The truth about kids’ poo – and what it says about your toddler’s health
Your child's stools will change when he switches from milk to solid food. So what can you expect of the new normal?
Undigested food in the stool, diarrhoea that lasts for days, a strained look on your toddler’s face when he’s on the potty … any of these scenarios are enough to make Mum and Dad worry. And we haven’t even addressed the unusual colours that Junior’s poop might take on (yellow or green poo, folks?).
Parents may be further perplexed when their little one has reached a dietary milestone and is weaning off milk and starting on solid food. His stool will also change according to his new diet. But what is the new normal?
“A newborn baby will pass black meconium soon after birth,” said Dr Ang Ai Tin, a consultant paediatrician and neonatologist with Thomson Medical Centre. “Subsequently, when the baby starts drinking breast milk or formula, the consistency of the stools will be drier, and appear yellow or green.”
The stool colours that raise concerns, said Dr Ang, are pale, clay-like or light yellow. Consult a doctor if that happens and bring along a sample of your child’s stool so that the doctor can make an assessment accordingly, she said.
Another top concern that new parents have is the frequency of their child’s bowel movements. Is the little one supposed to poop every day? It all depends on the stage your child is at, said Dr Ang.
“In older children, it may be once or twice daily, or even on alternate days. More importantly, the stools must not be hard and pellet-like, which is a sign of constipation."
Other than constipation, there are other potty situations that can leave parents perplexed. Here’s a look at some of them.
- The stool floats and appears shiny
It may be time to puree fewer vegetables for your little one. According to Dr Ang, the stool floats because there is too much fibre-induced gas in it. “Cutting down on fibre such as reducing the amount of beans, sprouts, cauliflower and broccoli in your child’s diet would help,” she said. If doing so doesn’t change anything, it could point to gastroenteritis or lactose intolerance, she added, which would need a doctor’s assessment.
On the other hand, stools with an oily sheen are a bigger concern as they could mean malabsorption caused by pancreatic disease, said Dr Ang. “So please see a doctor if the stools are floating and difficult to flush. It implies fat malabsorption and medical evaluation is needed.”
- There’s undigested food in your child’s stool
Undigested food in the stool can suggest that food is passing too quickly through the digestive tract for it to be fully digested, said Dr Lynette Goh, an associate consultant with KK Women’s and Children’s Hospital’s Gastroenterology, Hepatology and Nutrition Service Department.
“This may be accompanied by loose or watery stools and is often referred to as toddler’s diarrhoea, which typically occurs between the ages of one and four years old,” said Dr Goh.
The good news is, toddler’s diarrhoea usually resolves itself by four to five years of age. “It is common and there is no need to seek medical treatment if your child is otherwise well,” she said.
In the meantime, monitor your child’s activity, appetite and weight gain for any changes, and keep him hydrated. “Take your child to a doctor if the stool contains blood or if he is lethargic, eating poorly and/or losing weight,” said Dr Goh.
- The stool is loose and accompanied by lots of gas
Acute gastroenteritis can cause your child to feel bloated and/or have diarrhoea. “This is largely caused by viruses which infect the intestine,” said Dr Goh, who added that other signs to look out for include vomiting, fever and abdominal pain.
“Depending on the cause of the diarrhoea, it may last for two to four days. Occasionally, it may persist for up to two weeks,” she said.
It is a good idea to monitor the little one’s activity and feeding, and keep him hydrated. See a doctor if your child is dehydrated, lethargic, eating poorly and/or has blood in his stools, advised Dr Goh.
- Watery stool is passed a few times a day but your child is otherwise well
Just as some adults have irritable bowel syndrome (IBS), children can have the same condition, too. An intermittent diarrhoea could be a symptom of IBS, according to Dr Goh, especially when there is no fever or vomiting.
“In IBS, the gut is particularly irritable or sensitive, and symptoms can be triggered by specific food or even stress and anxiety,” she said. The child may experience abdominal pain, bloating, constipation and/or diarrhoea.
Sometimes, the diarrhoea could be caused by food intolerance or lactose intolerance, said Dr Ang. “In such instances, probiotics, adequate fluid intake and switching to lactose-free milk may be needed.”
But before such a diagnosis is made, Dr Ang said that “a proper dietary history and food diary in relationship to bowel pattern need to be studied”. Allergy testing or food challenge may be needed, she added.