Latest / Baby's First 100 Days with Dr. Roma Franzia / The #1 Trick That ACTUALLY Helps Your Newborn Poop (Pediatrician’s Hot Take)

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The #1 Trick That ACTUALLY Helps Your Newborn Poop (Pediatrician’s Hot Take) · Baby's First 100 Days with Dr. Roma Franzia

• 0:00
  SPEAKER_00: If your newborn is grunting, turning red, pulling their legs up, and pushing like they're trying to move a bowling ball out, do not automatically assume they are constipated.
• 0:12
  SPEAKER_00: Once you understand that they are actually struggling with, there is a very simple little trick I use when a baby has gone too long without pooping or is clearly miserable trying to.
• 0:27
  SPEAKER_00: I'm Dr.
• 0:28
  SPEAKER_00: Roma Francia.
• 0:29
  SPEAKER_00: I've cared for tens of thousands of newborns over more than 30 years.
• 0:35
  SPEAKER_00: And this is one of those things that makes first-time parents absolutely crazy because the baby can look like they are working so hard to poop.
• 0:47
  SPEAKER_00: But before I show you what I do, you need to understand why all that straining can happen even when there is nothing hard or stuck.
• 0:58
  SPEAKER_00: Why newborns look like they are trying so hard.
• 1:04
  SPEAKER_00: Newborn pooping is not elegant.
• 1:06
  SPEAKER_00: You have this beautiful little baby lying there, and suddenly the face turns red, the knees come up, they start grunting, they push, they pass some gas, maybe they cry, and you're standing there thinking, this poor child cannot poop.
• 1:26
  SPEAKER_00: And then finally the bowel movement comes out and it is soft.
• 1:31
  SPEAKER_00: So what happened?
• 1:33
  SPEAKER_00: Your baby is learning something you and I have been doing for so long that we never think about it anymore.
• 1:41
  SPEAKER_00: To have a bowel movement, you have to push from above while relaxing the muscles below.
• 1:49
  SPEAKER_00: Newborns are not very coordinated yet, so sometimes they push and tighten everything at the same time.
• 1:57
  SPEAKER_00: Then nothing happens, so they push harder, get redder, grunt louder, and now everybody in the house is staring at the diaper, waiting for something to happen.
• 2:10
  SPEAKER_00: If you did all of that every time you went to the bathroom, somebody would probably take you to the emergency room.
• 2:18
  SPEAKER_00: But for a newborn, this can simply be part of learning the mechanics.
• 2:24
  SPEAKER_00: This is why I care a lot about what the poop looks like when it finally comes out.
• 2:29
  SPEAKER_00: Because dramatic straining before a soft bowel movement tells me something very different from a baby repeatedly passing hard stools that look like little balls.
• 2:42
  SPEAKER_00: And before we talk about helping them, there is another question parents always ask how often should a newborn poop?
• 2:51
  SPEAKER_00: There is a pretty wide range here.
• 2:54
  SPEAKER_00: Some newborns poop almost after every feed, which makes you feel like your whole life is milk and diapers.
• 3:03
  SPEAKER_00: Other babies may only have one bowel movement a day, and the stools change a lot in those first days.
• 3:10
  SPEAKER_00: You start with that sticky, concentrated blackish green meconium, and then you may see yellow, green, tan, brown, basically every color under the rainbow except red for blood.
• 3:25
  SPEAKER_00: A breastfed baby often has that mustard yellow, loose, almost seed-looking stool.
• 3:31
  SPEAKER_00: So I do not want you deciding your baby is constipated simply because someone else's poop six times a day and yours poops once a day.
• 3:42
  SPEAKER_00: I want to know when your baby last pooped, what it looked like and when it came out, and whether this baby is simply making a lot of noise or is actually distressed.
• 3:55
  SPEAKER_00: Because that is where I start deciding whether I leave it alone or give the baby a little help when I actually step in.
• 4:04
  SPEAKER_00: If the baby grunts and turns red for a few minutes and then passes a nice soft bowel movement, wonderful.
• 4:12
  SPEAKER_00: That baby is practicing.
• 4:14
  SPEAKER_00: I do not need to fix that.
