The First Poop
Your baby’s first poop is called meconium. It begins within 12 hours of birth and will be black or greenish, and very sticky.

The First Month
Up until your baby is a month old, if you are breastfeeding her poop will likely be a mustard color, seedy and runny. Oh, and you can expect a lot of it!

If she is formula fed, her poop will likely be firmer, but not any firmer than peanut butter.

Beyond One Month
After the first month, she may have fewer bowel movements (3-4 times per day), but this is nothing to worry about! A little grunting is normal as well. You may see a variety of colors, some are perfectly normal while others should be red flags and reasons to phone the doc:

Brown: Perfectly Normal

Green: Usually nothing to worry about, more common if you have a lot of iron in your diet or are using an iron-fortified formula

Orange or Yellow: Also nothing to worry about, these colors are most common once you start introducing baby foods like those colorful strained carrots

White: Call the doctor, the chalky color indicates there may be no bile from the liver to digest the food, which needs to be addressed right away

Black: Consult the doctor, tarry black poop may be a sign of blood in the digestive tract that has turned dark black while moving down the intestines. Bloody stool can signal a variety of allergic/gastrointestinal conditions, including infant reflux and milk protein allergy.

Red: Reddish poop could come from a colorful last meal if you’ve just started baby food (think beets). But if you see bright red blood in the poop, call the doctor right away. That is a sign of bleeding around the anus, which is very painful for the baby and can be a sign of an allergic/gastrointestinal condition, such as reflux or milk protein allergy. If this is the case, you might be seeing other symptoms as well (like a very cranky baby), which you can check out here.

Also, don’t forget about the texture. Mucasy stool is reason to call the doc and diarrhea too, if it is persistent. The diarrhea can be a tough one because baby poop is soft, especially in a breastfed child. But, if it is runnier than normal and happens 2-4 times a day for more than 5 days, it’s something to bring up with the doc.

We would like to thank Jodie DiMisa for guest blogging for us and sharing her family’s allergy story.

I’m a mother of 3, which keeps me busy enough. But to have a son with milk and soy allergies and severe reflux, life became crazy.

My son Sam was born early and spent extra time at the hospital. It was very hard to come home without my son but I knew he was in the best place to remain safe and become healthy. When the day came to bring him home, it was very exciting buy also a little scary. He came home with a visiting home nurse who could monitor him on a regular basis to make sure he continued to thrive. Shortly after he came home the signs of allergies and reflux started to show. He was cranky and cried all the time, losing weight, a stool after every bottle, spiting up all the time and more. Then he was labeled “failure to thrive.” I sat at the doctor’s office and cried. No parent wants there child to suffer and not be able to eat. Unfortunately, I was no stranger to these symptoms. My first child Patrick also had allergies and severe reflux.

My pediatrician Dr. Liu was wonderful and knew I had the experience of knowing what to look for. I took several samples of Sam’s stools to the doctor and they were full of blood. His intestines were bleeding out and his stomach was a mess. With the positive stools samples, we immediately changed his formula to Neocate. The amino acid based formula is what he needed. Within a short period of time, he started gaining weight back and the bloody stools stopped. As a parent you vow to do anything and everything for your child, so when you’re told your child has a medical issue causing you to have to purchase an expensive formula to eat and survive, you find a way to buy it.

When my oldest son was diagnosed with these same issues, I fought hard with the insurance company. Appeal after appeal, writing letters, phone calls, going in front of a board of doctors and nurses, just to be turned down time and time again. They said since it was formula and that was a means of food, it was a nutritional issue and not a medical issue, therefore not covered by insurance. I felt so defeated and very alone.

When Sam came along I started my fight all over again. Even though he was my 3rd child and I had experience dealing with these problems, it was still exhausting and mentally draining. You feel like you’re the only one out there with a child that is not the “text book baby”. The questions of “why me?” played in my mind over and over again.

I ended up having to quit my job to take care of Sam. He was such a demanding baby and not happy 24 hours a day. Between the medication schedule and his medical issues, my daycare provider just couldn’t handle him. We then became a one income family with 3 children and the expense was overwhelming.

When I was informed the Governor Martin O’Malley (D) signed into law that insurance companies now have to provide benefits for families of children like mine and many other families for medically necessary formula in Maryland, tears came to my eyes. This is such wonderful news and parents of these children will now have the help they so desperately need and deserve. I encourage every parent to be in contact with their insurance company to find out about the benefits you’re entitled to.

Sam will be turning 1 in November and hopefully by then will have out grown his allergies and reflux. I may not benefit much from the new law, but it warms my heart that other parents like me with these children will no longer have to fight the battle with insurance companies so they can feed there kids.

Remember, many parents are in your same position and you’re not alone. Just look down at your son or daughter and the smile will make it all worth it.

- Jodie DiMisa

Hello!

My name is Christine Graham-Garo, and I am the newest addition to the Baby Health blog. I’m a nutrition specialist and I work with Sarah and Steven here at Nutricia North America.

A little about me – I grew up in Miami and received my Bachelor of Science degree in dietetics and nutrition from Florida International University. Since then, I’ve worked in hospitals in Florida and in North Dakota (hubby was stationed there for the military). Just recently, the hubs and I settled into a cozy little place in Northern Virginia and I joined the nutrition team at Nutricia North America.

I am very excited to begin this blogging adventure and the time couldn’t be better – starting something new as summer winds down always makes me think of the excitement of back-to-school when I was growing up.

I know it’s hard to believe it’s that time of the year again, but traffic is beginning to pick up and the big yellow buses will soon fill the streets. It’s a busy time for any parent, but when your child has allergies, it can be more stressful than most. Anything from craft projects to birthday parties may cause concern!

