A newborn baby’s first bowel movement is called meconium. Meconium is a newborn’s first stool, or poop. It is sticky, thick, and dark green or black in color. Meconium starts forming in the baby’s intestines around the 12th week of pregnancy. It is made up of amniotic fluid, mucus, skin cells, and other substances swallowed by the baby while in the womb. Meconium is sterile, meaning it does not contain any bacteria. It accumulates in the baby’s intestines throughout pregnancy and is passed after birth, usually within the first 48 hours. Passing meconium is an important developmental milestone that indicates the baby’s digestive system is working properly.
When Does a Baby Pass Meconium?
Most babies will pass their first meconium stool within the first 24-48 hours after birth. However, some babies may pass meconium in utero before birth during labor and delivery. This can happen if the baby is under stress or has passed their due date. Babies that are born via c-section also tend to pass meconium later, usually within the first 48 hours.
Here is a general timeline for when a newborn will pass their first meconium stool:
During pregnancy
In some cases, the baby may pass meconium in utero before birth. This typically occurs during the labor and delivery process. Reasons this may happen include:
- The baby is post-term or past their due date
- The baby is under stress such as from contractions or cord compression
- The baby has a bowel movement in response to hormone changes before birth
If meconium is passed in utero it can stain the amniotic fluid green or yellow. This is referred to as meconium-stained amniotic fluid and may indicate fetal distress.
During labor and delivery
Some babies will pass meconium as they go through the birthing process. This is very common and happens in about 10-15% of births. Reasons for passing meconium during labor and delivery include:
- Pressure on the abdomen from contractions
- Relaxation of the anal sphincter during delivery
- A response to the stress of labor
As long as the baby is not in distress, meconium passed during labor is considered normal.
Within the first 24 hours after birth
Most healthy babies will pass their first meconium stool within the first 24 hours after birth. This usually happens once breastfeeding has been established or formula feedings begin. Stimulation from nursing helps get the baby’s digestive system moving.
24 to 48 hours after birth
Some babies may not pass meconium until 24-48 hours after birth. This timing is still considered normal, especially for babies born by c-section. As long as the baby is eating regularly and does not appear distressed, there is no cause for concern.
After 48 hours, if the baby still has not had a bowel movement, it is considered a medical concern. The doctor should be notified so they can check for signs of bowel obstruction or other problems.
What Does Meconium Look Like?
Meconium is very distinct in appearance. Here are the typical characteristics of a newborn’s first stools:
- Color: Meconium is very dark green or blackish with a tar-like, sticky consistency.
- Texture: It is very thick, sticky, and paste-like. It can be difficult to wipe off the skin.
- Odor: Meconium has little odor.
- Contents: Meconium contains intestinal epithelial cells, lanugo (the soft hair that covers the baby’s skin in utero), mucus, amniotic fluid, and bile.
The first few meconium stools may still be thick but after a few days, they start to transition to a looser, mustard-yellow color with mild odor as the baby digests breast milk or formula.
Why is Meconium Thick and Sticky?
There are several reasons why meconium has its characteristic thick, tarry appearance:
- Meconium contains shed intestinal cells and skin cells (vernix caseosa) which gives it its thick, sticky consistency.
- It also contains amniotic fluid, bile, and mucus which contributes to its viscosity.
- Unlike later stools, meconium is not made up of foods and liquids that have been digested and absorbed by the baby after birth. This means it still contains concentrated intestinal contents.
- The lack of helpful gut bacteria in a newborn’s intestines also contributes to the thick consistency.
- Meconium sits in the infant’s intestines for months before being passed after birth. This allows more time for mucus and cellular debris to accumulate, concentrating the meconium.
The sticky, tarry nature helps meconium adhere to the intestinal lining when it is passed. This allows meconium to help populate the newborn’s gastrointestinal tract with early gut bacteria.
Is Meconium Normal?
Passing meconium is a completely normal part of development for newborns. Here are some reasons it is considered normal:
- Almost all babies (over 90%) pass meconium within the first 48 hours after birth.
- Meconium is sterile and does not contain dangerous bacteria that could harm the infant.
- Passing meconium shows the baby’s digestive system is maturing and working properly.
- The intestines are able to move meconium out through the rectum appropriately.
- It indicates the baby is receiving adequate feeding and stimulation after birth.
As long as the baby appears healthy otherwise, passes meconium within 48 hours, and the stool does not contain evidence of fetal distress, meconium is considered a normal part of the newborn period. If an infant does not pass meconium or has difficulty defecating, it may indicate a bowel complication that requires medical attention.
Can Meconium Indicate a Problem?
