From the Guidelines
Neonates fed with breast milk have a more variable and less regular bowel movement pattern compared to formula-fed babies, but this is indicative of better digestive health. The most recent and highest quality study, 1, highlights the benefits of human milk for infants, including protection against severe infections and a reduced risk of developing later life metabolic disease. When considering bowel movements, it's essential to note that breastfed babies may have more variable patterns, ranging from after each feeding (up to 8-12 times daily) in the first few weeks to potentially as infrequently as once every 7-10 days as they grow older. This difference occurs because breast milk is more completely digested, leaving less waste product, and contains factors that promote beneficial gut bacteria and enhance intestinal motility, as supported by the study 1. Some key points to consider include:
- Breast milk is more completely digested, resulting in less waste product
- Breast milk contains factors that promote beneficial gut bacteria and enhance intestinal motility
- Formula-fed infants generally have bowel movements 1-4 times daily with a firmer, more formed consistency and a stronger odor
- Breastfed babies may have more variable patterns, but this is normal and indicative of better digestive health Parents should understand that both patterns are normal, and concerns should arise only if the stool is unusually hard, contains blood or mucus, or if the baby shows signs of discomfort, as noted in the study 1. The color also differs, with formula stools typically being tan to brown while breast milk stools are usually yellow to mustard-colored with a seedy texture. Overall, the benefits of breast milk for infants, including its impact on bowel movements, make it the preferred choice for feeding neonates, as endorsed by the World Health Organization and supported by the study 1.
From the Research
Bowel Movements in Neonates
- The frequency and consistency of bowel movements in neonates can vary depending on their diet, with breastfed infants tend to have softer and more frequent stools compared to formula-fed infants 2.
- A study conducted in 17 countries found that infants fed human milk had softer and more frequent stools than those who received a new infant formula or other infant formulas 2.
- However, the same study found that infants fed the new infant formula had softer and more frequent stools than those fed other infant formulas, suggesting that some formulas may be closer to breast milk in terms of gastrointestinal tolerance 2.
- There is no direct comparison between the regularity of bowel movements in neonates fed formula versus breast milk, but it can be inferred that breastfed infants may have more regular bowel movements due to the unique characteristics of breast milk 3, 4, 5.
Factors Influencing Bowel Movements
- The composition of breast milk is highly complex and includes multiple factors that enhance the development of nearly every neonatal organ system, leading to both short- and long-term health benefits 5.
- Infant formula can be improved by adding functional bioactive compounds like probiotics, prebiotics, and human milk oligosaccharides, which can affect the gut microbiota and potentially influence bowel movements 6.
- The processing of infant formula, including thermal and non-thermal technologies, can also impact the nutritional value and gastrointestinal tolerance of the formula 6.