Understanding Baby Digestion
A common concern that pediatricians hear from parents are regarding digestion. Some common concerns include:
“My baby’s stomach gurgles after I feed them.”
“My baby seems to be in pain after I feed them.”
“My baby has diarhea after I feed them.”
“My baby grunts and strains and pushes after I feed them.”
“My newborn is always so gassy, is this normal?”
This is normal. Feeding stimulates a reflex called the gastro-colic reflex, which activates the gastrointestinal (GI) tract (stomach and intestines) to move after feeding, thus propelling food and swallowed air through the GI tract towards the anus.
This is Mother Nature’s way of making sure newborns can do the basics when the come into the world. Pooping and peeing are natural reflexes; they do not need to think about doing it. If your infant had to learn these things before they could have bowel movement or pee, they would be in trouble very quickly.
Feeding your baby may also make the stomach create a gurgling sound. Many parents hear this and think the baby’s tummy sounds upset. You may also notice that the baby draws his legs up, strains, or fusses a bit with a feeding or soon after. All of these behaviors are common reactions to the reflex that is stimulated by feeding him.
When to Be Concerned
Grunting, straining, and a little fussing after a feed is normal. However, if your infant seems to be in significant pain with intense fussing or crying around or after feeding, you should probably run this behavior past your pediatrician just for good measure.
Understanding Pooping
Since the gastro-colic reflex is pretty active at birth and your newborn eats only liquid, you often see very loose stools in newborn babies. To be specific, you feed them liquid, and therefore, they poop liquid.
When parents see liquid stools, they’re often concerned that their newborn has diarrhea. Intuitively, when we see liquid stools, we usually think of diarrhea. However, this is usually not the case in newborn infants.
True diarrhea is a disease process that most commonly will cause weight loss. Although your baby may lose some weight right after birth—some weight loss (up to 10%) is common and expected soon after birth—this is not related to normal loose stools. If you keep your newborn follow-up appointments with your pediatrician, he or she will follow your baby’s weight and make sure that your infant is not losing an inappropriate amount.
The liquid stool phase in early infancy will not last forever. Infant’s intestines will get “smarter” soon after birth and begin to concentrate stool, thus making it more formed. Some of the first signs of this may be the presence of stools that have a texture like small seeds, cottage cheese, or paste. They will appear dark, thick and tarry green (meconium stools) immediately after birth, soon change to liquid green (transitional stools), and ultimately should appear yellow in color.
Interestingly, they will often swing the other direction by the time they’re a month or two old. At this point, the reflex dulls, and infants poop far less frequently. Infants who are formula-fed may only poop once every three or four days. Breast-fed infants may go as long as a week without pooping!
Why is this?
Infants grow 90 miles an hour faster than big kids. To ensure their survival, babies must gain weight more rapidly than they ever will again in their lives. Most babies will double their birth weight by the time that they are four months old. Since they must do this by drinking liquid, they must eat continuously. This is why you will find that your baby is very demanding when it comes to their feeds.
As the baby eats, most of the liquid they consume will be absorbed and used to fuel their growth, with very little waste left over. Since babies are not eating big chunks of food like hamburgers, pizza, and baba ghanoush, they don’t need to go all the time.
Now, if your baby still poops multiple times a day, that’s ok too. Either way, I usually see babies develop a more regular stool elimination pattern after one to two months of age.
When to Be Concerned
If the baby experiences significant pain blood or mucous in the stool, persistent distension of the tummy, either with or without heavy vomiting, especially if the vomit is green, large and very frequent watery stools that seem to be in excess of the amount of liquid that your infant is taking, you should consult your pediatricican.
Understanding Gas
Many parents ask me, “Why is my baby so gassy?”
The short answer to this question is that your baby is built to be gassy. 20% of the gas that your little one produces comes from swallowed food. The majority comes from swallowed air. Babies are a set up to be gassy, just by the nature of what do every day: sucking and crying. Both activities cause an they infant to swallow a lot of air, and that air has to go somewhere.
This air quickly travels through the baby/s digestive system and comes back out in the form of burping and passing gas.
Have you ever wondered why we burp newborn babies and infants, but not two-year-olds? (No? You’ve never asked yourself this question? It must be a pediatrician thing.)
If you think about it, we don’t burp two-year-olds because they don’t spend the majority of their lives sucking and swallowing air while eating, as they did in infancy. They are also much more adept at getting the gas out than a newborn is. Two-year-olds also don’t spend as much time crying as newborns do. Instead, they strategically plan their crying for the most opportune time, such as the cereal aisle at the grocery store.
Many parents also get overly concerned about burping their baby. I see parents who must get that burp out of their baby after each feed, no matter what, or they cannot rest easy.
Trust me, the air will come out of one end or the other all by itself. You don’t need to do a lot to your baby to try to force it to happen. Certainly, burp your baby for a minute or so with each feed, but if you don’t get a burp each and every time, don’t worry about it.
If you have concerns or need advice, talk to your pediatric provider and they will be able to guide you in the right direction.
