Meconium: Baby’s First Poop

January 29, 2023

There are a lot of things new parents are surprised by in the first days and weeks of parenthood. Baby’s first poop, called meconium, is one of them. Meconium is unlike any poop you’ve ever seen and can be quite surprising if you’re not prepared for it.

What is meconium?

Your baby’s first stools should be thick, black, sticky deposits called meconium. While it’s a far cry from the “poop” that will follow, and sometimes a challenge to clean off of your baby’s delicate skin, meconium’s role in clearing bilirubin makes it a welcome sign for your baby’s well-being.

It’s thought that meconium is sterile (unlike other baby poo, which is colonized by colostrum and breastmilk), which is why this first poo doesn’t have any smell.

For the last couple of months, your baby has been swallowing amniotic fluid in preparation for breastfeeding. This is an intestinal secretion we call meconium. Meconium is made up of bile salts, bile acids, lanugo, and other debris, and starts forming at 16 weeks gestation.

Does every baby make meconium?

Yes, yes they do!!! Meconium is a placeholder, keeping the large intestine open during growth in the womb.

What does meconium look like?

Meconium is thick and sticky. It resembles tar or sludge. Meconium is blackish-green. Unlike normal poop, meconium doesn’t smell.

Don’t worry, after a few days, your baby’s poop will start to change color.

  • In breastfed babies, it changes into a dark green stool, and then resembles mustard with a seedy appearance.
  • Formula-fed babies have tarry black, then green, then more of a pasty, tan-colored stool.

Why does the poop color change?

Once air enters the GI tract, the bacteria E. coli colonizes the bowel, making stool become brownish-yellow and smelly. ?

Any color of poop that resembles an earth tone is considered healthy and normal. This includes the colors yellow, green, brown, and anything in between.

However, if your baby’s poop is white, red, or black, talk to your baby’s doctor. White poop is a sign that your baby’s liver is not working correctly. Red poop indicates the presence of fresh blood — your baby’s or yours if your nipples are bleeding. Black poop indicates the presence of old blood since blood turns black with age.

When does the meconium pass?

Black meconium passes within the first 24 hours after birth for 99% of healthy full-term babies.

Sometimes the passage of meconium takes up to 48–72 hours before it changes to dark green, and then yellow as mentioned above.

Premature babies take longer to pass meconium, with 32% on average taking longer than 48 hours to pass meconium.

If meconium isn’t passed in this time frame, baby may experience jaundice. Jaundice affects nearly all infants, but some babies get a particularly severe case that may need to be treated.

To help baby pass her meconium as soon as possible (and avoid jaundice), be sure to begin skin-to-skin contact and nursing as soon as possible after birth. The more baby nurses, the faster the meconium will pass.

What if the meconium doesn’t pass?

If it’s been 48 hours and the meconium hasn’t passed, call your pediatrician. It could mean that baby is suffering from a bowel obstruction.

Keep in mind that babies born before their due date typically take longer to pass meconium, so there may not be a reason for concern yet. Watch out for poor feeding, vomiting, and/or diarrhea, which could indicate a systemic infection.

Meconium plug

Meconium plug (not to be confused with mucus plug) is where the meconium is plugging part of the colon instead of the lower ileus. It occurs in 1 in 500 to 1 in 1,000 live births.

If your baby hasn’t passed meconium in 24–36 hours and is experiencing abdominal distention, refusal to eat, and vomiting with green bile, then she/he should be checked for a meconium plug.

It may also be caused by an abnormally small left colon, which is more common in mamas who have diabetes or gestational diabetes. Thankfully, the small colon will develop normally after the initial blockage is removed.

Tips on dealing with meconium

Meconium is surprisingly sticky. Here are some tips for dealing with this new-to-you kind of poop.

  • Many midwives swear by olive oil for easy meconium cleanup. If meconium is stuck to baby’s skin, use olive oil to wipe it off. You can even apply olive oil or vaseline on before the first poop for easy cleanup (of course, it’s OK to just snuggle with your new little one too).
  • Most new parents decide to not use cloth diapers for the first few days to avoid dealing with trying to wash away sticky meconium. 

Final thoughts on meconium

Meconium is your baby’s first poop. It might look alarming, but it’s normal for it to be dark, thick, and sticky. Your baby should pass meconium within 48 hours of birth, but may not be because of an obstruction or complication. Meconium may cause stains on clothing, but can usually be treated with natural stain removers. Just think of this as your introduction to the weird and crazy things that happen in parenthood!?