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Last Updated 1/2010
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Stooling
This page discusses the usual pattern of stooling or bowel movements (BMs) for children by age. It also contains some information on Toilet Training.
The advice given here is not individualized for your specific child or situation. Nor is it everything there is to know on these topics! If anything is unclear or confusing, or if you have additional questions or concerns, please call the office or consult your pediatrician.
Newborns (0-2 months of age)
1-6 month old Infants (nursing or formula only; not yet on baby food)
4-7 month old Infants (baby food has been added to their diet)
8-12 month old Infants (finger foods and table foods have been added to their diet)
Toddlers (12-23 months old)
2-3 year olds
4 years old and older
Getting Ready for Toilet Training
Click here for information on Constipation, Diarrhea, and Nutrition, Feeding and Growth
Newborns (0-2 months of age)
Normal Stool:
- For the first few days after birth, newborns usually pass thick dark tarry stools. Once this meconium is cleared, and your newborn is feeding well, s/he will most likely stool with every feeding, sometimes 2 or 3 times per feeding.
- The color is usually mustard yellow or yellow-green.
- The consistency is liquid & curdy to mushy. A normal bowel movement (BM) is always messy, requiring you to wipe your baby’s bottom clean.
- Your newborn may have a mild diaper rash about the anus for the 1 st week or two because newborn stools tend to be acidic and newborn skin is very sensitive. Use water rather than wipes to cleanse, and then coat the skin with diaper ointment to protect.
- By 1 month, stools thicken somewhat and should decrease in frequency (It can be normal to have one BM per week, especially with breast fed infants, as long as that BM is soft and messy).
Straining: Some newborns will strain, grunt, and turn red in the face during their BMs. As long as their BMs are liquid or mushy, not hard, they are not constipated.
Some newborns may strain, yet not be able to pass a BM. They may also cry or be upset. These newborns may actually need some help in learning how to pass a BM. Their involuntary bowel muscles are pushing, but their voluntary anal sphincter is tightening. Moisten or lubricate a rectal thermometer and gently insert it, about an inch, while your baby is straining. This will open the anal sphincter and allow gas or stool to pass. After a few times of doing this, your baby will learn how to have a BM. The rectal thermometer will not hurt your baby – the stool s/he passes is larger and more forceful.
1-6 month old Infants (nursing or formula only; not yet on baby food)
Normal Stool:
- Frequency can vary from 1-4 times per 24 hours to once every week.
- Consistency is liquid with curds to mushy. A normal BM is always messy, requiring you to wipe your baby’s bottom clean.
- Color can vary from mustard yellow to green to brownish.
- Some babies may still strain, grunt or turn red in the face during BMs. This is OK if they are not crying or upset and their BM is not hard. You should not have to use a rectal thermometer at this age.
4-7 month old Infants (baby food has been added to their diet)
Normal Stool:
- As baby foods are added to the diet, stools will become more solid. They will also have varied and stronger odors. Color varies depending on the food: yellowish, greenish, various shades of brown.
- Frequency can vary from 1-3 times per 24 hours to once every 3-5 days depending on how much solid food your baby is fed.
- Consistency is mushy, but more variable depending on what baby is eating.
- Loose stools may result from too much fruit juice, adding new foods to the diet too quickly, too wide a variety of fruits & vegetables, too much of certain fruits or vegetables, or an allergic reaction.
- Loose stools can also occur due to a runny or congested nose from a mild cold or teething.
8-12 month old Infants (finger foods and table foods have been added to their diet)
Normal Stool:
- Baby’s stools can vary in color, consistency, and odor depending on what is eaten.
- Undigested particles of food may occasionally appear in the stool.
- Frequency can vary from 1-3 times per 24 hours to once every 3 days. However, most 8-12 month old babies will have at least one BM per day.
- Loose stools may result from too much fruit juice, adding new foods to the diet too quickly, too wide a variety of fruits & vegetables, too much of certain fruits or vegetables, or an allergic reaction.
- Loose stools can also occur due to a runny or congested nose from a mild cold or teething.
Toddlers (12-23 months old)
Normal Stool:
- Toddler’s stools can vary in color, consistency, and odor depending on what is eaten.
