FAMILY HEALTH + WELLNESS
Tiny Tummy Trouble The scoop on poop and other first-year digestive drama By Malia Jacobson Babies, especially newborns, spend most of their waking hours feeding and pooping. So, it’s understandable that digestive issues are a top concern for new parents, says Uma K. Pisharody, M.D., a specialist in pediatric gastroenterology with Swedish Medical Center. “New babies mostly eat, poop and sleep, so anything that makes them fussier than normal often leads to an assumption that there’s a problem with the baby’s digestion.” Happily, most babies have healthy, functional digestive systems — even those who experience an occasional bout of gas, diarrhea or tummy pain. But because common digestive issues such as spitting up, reflux, diarrhea, gas, constipation and changes in bowel movements top the list of concerns for new parents, they’re well worth clearing up. From the first poop to the first birthday, Dr. Pisharody answers your questions about first-year digestive dramas. What are the top digestive issues you see in babies? The top issues I see and treat in babies are feeding problems, difficulty gaining weight, vomiting, changes in bowel movements, like diarrhea or constipation, and reflux. Conditions like digestive tract birth defects or bowel obstructions are much less common.
issues are present, there could be something going on. Does a breastfeeding parent’s diet create gassiness in her baby? While by-products of some foods that make a mother gassier can also occasionally cause gassiness in her infant, this type of gas typically shouldn’t cause severe pain. The gas produced within a mother’s own digestive tract after she eats certain foods doesn’t get passed through her breast milk to her baby. I tell mothers that it’s wise not to eat too much of any one food, but to eat a varied and healthful diet while breastfeeding.
When it comes to spitting up, what’s normal? How much is too much? There is actually no “normal” or “abnormal” amount of baby spit-up, as each and every baby is different, and it’s best not to compare babies to each other. What I look for first and foremost is whether or not there is any forceful vomiting. Second, does the spit-up contain bile or blood? And third, is the baby gaining weight?
A newborn’s poop is already so watery — how can a parent tell if their baby has diarrhea? When I examine diarrhea in newborns, I am looking specifically for a significant change in frequency of bowel movements more than a change in consistency. If a baby who was having about six watery bowel movements each day suddenly begins having 10 to 15, that’s probably diarrhea and worth a call to your pediatrician.
If a baby spits up dozens of times per day but the spit-up isn’t forceful, doesn’t contain blood or bile, and the baby is happy and growing well, I don’t consider that a problem. On the other hand, a baby could spit up hardly a few times each day, but if those
But with constipation, we look for changes not only in frequency, but also in consistency. A baby should pass the first black, sticky stool, called meconium, within 24 hours of birth. From there, a baby’s bowel continued on page 44
43
