to the new foods. If you notice consistently hard, pellet-like stools or really liquidy stools, you may want to reach out to your doctor or a dietitian to figure out if you need some dietary changes.

You may also notice some undigested pieces of food at first. This is normal until kids really learn to chew their foods properly. If your child is having extreme diarrhea (along with vomiting) after trying new foods, bring it up with your pediatrician. This can be a sign of a rare food allergy called FPIES.

Color:

Breast milk only diets generally produce a yellow poop. Formula diets produce a yellow to brown colored poop. When you introduce solids, that color can change. Most poops are brownish in color (although the hue can change based on a variety of factors). If you notice colors such as red, black, yellow (once consistently eating solids), or white, definitely bring it up with your doctor. It doesn’t necessarily mean there’s a problem, but it’s good to rule out the possibility. Food coloring may create some vividly colored poops (many parents panic after their baby has a blue birthday cake).

Smell:

This will be especially noticeable in breastmilk fed babies as their poop usually has a sweeter smell prior to solid introduction. Poop is made up of undigested compounds such as bacteria, fiber, undigested lipids, minerals, and cellular proteins, all of which contribute to the smell. The smell can change depending on what your child eats (which you have control over) or the bacteria that make up their poop (which you have less control over). If you notice a huge change in smell once they’re consistently eating solids (especially if it’s super rancid smelling), bring it up with your doctor.

Frequency:

Generally, there will be a change in how often your child poops. For some, they will poop more frequently. Others will poop less frequently. The frequency isn’t super important as long as they don’t seem uncomfortable and the poops are of a normal consistency (not pebbles and not super liquidy). You’ll notice a big change when you first introduce solids and then it should stabilize after a few weeks or months. Ideally, we want babies to poop everyday, but “normal” poops are anywhere from 3 times per day to once every 3 days.

Constipation

The first thing to consider when dealing with constipation is whether or not your baby is uncomfortable. While ideally most people pass a bowel movement daily, not everyone does. If your baby is passing them less frequently, but does not seem uncomfortable and the stools they are passing are soft, you probably don’t need to be concerned. If the stools are hard or pebble-like or if your baby seems to strain or appear uncomfortable while passing them, that’s usually a sign of constipation. When dealing with constipation, our focus is usually on fiber, fluids, and movement. You may also want to check out this list of foods that can cause constipation in kids.

Fiber:

Fiber is found in a variety of foods like fruits, vegetables, whole grains, beans, and lentils. Most foods that contain fiber contain both kinds of fiber: insoluble and soluble. Many supplements just contain soluble. Insoluble fiber is what helps to bulk up the poop and move it along. Soluble fiber absorbs water (and cholesterol which is why it is recommended for adults with higher cholesterol).

If your child is not eating a lot of fiber, introduce it gradually. Too much fiber at once can cause gastrointestinal symptoms. “P” foods are often recommended: prunes, pears, etc. While many adults dislike prunes, often little ones really enjoy them. A recent study also found that kiwis can help with constipation as well. Remember, as with all foods, your job as the parent is to just offer the foods and it’s up to your kids to decide if they are going to eat it.

Fluids:

This is often the problem I see with toddlers. Once they are no longer on breastmilk or formula, fluid intake decreases (find out more about when your baby can drink water). We do expect a decrease as they are now eating a solid diet, but fluids are still important. Without fluids, fiber can’t do its job and your child may get even more constipated.

I always recommend water first. You can add some fruit slices to give it a little more flavor. Encourage sips of water throughout the day. You can also offer small amounts of juice such as apple, pear, prune, or white grape juice once your baby is over the age of 1. Always make sure that it is 100% juice and limit it to no more than 4 ounces per day. I generally recommend to wait and see if other methods work prior to offering juice as it can be bad for teeth.

Movement:

For babies, focus on adequate tummy time as the pressure can help. You can also do bicycle kicks with their legs. Most toddlers get enough movement, but if you’ve found that they have been increasing screen time and decreasing movement, see if you can work towards more activity. Tummy massages can also help. The colon is a big upside down U, so trace that around your child’s abdomen (it works on yourself too!).

Diarrhea

If your child is having chronic diarrhea, reach out to your doctor. It’s important to establish what the cause is and address it. If your child is having diarrhea due to an illness, medication or something like that, these tips can help.

• Focus on keeping you child hydrated. For kids under 1, that means breast milk or formula. For kids over 1, water and hydrating foods (watermelon, cucumber, etc) can help. Your child is losing liquid through their poop, so we want to replenish it. There’s no need to stop breastfeeding or changing formula for acute diarrhea. If it is ongoing, you may want to speak to your doctor or a pediatric dietitian to see if there are any changes you should make.
• You may have heard about the BRAT diet: bananas, rice, applesauce, and toast. While these foods are easily digestible and can be offered during bouts of diarrhea, there is no research to support limiting your child’s diet to only these foods.
• Focus on nutrient-dense foods. Your child’s appetite and intake may be less than usual, so it’s important to make sure you are giving them the best chance to meet their needs. Make every bite count.
• Probiotics *may* help, depending on the reason for the diarrhea. Talk to your doctor before starting any supplement.
• Try to limit juice intake. If you are offering juice, consider diluting it. Sometimes the fructose (fruit sugars) in juice can make diarrhea worse.

Probiotics versus Prebiotics

You may have heard these terms in relation to gut health, but what exactly are they? And does your child need them? We don’t have an “ideal” microbiome at this time, so current recommendations are to offer a variety of probiotics and prebiotics in our diet by eating a variety of foods. A healthy gut can help prevent poop problems.

Probiotics:

These are live bacteria that we eat which can provide a health benefit. Supplements are available, but aren’t recommended for everyone. Probiotics can be found in fermented foods such as yogurt, kefir, kombucha, sauerkraut, miso, tempeh, kimchi, sourdough bread, and some cheeses. The amounts that are naturally occurring in these foods may not be enough to provide a benefit, so some foods will add in extra probiotics. The recommended dose for benefits is 1 million colony forming units per ml/gram. There are some probiotics naturally found in breast milk and many formulas add them in as well.

Prebiotics:

Simply put, these are the foods that your gut bacteria eat. The bacteria in our gut will break down some of the fibers that we are not able to. Food sources include: pulses (such as beans, lentils, split peas), vegetables (such as garlic, onion, asparagus, cruciferous vegetables), fruits (such as under-ripe bananas, apples, berries), and whole grain products (such as oats, barley, and rye). Gas is a byproduct of the bacteria breaking down the fibers so many of these foods can cause excessive gas or gastrointestinal discomfort in those who are sensitive to them. Introduce these foods slowly to help with tolerance. There are also prebiotics naturally found in breast milk and added into many formulas.