- Undigested particles of food may occasionally appear in the stool.
- Frequency can vary from 1-3 times per 24 hours to once every 3 days. However, most toddlers will have at least one BM per day.
- Loose stools may result from too much fruit juice or too much of certain fruits or vegetables.
- Loose stools can also occur due to a runny or congested nose from a mild cold or teething.
2-3 year olds
Normal Stool:
- Stools can vary in color, consistency, and odor depending on what is eaten. Undigested particles of food may occasionally appear in the stool.
- Most 2-3 year olds will have at least one BM per day. However, frequency can vary from 1-3 times per 24 hours to once every 3 days.
4 years old and older
Normal Stool:
- Stools tend to vary less in color and consistency as a child grows older.
- Most children will have one BM per day. However, frequency can vary from 1-3 times per 24 hours to once every 3 days.
Getting Ready for Toilet Training:
Most children are ready to be toilet trained around their second birthday, with a range of anywhere from 18 months to 2 ½ yrs. Starting too early may put unnecessary pressure on your toddler. S/he may not have the necessary bowel or bladder control, or the motor skills needed to remove clothes quickly and reliably before using the toilet.
Signals that your toddler is ready for toilet training are:
- Bowel movements (BMs) occur on a fairly predictable schedule.
- Diaper is not always wet (indicates that bladder is able to store urine).
- S/he can and will follow instructions.
- S/he shows an interest in imitating other family members or friends in the bathroom.
- Through words, facial expressions, or a change in activity, s/he shows you that s/he knows when his/her bladder is full or when s/he’s about to have a BM.
Even if your toddler is not quite ready, you can install a toddler toilet seat and step stool on your toilet, let him/her sit on the toilet, and explain how it works. Let him/her see mom, dad and siblings use the toilet. When you notice your toddler having a bowel movement, mention it: “You’re going poop. Tell me when you are done so I can change you.” After the diaper change, have him/her help take the diaper to the toilet, dump the bowel movement in, and flush it down. Some toddlers will toilet train, but they need supervision and reminders. Never get angry or punish for accidents. Never force your toddler to sit on a toilet or potty chair.
A 4 year old that won't use the toilet for bowel movements (BMs): The child can urinate in the toilet, but asks for a pull-up every time s/he needs to have a BM. S/he also refuses to use a potty training chair. The child is not constipated and has never passed a hard, painful BM.S/he has a good appetite, regular bowel movements, and is developmentally normal. Your first priority is to keep your child from becoming constipated, so do not withhold pull-ups or diapers. Refusing pull-ups or diapers can lead your child to withhold stool, leading to painful bowel movements, more holding back, and impaction.
Here are recommendations for solving this problem:
- Put your child in charge of solving the problem. Do not even mention poop or potty when s/he is around. Pretend that the potty problem is "boring."
- Dress your child in underwear at the start of every day.
- Make pull-ups available for bowel movements, but put them in a distant room. Increase the inconvenience by insisting that your child get his/her own pull-up if s/he wants to use one.
- Make the potty chair convenient by keeping it in whatever room your child is in.
- Have a footstool at the toilet so that your child's feet are comfortably supported when sitting on the toilet.
- Avoid all reminders to use the toilet, and don't make practice runs to the bathroom or force your child to sit on the potty.
- When your child is soiled, help him/her clean up. If s/he is uncooperative, "ground" him/her until s/he wants to be changed.
- Provide an incentive for releasing a normal-sized bowel movement into the toilet. The best incentives are privileges or food treats, not possessions. Privileges might be an hour of movie time or computer game time, or extra bike time or reading time with Dad. What is your child's favorite activity or toy? Try to "make an offer s/he can't refuse."
- Some strong-willed children may need a disincentive added. A very effective one is to put your child into a video-free world. That means no TV, video, or computer game time until the child learns to use the toilet or potty for bowel movements. Substitute lots of physical affection and parent contact time. For every normal-sized bowel movement the child releases into the toilet, s/he receives two hours access to TV, video, or computers. Otherwise, all TV and video viewing is in a closed room that only poop-trained children have access to.
With simultaneous use of incentive and disincentive programs, the average child responds in one to two weeks, and even the most stubborn, within two months.
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