Your Newborn's Digestive System
From Bowel Movements to GERD
By Jennifer Lacey
While your baby was growing inside of your womb, the placenta acted as a lifeline.
After birth, however, your little one is able to feed by sucking and swallowing milk
through the mouth and moving it through the digestive tract.
A newborn's digestive system is made up of an intricate, delicate system of organs
and functions. Nearly all newborns lose some birth weight during the first few days
after delivery. This can be a cause of confusion for parents, who may become
concerned Baby is not taking in enough formula or breast milk despite a steady
feeding schedule. However, just like Mom, Baby will undergo post-delivery fluid loss,
because for nine months, your baby has been on a fluid-only diet.
"Nearly all healthy newborns lose up to 10 percent of their body weight in the first days of life," says Dr. Jay Hochman, pediatric
gastroenterologist and hepatologist at the Children's Center for Digestive Health Care at Atlanta Children's Hospital. Usually by the
time your baby is around 2 weeks old, he will have regained or added to his birth weight.
Curious Finds
Bowel frequency varies from baby to baby. What is normal for some babies is not necessarily standard for others. Some newborns
only make a single bowel movement per day, while others may make as many as 15 during their first few weeks of life.
The color and consistency of bowel movements vary as well. During the first two days after birth, your baby will pass a substance
known as meconium in her stools. "In the womb, all infants swallow amniotic fluid," Dr. Hochman says. "This helps mature their
lungs, as well as the intestines. Meconium is the digested amniotic fluid."
Meconium appears greenish-black in color and sticky in consistency. Once your baby begins regular feedings, meconium gradually
disappears and the stools begin to take on new colors and odors. "When feeding begins, the meconium is replaced by greenishbrown transition stools," says Dr. Alan Sacks, pediatric gastroenterologist with Nemours Children's Clinic in Pensacola, Fla.
Breast Versus Bottle
The bowel movements of breastfed versus bottle-fed newborns are different from each other, varying in consistency, color and odor.
Around the third week after birth, mothers who breastfeed their newborns will notice they are passing stools that appear to be
orange-yellow in tint and have a sweet-sour smell, much like warm milk.
Babies who are exclusively bottle-fed during this same stage of life will pass stools that are pale brown, more solid in texture and
that contain a strong odor. "Until solid foods are started, the stool consistency is usually soft to slightly runny," says Dr. Sacks.
Signs of Digestive System Problems
There are tell-tale signs to look for in your newborn's diaper that might indicate a problem. Mucus and/or blood may be found in the
stool of some infants. According to Dr. Hochman, mucus may be a normal find in the diaper or it may be an indication of
inflammation of the intestines. "Typically, when there is inflammation, diarrhea is also present," he says.
At times, blood found in the stools may be due to a small tear (known as a fissure) near your baby's anus. However, both Dr.
Hochman and Dr. Sacks agree that blood found in the stool may also indicate a serious problem, particularly during the first month
of life. "In the newborn, some of the reasons (for bloody stools) may include swallowed maternal blood, bleeding disorders, infection
or inflammation of the intestines," says Dr. Sacks.
Dr. Hochman and Dr. Sacks say if a parent should find either blood or mucus in an infant's stools, they should contact their
pediatrician immediately.
Digestive Disorders
There are several kinds of conditions or disorders of the digestive tract that can affect your newborn. They include:
Gastroenteritis
Gastroenteritis is caused by an inflammation of the gastrointestinal tract. A common problem in newborns, especially in babies who
suffer from immune suppression or who are enrolled in daycare, symptoms of gastroenteritis include fever, vomiting and diarrhea.
Gastroenteritis is contagious and can be spread through the oral-fecal route. To date, there is no known cure for this condition.
Dehydration is a major side effect. Fluids that may help prevent dehydration include unflavored/flavored oral rehydration solutions,
commonly known under the brand names Pedialyte‚ Infalyte or Kaoelectolyte. However, consult with your pediatrician before you
administer these fluids to your baby.
Gastroesophageal Reflux
When one swallows food, it travels down a path through the esophagus and into the lower esophageal sphincter. In most newborn
babies, this sphincter is immature, making spitting up a common occurrence. Gastroesophageal reflux (GER) usually occurs during
or after a feeding when the stomach contents regurgitate into the esophagus.
"More than half of all babies experience reflux in the first three months of life, and most infants stop spitting up between 12 months
to 18 months of age," Dr. Hochman says. According to Dr. Sacks, GER can be toned down through changes in feeding techniques,
changes in infant positioning, changes in the infant formula or thickening the formula with rice cereal.
Gastroesophageal reflux may develop into a more severe condition called gastroesophageal reflux disease (GERD). Signs and
symptoms of GERD include weight loss, breathing problems, feeding problems and spitting up blood. In these cases, Dr. Sacks
says that acid suppression medications should be prescribed and are usually well tolerated. He says surgery is rarely needed.
Necrotizing Entercolitis
Necrotizing entercolitis (NEC) is an infection of the bowel (intestine) that causes the
lining to swell. This inflammation makes a newborn stop digesting food.
Signs and symptoms to look for include bloody stools, a swollen, firm stomach
(known as abdominal distension), decrease of appetite or acting or looking sick. Risk
factors that may make a newborn more likely to be become infected with NEC
include premature birth, low birth weight, heart problems that present at birth and
exposure to bacteria while in the nursery (due to their immature immune systems).
Intestinal function is measured by how much NEC has damaged the baby's intestinal lining. The more infection and damage found,
the more likelihood of complications. Necrotizing entercolitis is a serious condition, and if left untreated, it may result in severe
complications. Any newborn baby diagnosed with NEC must be treated in a hospital, but the survival and recovery rate for
newborns is good if they are properly diagnosed and treated.
Spittle: The Reason Behind the Extra Laundry To a parent, when a newborn spits up, it may appear to be an entire feeding of
milk. In reality, this seemingly large amount probably only measures a teaspoon. Regurgitation, or “spittle,” is very common during
the first few months of life. Some babies spit up a little, others with almost every feeding.
There are ways to minimize the amount that your baby spits up. If your newborn is crying, delay feeding until he has calmed down.
Keep her in an upright position during feeding times. Most importantly, take a little break during a feeding to burp, then continue and
burp again at the end.