stool, poop appearance tells us a lot about health
Yes, let’s talk about poop.  We love to talk about poop!  We understand that most of our patients don’t enjoy talking about it quite as much as we do, [enter eye rolls and bowing of heads]  But poop is oh so important!  This article is mainly applicable to children ages 2 years and above, but stooling in children under 2 is very important as well (just not covered here).

Why is poop so important?

Your child’s (and your) poop is a very good indication of his/her current health status, including fluid intake and diet.  The digestive system is not only responsible for digestion of food, but also the absorption of water and elimination of toxins from the body.  The gut contains 3 trillion microbes (bacteria and yeast) that play a huge role in our immune system and the creation of vitamins, hormones and neurotransmitters that are used all over the body.  That is why we are so interested in your child’s poop!

Other terms you may hear us use for poop – Stool, Bowel Movement.

What is the ideal Poop?

Ideally your child will have one soft bowel movement that is easy to pass daily.  The ideal is type 4 on the diagram below – it may be broken in to smaller parts.  A soft pile of poo – like the soft serve ice cream-like version above is actually normal as well. #3 is approaching constipation, #2 and #1 is constipation and needs to be seen. Multiple stools daily after the age of 2 is not necessarily ideal, so let us know if your child is having multiple small stools daily as this may be a sign of incomplete evacuation of the rectum.  Looser stools may indicate other problems, including infection, but also reduced ability to absorb nutrients.
Each individual is different in their stooling patterns.  Some go in the morning, some in the evening.  Meal often stimulate the desire for a bowel movement, as the body wants to prepare room for the new food about to be digested.  Some people have urges to have a bowel movement upon awakening.  
bristol chart helps identify stooling patterns that may be abnormal

What can I do to facilitate ideal pooping?

  • Normalize POOP! Talk to them about their poop! Teach them to look at their poop every time they go!  Teach them about normal stool patterns and have them tell you when their stool is changing.  Use the choose your poo chart to educate them.
  • Monitor for withholding behavior, signs that your child is avoiding having a bowel movement. This may be a sign that your child is constipated and has pain with passage of bowel movements, which becomes a vicious cycle.
  • Children tend to rush through potty time because they want to go play and do fun things. Encourage your child to sit on the potty, especially after a meal to encourage the passage of stool.
  • Give your child a stool to allow him/her to change the angle of the pelvis and allow stool to pass easier. Consider the Squatty Potty.
FOOD MATTERS!
  • Reduce processed foods. These foods often have very little nutritional value, including fiber.
  • Encourage your child to eat AT LEAST 5 servings of vegetables and fruit daily, preferably fresh or frozen. [But as we discuss in well visits, the healthiest people eat upwards of 9-12 servings of veggies and fruit daily. See the rainbow checklist for kids for ideas of F&V of all colors.
  • Keep peels on foods like apples and peaches, as this increases the fiber and mineral content.
  • Include other high fiber foods in your child’s diet include:
    • Beans
    • Bran
    • Flaxseed
    • Whole grains (if not gluten sensitive)
  • Monitor dairy intake. Dairy can be constipating, especially when consumed in excess. Children ages 2-8 years need no more than 2 cups of milk daily, ages 9-18 years no more than 3 cups daily. If your child eats cheese or yogurt, reduce the milk to approximately 8 ounces.  You can also offer other calcium containing foods to reduce need for dairy.
Other
  • Ensure your child is getting enough WATER. An easy guideline to use is 1 – 8oz cup per year of age (ie. 1 year old drink 1 cup, 4 year olds – 4 cups, etc), up to maximum of 64 ounces for children over age 8 years.
  • Eat probiotic containing foods/beverages (raw sauerkraut, pickles), consider probiotic supplement
We hope this article supports you in understanding bowel movements and their importance, as well as in having conversations with your children about their poop.  Let’s create wellness that lasts a lifetime!