Stooling and Digestion

  • Parents pay particular attention to their infant's stooling. When they have concerns about the frequency, consistency, or color, they often don’t hesitate to consult you.

    Stooling and the Concerned Parent

    Parents may become concerned after having noticed a delay in defecation, or they may become concerned when they see their infant working hard to pass stool.

    According to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidelines, most cases of stooling concerns are functional and are not caused by underlying medical issues. The guidelines define true constipation as1:

    • A delay or difficulty in defecation
    • Present for 2 or more weeks

    Of course, parents often consult a physician before 2 weeks have passed, and infants often strain when passing stool because their abdominal muscles aren’t yet fully developed.

    When true constipation is present, however, NASPGHAN guidelines caution that evaluation of infants should follow these steps1:

    • History, physical exam, occult blood (if indicated)
    • Delayed passage of meconium or other red flags* present, test for Hirschsprung disease
    • If Hirschsprung disease ruled out, perform sweat test for cystic fibrosis
    • If either Hirschsprung disease, cystic fibrosis, or other serious disease is present, refer to a specialist
    • If the infant is breastfed, >2 weeks old, growing and breastfeeding normally, and there is no serious disease and no signs or symptoms of obstruction or enterocolitis, follow up closely
    • If the infant is formula fed, and there is no sign of serious disease, treat for functional constipation

    * Fever, vomiting, bloody diarrhea, failure to thrive, anal stenosis, tight empty rectum, impaction, distension

  • For your convenience, you can download and review the Parents Guide to Stool with them.

    Easing Parents’ Concerns About Stool Color and Consistency

    When parents have concerns about stool color and consistency, it can be helpful to have a visual tool to help them understand what normal stool might look like.

    For your convenience, you can download and review the Parents Guide to Stool with them.

    • Includes what to expect at different stages during the first year and when to contact you
    • Differentiates between stool color/consistency in breast-fed and formula-fed infants
  • Stool Parent Educator PDF

    Are parents asking about pooping difficulties or occasional constipation?

    Help transform parental concern into a positive conversation about comfortable stooling.

    Download the Stool Parent Educator or ask your Mead Johnson sales representatvis for copies.

  • Reference: 1. Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2006;43:e1-e13.