As a pediatrician, it is almost comical the number of calls/queries I receive on the various colours and sizes of a child’s potty. Most new parents are quite bewildered by the sheer number of potties a baby does, which changes from day to day. Trying to decipher whether this is a normal variation or if it is a problem may consume most of your time. But, honestly, there is no point in spending too much time mulling over the contents of your baby’s diaper. Here’s a quick guide to what the poop colours indicate and what they might mean:

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The first potty that the baby passes within 24 hours after birth is called meconium, it’s really dark green to black in colour and has a tarry consistency. It is made up of all the stuff that the baby has swallowed when in utero, such as amniotic fluid, lanugo hair, mucous, bile, and intestinal fluid. If your baby does not pass meconium within 48 hours, your pediatrician may want to run some tests.

In the first few weeks of your baby’s life, in case it’s white or clay coloured or you see blood in the potty, you will need to talk to your pediatrician.

The typical breast milk potty which happens within a few days of birth when breast milk is consumed in good quantities is very yellow and seedy. It can be many times a day and can be after every feed and, sometimes, even during a feed. it tends to be very explosive. Over the next few weeks, it reduces to three or four times a day or even once in three to four days, both are normal.

Babies who are mainly on formula have thicker pasty stools and may pass it only once a day. It is usually more brown in colour, but can be green, too, sometimes.

The next stage when you see a change in colour and consistency is when you start solids. It may be a lighter green and can, sometimes, take the hue of the food eaten. For example, it maybe orange in colour because of carrots eaten at lunch. Sometimes whole bits of partially digested food maybe seen in the potty, like pieces of peas.

Potties of toddlers are more like play doh and tend to be smellier, too.

Sometimes the potty can be quite hard and pellet-like and you may need to increase the fibre and water content in the diet, with more fruits and vegetables that provide roughage.

This causes the most problem for new parents. I have been sent pictures and elaborate descriptions of this offending diaper along with pictures. It is, however, no cause for concern — it is usually due to iron or iron-fortified formula. It does no harm to the baby other than to frighten the mother.

Bright green stools are usually seen in viral gastroenteritis. Sometimes, babies who switch breasts often and don’t empty the breast, get low-fat milk, have light green potty.

Potty colours vary from yellow to green to brown. As long as babies poop every day or have soft potty, you don’t need to worry, breast-fed babies sometimes do potty once in five to seven days. As long as your baby is comfortable, without any abdominal distension, and not irritable, there is no reason to worry.

When do you need to worry about your baby’s potty?

Occasionally, the potty may be red because of the food she has eaten like beetroot, but specks of blood along with hard potty maybe because of constipation. A tummy infection can lead to blood in the stool and also cow’s-milk-protein allergy, in which case you will need to speak to your pediatrician.

If your baby continues to pass pale or chalky-white potty, it can be a serious issue involving the liver, which would require urgent investigation.

Black stools after the first two or three days is a cause of concern as it may because of large amounts of blood in the potty.

If your baby is doing too many loose potties, far more than usual, it may because of a tummy infection or even a food allergy. Too much fruit juice in a day can also give your baby loose motions.

Most gastroenteritis settles without treatment in two to three days, but if it persists, or you see blood in the stool, you will need to speak to your pediatrician. Certain antibiotics given for some other illnesses like a ear infection can cause diarrhea.

If your baby has to strain to pass stool and they appear like pellets, then your baby is constipated. It may be that the intestine is absorbing all the water or there might be a food sensitivity. In either case, you need to speak to your doctor. Rarely, it may be due to a more serious condition such as Hirschsprung’s disease or even a thyroid problem.

Most babies in the first few months will pass soft stools which slowly firm up as they get older. Hard pellet-like stools are not normal and you will need to speak to your doctor about it.

If you have any doubt about your baby’s potty, it is better to speak to your pediatrician. But a word of caution, please — remember to ask if it is okay before you spam her phone with a dozen potty pictures from all angles.

Dr Saroja Balan is consultant neonatologist and pediatrician at Indraprastha Apollo Hospital. Her column appears every fortnight.

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