Friday, April 28, 2017

The poop series chapter two/ Along comes solids

Topic of the Week: chapter two of the Poop Series

Baby Poop: Along comes solids
Baby poop is a fairly benign substance. Once you start feeding your little one solids, everything is about to change.
I remember an email that I got one Sunday morning. I should have known better then to open it when I was sitting down to eat breakfast. The subject line was “undigested carrots, is this normal?”
The answer was yes, but there needed to be a much stronger warning for the attached photo.
As your child learns to digest substances other than milk, the consistency of the stool will change. As I tell the parents who come to my solid foods class, "You are the Conductor of the Poop Orchestra."
What I mean by this is that you are in charge of how much milk, how much solid food and how much extra fluid goes into your baby. You should pay attention to the outcome and make adjustments as needed. You don't want watery stools and you certainly don't want formed little pellets.
The goal is for the stools to remain soft. At at the risk of ruining your appetite or changing your dinner plans,( if I haven’t done so already),  think hummus.
Unless you are in a very hot climate, until your baby starts solids, it is unlikely that they need extra water in their diet. Once they start eating food,it is time to get in the habit of offering water throughout the day. If the stool is getting thicker, the first thing to do is add a little extra fluid to the diet. Plain water or very diluted prune juice are good options.
Most foods are fairly neutral but some  will help keep the stools soft.  Many fruits and veggies fall into this category. Prunes, pears and peas are some of my favorites. A little molasses can also get things moving.
On the other hand, some  foods tend to make the poops more solid. Keep in mind that if your older child ever has diarrhea, we will suggest the BRAT diet. This is a diet with bland starchy foods such as bananas, rice, or applesauce (the apples have pectin with tends to be binding) and toast.
Those foods are certainly fine for your beginning eater, but if the stool is getting thick, there are better choices for first foods.
Some organic formulas seem to bind up my patients, so keep an eye on that. 
With the addition of new foods, the poops can be quite fascinating. Different colored foods can give you a rainbow of different poop shades. My daughter Alana once unbeknownst to me ate a pint of blueberries and had a bright blue load in her diaper that caught me by surprise to say the least. Anything with red color can stain it red. Beets are the obvious culprits, but watermelon can least to an interesting shade.
Bananas can cause little brown thread-like substances to be in there; imagine a piece of banana cake. When I get the frantic “there are little brown worms in my babies poop” call, the first question is whether or not they had bananas.
Most babies start the solid food journey with pureed food. As soon as they are able, I like to do a combination of feeding styles and introduce some “Baby led weaning”. With this method, babies can simply pick up soft pieces of food and feed themselves.  Once they start eating little pieces be prepared to see some of those same pieces pass through without being digested. This is normal.
Constipated kids are really miserable. Please be proactive with diet, fluids and fiber and make sure it doesn't happen on your watch. If you know there is a bunch of hard stool in there, all the prunes in the world aren't going to help you. You may need to go in from the bottom and help get the plug out (see the earlier postregarding the glycerin options.) Once the hard piece comes out, focus on finding your balance with fluids and solids so that you aren't dependent on a suppository; I have no problem with occasional use.
If you ever see blood in the stool at this age, it can be caused by poop at either end of the consistency spectrum. A very hard stool can cause a little tear near the anus. Lots of diarrhea can cause irritation that can bleed. If you are seeing blood with no obvious cause, or very mucousy stools, check in with your doctor.

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