• 4:16
  SPEAKER_00: But if your newborn has gone 12 to 24 hours without pooping, or they are really distressed and straining with nothing happening, now I start thinking about whether that little anal muscle sphincter simply needs some help relaxing.
• 4:35
  SPEAKER_00: And this is where I use something my practice know very well.
• 4:39
  SPEAKER_00: I call it Dr.
• 4:40
  SPEAKER_00: Roma's Q-tip trick.
• 4:42
  SPEAKER_00: Now I know what you are thinking.
• 4:44
  SPEAKER_00: The first time I explain this to parents, I usually get a look.
• 4:48
  SPEAKER_00: So before you decide I have completely lost my mind, let me explain what I am actually trying to do.
• 4:56
  SPEAKER_00: Why the Q-tip can help.
• 4:58
  SPEAKER_00: Remember the problem, the baby knows how to push.
• 5:02
  SPEAKER_00: What they may not know how to do is relax the little anal sphincter muscle at exactly the same time.
• 5:11
  SPEAKER_00: So I'm not trying to dig anything out with the Q-tip.
• 5:15
  SPEAKER_00: I am not trying to pull poop out.
• 5:18
  SPEAKER_00: I am simply trying to get the little anal sphincter muscle to relax long enough for the baby to finish the job.
• 5:26
  SPEAKER_00: And sometimes that tiny bit of stimulation is enough.
• 5:30
  SPEAKER_00: Once you understand the mechanism, the technique makes a lot more sense.
• 5:35
  SPEAKER_00: If you imagine there is some giant hard poop stuck in there, a Q tip sounds ridiculous.
• 5:42
  SPEAKER_00: But if the problem is the baby is pushing against a muscle, they have not learned to relax yet.
• 5:50
  SPEAKER_00: Now you understand what I'm trying to accomplish.
• 5:54
  SPEAKER_00: If you are a new parent and these kinds of little practical newborn things are useful to you, please subscribe.
• 6:02
  SPEAKER_00: It's free.
• 6:04
  SPEAKER_00: I'm going to keep sharing the same things I teach families in my practice because babies do a lot of things that look like a big problem when sometimes they just need a little help figuring out how their brand new body works.
• 6:18
  SPEAKER_00: Now, let me show you how I actually do this because the details matter.
• 6:23
  SPEAKER_00: Dr.
• 6:24
  SPEAKER_00: Roma's Q-tip trick.
• 6:26
  SPEAKER_00: I like to do this before feeding.
• 6:28
  SPEAKER_00: I take a Q-tip, I put Vaseline at the end or a lubricant, and then I gently insert it into the rectum until I no longer feel resistance, which depends on the baby, maybe up to a half the length of the Q-tip.
• 6:46
  SPEAKER_00: Once it is there, I leave it in for a minute, and I sometimes gently twirl it while I bring the baby's legs up over the stomach.
• 6:57
  SPEAKER_00: And that position helps bear down while the stimulation helps little muscles relax.
• 7:05
  SPEAKER_00: And very often you will see exactly what I'm talking about.
• 7:08
  SPEAKER_00: The baby pushes, the q-tip comes out, and the poop follows.
• 7:13
  SPEAKER_00: Parents look at me like I just performed a magic trick.
• 7:17
  SPEAKER_00: It is not magic.
• 7:19
  SPEAKER_00: We just help the baby coordinate two things their little nervous system is still learning to do together.
• 7:26
  SPEAKER_00: What if nothing happens?
• 7:28
  SPEAKER_00: Now, I do not want you turning this into a wrestling match with your newborn.
• 7:35
  SPEAKER_00: If you try the Q-tip and nothing happens, take it out, stop.
• 7:39
  SPEAKER_00: You can try again before the next feed.
• 7:43
  SPEAKER_00: The whole idea is to encourage the baby, not force it.
• 7:48
  SPEAKER_00: If that still does not work and the baby is clearly distressed, my next step is an over-the-counter glycerin suppository.
• 7:57
  SPEAKER_00: And if that does not produce a bowel movement within an hour, then I want you to call your pediatrician.
• 8:05
  SPEAKER_00: So there is a sequence here.
