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Is my breastfed baby constipated? Does he need a laxative? He is three months old and has bowel movements only every three days.

While the amount and frequency of a breastfed baby's wet diapers and bowel movements can be a valuable indicator of his well-being, there is a wide range of normal in infant stooling patterns.

The First Few Days of Life

In the first two or three days of life, it would be typical for a baby to wet only one or two diapers per day. As the mother's milk increases, his urine output will increase markedly. Newborns in the first few days after birth will pass dark, tarry stools called meconium, the substance he has stored since before birth. As the baby receives milk, it clears the meconium out of the intestinal tract, so that within a few days the stools will become softer and much lighter in color. The stools are normally yellow, yellow-green or tan. It's not abnormal for an occasional stool to be green. The odor should be mild, and not particularly unpleasant. The consistency may be described as being similar to scrambled eggs, custard, pea soup, or even prepared mustard. There are often small, seedy-looking solid particles in the stool.

The First Six Weeks

Most babies, after the first few days, have two to five bowel movements every 24 hours, until they are about six weeks old. The stools should be as large as a US quarter to "count" in this number. Some babies will have more frequent bowel movements, and it is possible for a healthy baby to have fewer bowel movements. If a baby younger than six weeks has fewer than two bowel movements a day, that can still be a variation of normal provided that the baby has an adequate number of wet diapers, is known to be gaining weight at an adequate rate, and the stools produced are substantial in volume.

After the first few days, a breastfed baby should have at least six to eight wet cloth diapers, or five to six disposables, in 24 hours. To gauge the wetness, pour 2-4 tablespoons (30-60 ml) of water on a dry diaper. This is how the normally wet diaper of a young baby feels. It is easier to judge wetness in cloth diapers. If you are using disposables, know that there is a wide variation in brands and types. One brand may not "feel wet" while another may feel soaked with the same amount of fluid. It may be helpful to place a facial tissue inside the diaper to help judge wetness.

After Six Weeks

It is normal for the bowel movements of a breastfed to decrease in frequency when the colostrum, which has laxative properties, is completely gone from the mother's milk after about six weeks of age. A baby this age may continue to have bowel movements as frequently as five times a day, sometimes even after every nursing. It is also normal for a breastfed baby older than six weeks to have only one bowel movement every few days. Some healthy babies will have only one bowel movement a week. When bowel movements are less frequent, they should be more profuse in volume. As long as the baby is gaining well, wetting sufficiently, and is happy and content there is no cause to be alarmed by infrequent bowel movements, and it is not necessary to give the baby a laxative, fruit juice, or any other "helpers." In fact, attempting to force bowel movements can have harmful consequences to your baby.

After the baby is about six weeks old, he may wet only five to six cloth diapers per day, but if so these diapers will be much wetter. As the baby's bladder grows, he can produce and hold more urine at a time. To judge wetness of a diaper for an older baby, pour 8 tablespoons (120 ml) onto a dry diaper. That would be considered a normally wet diaper.

After Solid Foods

Once solid foods or other liquids are introduced to your breastfed baby, there will be many changes in his elimination patterns. The stools will have a stronger odor and different color and consistency. It is normal to find bits of vegetables in the diaper, as even cooked vegetables are harder to digest than many other foods. Now it is indeed possible for your baby to experience constipation and even diarrhea, which are good clues that he is not tolerating a new food or juice. For more information, see our FAQ on starting solids.

Recommended Reading: Our resource page on Stooling (Bowel Movements).

Our FAQs present information from La Leche League International on topics of interest to parents of breastfed children. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature and not intended to be advice, medical or otherwise. If you have a serious breastfeeding problem or concern, you are strongly encouraged to talk directly to a La Leche League Leader. Please consult health care professionals on any medical issue, as La Leche League Leaders are not medical practitioners.

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