While passing meconium is normal, there are certain situations where it can signify a potential medical problem:
- Meconium staining during labor/delivery – If meconium is passed in utero it can stain the amniotic fluid yellow or green. This is called meconium-stained amniotic fluid and can indicate fetal distress and mean the baby has passed a bowel movement due to stress.
- Thick meconium – Extremely thick, sticky meconium may be harder for the baby to pass and can potentially lead to a bowel obstruction.
- No meconium after 48 hours – If the baby does not pass meconium within the first 48 hours after birth, there may be an obstruction or other delay in the intestines that requires evaluation.
- Difficulty defecating – Babies that appear uncomfortable, strain, or have pain when trying to pass meconium may have a problem such as meconium plug syndrome or cystic fibrosis.
- Abnormal color – While normal meconium is dark green, black, or brownish, red or yellow tinged meconium can indicate a possible intestinal problem.
If the baby’s meconium stools seem abnormal, it is important parents notify the pediatrician right away so the cause can be determined.
How to Handle Meconium Diaper Changes
Since meconium is very sticky and viscous, it requires some special care during diaper changes:
- Use warm water and gentle wipes or damp cloths to clean the skin. Avoid aggressive rubbing which can be abrasive.
- Pay close attention to skin folds and creases where meconium can collect.
- Use barrier creams or petroleum jelly to prevent irritation from the sticky meconium.
- It may require multiple wipes or several cycles of rinsing with warm water to fully remove all the meconium off the skin.
- Make sure to thoroughly clean all residue, since leaving meconium on the skin can increase the risk of rashes or irritation.
- Dispose of used wipes and diapers properly to avoid staining.
- If using cloth diapers, rinse immediately and allow to soak to make cleanup easier.
With some extra time and patience, parents can successfully handle those first black, sticky newborn poops while keeping their baby’s skin healthy. If diaper rash does develop, consult the pediatrician for appropriate diaper creams or ointments to treat it.
When to Call the Doctor
It is important to let the pediatrician know if the baby:
- Does not pass any meconium within 48 hours after birth
- Seems distressed or struggles excessively to pass meconium
- Has bloody or red-tinged meconium
- Goes more than 24 hours without a wet diaper
- Has a fever over 100.4 F (38 C)
- Develops a rash, edema, vomiting, diarrhea, or other signs of illness
These could indicate a blockage, infection, or other complication requiring medical attention. Parents should also watch for signs of dehydration including dry lips and fontanel, dark urine, and excessive sleepiness or fussiness.
How Long Does Passing Meconium Last?
Meconium stools will typically continue for the first 2-4 days after birth. After that, the stools start transitioning to a lighter greenish-brown color with a looser consistency. These later stools are made up of milk or formula contents and are easier for the baby to pass.
Here is a typical timeline for how long the newborn period of meconium stools lasts:
- First 24 hours: Thick, dark meconium
- 2-4 days: Progressively lighter meconium stools
- 5-7 days: Transitional stools that are looser, greenish-brown
- 8+ days: Yellow, seedy, mushy stools
However, each baby goes at their own pace. Some may pass sticky meconium for up to a week before transitioning to the lighter seeded stools. After 2-3 weeks, their stools start resembling the classic infant poop with its distinctive color and odor. Monitoring the baby’s bowel movements can give parents insight into how well the digestive system is maturing.
Tips for Coping With Meconium
Here are some tips to make dealing with those first sticky black newborn poops a little easier:
- Stock up on warm water, wipes, washcloths, diaper cream, and petroleum jelly to handle diaper changes.
- Use disposable or easily washable pads and changing covers.
- Try a nasal aspirator to help suction meconium out of skin folds.
- Let the baby go diaper-free for short periods to air out their skin.
- Change diapers frequently to minimize skin contact with irritating meconium.
- Console baby with pacifier, swaddle, white noise machine, etc. to calm them during changes.
- Involve dad or another helper – it makes those messy newborn diapers easier!
While meconium stools can be challenging, remember this too shall pass! With teamwork and the right supplies, parents can clean up their newborn’s tarry first poops while keeping their baby’s skin healthy.
Conclusion
In summary, a newborn’s first bowel movement is called meconium. It is thick, sticky, and dark green-black in color. Meconium starts accumulating in the infant’s intestines during pregnancy and is sterile. Most babies will pass meconium within the first 48 hours after birth. This indicates the gastrointestinal system is functioning normally. While meconium can sometimes indicate fetal distress, it is generally a normal part of newborn development. With some extra care during diaper changes, parents can handle meconium while keeping their baby comfortable. Consulting the pediatrician if meconium appears abnormal or causes concern is recommended. With time, the baby’s bowel movements will transition to the classic infant poop. Meconium marks a key milestone in the newborn period!