Here are a few suggestions to help your child start the school year off right and to ease your mind as an allergy parent!

• Meet the Teacher
  Meet with your child’s teacher before the beginning of every school year – especially if he or she is new, but don’t forget the familiar faces as they’ll likely benefit from a refresher on your child’s condition. Make sure the teacher understands the condition and emergency procedures and ask about any activities or lessons he or she has planned that involve food. Offer to help find alternatives that everyone can enjoy (i.e. plastic beads instead of candies for counting exercises).
• Plan Ahead for Lunch
  If your child relies on formula like Neocate, make arrangements with the school to allow him or her to either spend lunchtime doing a quiet activity with the school nurse or secretary, or to bring a coloring/activity book in the lunchroom in place of food. If your little one is allergic to peanuts, talk to the school about a peanut-free lunch table.
• Talk to the other Parents
  Developing a good relationship with the other parents – especially those who help out around school – will go a long way. Explain your child’s condition and ask them to notify you when they bring in birthday treats so you can provide an allergen-free treat for your child or, if your child is on formula, a non-food treat like stickers or something to color.
• Introduce Yourself to the 504 Plan
  Section 504 of the Americans with Disabilities Act ensures that children with special needs get a level playing field from government services like public school. Depending on the details of your child’s food allergy, he or she may qualify for a 504 plan for the school to follow. Check out this entry at Allergy Moms for more.

Along these lines, the American Academy of Allergy, Asthma & Immunology has created a wonderful back-to-school checklist. Click here to see the checklist as well as to download a sample food allergy action plan. The checklists are divided up into three sections: asthma, allergens at school and food allergies at school. This is very helpful for those children with one or multiple allergies.

If you have any questions about me or about going back to school with food allergies, feel free to comment below or email me at babyhealthblog@ecius.net. I’m looking forward to a new year of blogging!

- Christine

We would like to thank Chris Kozimor for guest blogging for us and sharing her family’s allergy story.

Before I became a mother, I had heard all the stories of how hard it is to have a baby and how you don’t get any sleep. So when my daughter, Eva, was born and cried all the time, I thought it was normal.

I actually had friends tell me that they’ve decided not to have children after seeing how awful I looked and how Eva just kept crying and crying! She would only sleep 10 minutes at a time. Everything I fed her just came up and made her unhappy. My sister nicknamed her “the angry red star” because she would turn red and her legs and arms would stick out and she would just scream.

I eventually stopped breastfeeding, thinking that maybe she was just not liking my milk. But still, I was warned that having a baby was challenging and difficult so I just thought I had a normal baby.

Then, Eva started developing a horrible diaper rash that wouldn’t go away, no matter what type of ointment or medicine I put on her. It got to the point that she would scream every time she went to the bathroom (which is frequent for a newborn!). I called the pediatrician who recommended I put Eva on Nutramigen, as well as to try to let her sleep in the car seat to ease her reflux. It was better, but Eva was still not a happy baby and her diaper rash did not go away.

Finally, after months of guilt and worry that I was just not a good mother, I talked to the pediatrician. After being even on Nutramigen, she tested Eva’s stool for blood, which came out positive. We went to a pediatric GI doctor who put her on Neocate. Within a week, her diaper rash completely disappeared and her spitting up improved. She stopped crying all the time and actually started sleeping! The blood in her stool was gone. She was happy and healthy.

I felt like a confident normal mother for the first time in 5 months! And it was so wonderful to enjoy my happy healthy baby.

-Chris Kozimor

When my wife and I were expecting our first child, a lot of questions went through our minds, such as “My God, what have we done!”

Just kidding, we knew from the first kick Vincent would be awesome.

But we did ask ourselves a lot of big questions, including just how many ways are there to manufacture a sippy cup? And how do two people choose one from the entire wall of sippy cups at Babies R Us? What exact temperature should the bath water be? And how many IQ points is the kid going to lose if we paint the nursery the wrong color?

When you find out your baby has a food allergy, there’s a whole new set of questions. And just what exactly do you feed the little guy or gal is at the top of the list.

If you’re a breastfeeding mother, you’ll need to work with your healthcare team to identify everything the baby is allergic to and remove all those foods from your diet. If the baby relies on formula for some or all of his diet, you’ll need to make a formula change. But what do you change to?

Here’s the 411 on the different types of formula and what you should know about them if you’re a food allergy family.

Cow’s milk formula
This is most of the formula you’ll find in the grocery story aisle. It’s based on cow’s milk and fine for most healthy babies. But milk allergy is the most common food allergy among babies. So that milk, which contains full protein chains, is bad news for a food allergy baby.

Soy formula
This formula is based on soy instead of cow’s milk so it is dairy-free, but it is still not recommended for a food allergy baby, since as many as 70% of babies with a milk allergy also have a soy allergy.

Hydrolysate formula
Instead of the full protein chains in cow’s milk formula, hydrolysate formulas have protein chains that are broken into smaller pieces. This makes the formula easier for some food allergy babies to digest, but it doesn’t help everyone.

Amino acid-based formula
This formula doesn’t contain any protein chains at all. Instead it contains the individual amino acids that make up a protein. Essentially, it is baby’s nutrition in its simplest form and the absolute easiest thing for a milk allergy baby (or any baby with gastrointestinal issues) to digest. Using an amino acid-based formula like Neocate typically clears up a milk allergy baby’s gastrointestinal symptoms in 3-5 days and any skin rash associated with the food allergy within 2 weeks.

This is the basic rundown. If you have any further questions, feel free to post a comment below.

Be well,
Dr. Y