• 8:07
  SPEAKER_00: We do not jump from my baby grunted to something is terribly wrong.
• 8:13
  SPEAKER_00: But we also do not keep going home tricks indefinitely when the baby is miserable and nothing is moving.
• 8:22
  SPEAKER_00: That is the judgment piece I want you to understand.
• 8:25
  SPEAKER_00: So what is it actually constipation?
• 8:28
  SPEAKER_00: For me, the word constipation becomes much more useful when we start talking about what is actually coming out, not just how dramatic the baby looks beforehand.
• 8:40
  SPEAKER_00: If your baby finally poops and it is soft, that tells me the stool itself was able to move.
• 8:47
  SPEAKER_00: The baby may have struggled with the coordination of the muscle, the anal sphincter, but that is different from repeatedly passing hard stools shaped in little balls, or having a baby who remains distressed and simply cannot have a bowel movement.
• 9:04
  SPEAKER_00: And if you are not sure what you are seeing, save the diaper.
• 9:09
  SPEAKER_00: Seriously.
• 9:10
  SPEAKER_00: Parents sometimes think I'm kidding when I say that, but bring me the diaper or take a picture.
• 9:17
  SPEAKER_00: Show me what you are seeing.
• 9:19
  SPEAKER_00: That tells me much more than saying my baby seems constipated.
• 9:25
  SPEAKER_00: Because you and I may mean two completely different things by that word.
• 9:31
  SPEAKER_00: The more specific you can be, the easier it is for me to help you decide what the baby actually needs.
• 9:39
  SPEAKER_00: The big mistake is treating the face instead of the baby.
• 9:43
  SPEAKER_00: This is where newborns fool people.
• 9:46
  SPEAKER_00: They are dramatic little creatures.
• 9:49
  SPEAKER_00: They grunt, they turn red, they pull their legs up, they pass gas, they cry, and sometimes five minutes later they have a perfectly soft poop and fall asleep like nothing ever happened.
• 10:02
  SPEAKER_00: So I do not want you treating the red face by itself.
• 10:06
  SPEAKER_00: I want you looking at the whole picture.
• 10:09
  SPEAKER_00: Did the baby actually go a long time without pooping?
• 10:14
  SPEAKER_00: Was the stool hard when it came out?
• 10:18
  SPEAKER_00: Are they still distressed afterwards?
• 10:21
  SPEAKER_00: Or are you simply watching a newborn learn how to coordinate a bowel movement?
• 10:27
  SPEAKER_00: Once you start thinking that way, you stop feeling like every grunt needs an intervention.
• 10:33
  SPEAKER_00: The simple way to remember this, so the next time your newborn starts straining, turning red, and looking like pooping is the hardest job they have ever had, do not judge the problem by how dramatic the baby looks.
• 10:47
  SPEAKER_00: Wait and look at the bowel movement.
• 10:50
  SPEAKER_00: If the stool is soft and the baby settles afterwards, give them a little room to learn.
• 10:57
  SPEAKER_00: If they have gone 12 to 24 hours without pooping or they are clearly distressed and nothing is happening, that is when I consider using my Q-tup trick to help that little analsphinctor muscle relax.
• 11:13
  SPEAKER_00: And if the baby still cannot get things moving after that, you move to the next step rather than repeating the same thing over and over.
• 11:23
  SPEAKER_00: That is really the whole decision.
• 11:25
  SPEAKER_00: The thing I want you to take away is that straining does not automatically mean constipation.
• 11:35
  SPEAKER_00: Sometimes your newborn is simply trying to learn how to push and relax at the same time, and they are not very good at that yet.
• 11:44
  SPEAKER_00: They have only been here a few weeks, but when that baby has gone too long without pooping, or they are clearly uncomfortable and cannot get things moving, that is when I give them a little help.
• 11:58
  SPEAKER_00: And knowing when to help at home and when to call the doctor is one of the hardest parts of having a newborn.
• 12:06
  SPEAKER_00: So watch my video next on the five newborn symptoms I never want parents to ignore because I'll show you the difference between the weird things newborns do all the time and the signs that make me want you to call.