All things poo!

This might not be the episode to listen to while you are eating your breakfast. We’re talking poo. We’re covering texture, colour, smell, frequency - all the questions you ever wanted to ask, but were afraid to ask. And who better to answer those questions than Charlotte Treitl, IBCLC and founder of the Baby Poo Gallery? 

Charlotte and I discuss every aspect of poo from newborn to potty training, via allergies, when to seek medical help, elimination communication and much more.

You can find follow Charlotte on Instagram @themilkrebel or find out more about her here About Us – Breastfeeding Support

The Baby Poo Gallery is on Facebook at https://www.facebook.com/babypoogallery

Find out more about breastfeeding and chest feeding older babies and children in my book Supporting Breastfeeding Past the First Six Months and Beyond: A Guide for Professionals and Parents

Get 10% off my books with the code MMPE10 from 21st December 2023. Find them at https://uk.jkp.com/collections/author-emma-pickett-pid-240164

Follow me on Twitter @MakesMilk and on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com

This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

Transcript

Hi. I'm Emma Pickett, and I'm a lactation consultant from London. When I first started calling myself Makes Milk, that was my superpower at the time, because I was breastfeeding my own two children. And now I'm helping families on their journey. I want your feeding journey to work for you from the very beginning to the very end. And I'm big on making sure parents get support at the end to join me for conversations on how breastfeeding is amazing. And also, sometimes really, really hard. We'll look honestly and openly about that process of making milk. And of course, breastfeeding and chest feeding are a lot more than just making milk. 

Emma Pickett  00:45

Thank you very much for joining me for this episode. As Charlotte just said to me, before I hit the record button, we're going to talk crap for an hour, maybe slightly over an hour, we'll see how we go. I'm really happy to be joined by Charlotte Treitl, who is also from a peer support background originally like me, she's now an IBCLC she wears lots of different hats, you will find her on Instagram as @themilkrebel. She works for Anya health like Shell who I had in a previous podcast episode. She also works for the holistic sleep coach organisation. And we're here today to talk about her work with poo, because she is also the founder of the baby poo gallery on Facebook. And you'll find that link in the show notes. So just the other day a mom messaged me to say, I forgot this obsession with poop in the early days of breastfeeding. And it is so true that when you're a new parent who becomes important in a way you were not expecting and Charlotte very kindly and generously indulges our obsession with baby poo and helps parents to understand what's normal and what to expect and what's not normal. Because it you know, in 2023, many UK parents have never seen baby poo up close until they come to have their own children. And so it's really normal and natural to have some concerns about what we expect. And And when we're worried and we're nervous. And we've got worries about milk supply or milk production often who becomes that focus for those anxieties. So, Charlotte is the pool guru, which nicely rhymes and she's very kindly going to answer some questions today and help dispel some myths. Thanks very much for joining me, Charlotte,

Charlotte Treitl  02:17

Thank you very much for having me. It's great to be here.

Emma Pickett  02:19

Good even though we're going to be talking crap. Okay. So before we start the detail, how did you get into poo Charlotte?

Charlotte Treitl  02:26

So it's a funny story really. Typically, like most parents got pretty fascinated by poo. When I had my eldest, he's eight now. But we had a really tricky time getting going with breastfeeding. And that's, you know, the main sort of reason I got into doing peer support and why I moved into becoming an ibclc, inevitably, but he was mixed fed from a young age as a result of the ongoing problems that we had with his weight and with feeding. And his peers never looked like what I was told to expect as an exclusively breastfed baby, he did lots of very dry green spinach II type pose, because he wasn't transferring milk very well. And so I never really saw that mustard poo that, you know, I'm told to expect from therefore, and even when he was mixed fed, the pools were different. You know, there was there was no real conversation around what to expect with his Sterling patterns or with what his poo would look like. And my mom absolutely loves to tell this story. And it's probably the most memorable poll that either of my children have ever done. And he was, so he was probably about three, three and a half months old, so still quite young, and he was really struggling to poo. And we laid him out on a the changing mat and doing a bit of tummy massage like you do and bicycle legs and just encouraging him and you can do it and waiting for him to pass the stool that it was clearly struggling to get rid of. And my mum was sat next to me, like kneeled on the floor. And she was just horribly fascinated as this caulk because the only way I can describe it this firm cork of poo expunged from him and and you could see the relief on his face when this poo came out of him. But then within seconds just this tsunami of liquid who followed this this really firm was clearly was blocking him. And we both still love to tell that story is you know, whenever we get the opportunity that really stuck with me that I've never really been given any guidance on what to expect for mixed fed poo. And then, you know, equally once he got a bit older and started eating foods, there was no real conversation around it. What to expect in his nappies from there. So it's all been kind of an ongoing learning process. And once I'd worked with more families and you know, skip skip a few years ahead now to kind of the the lockdown times where, you know, during COVID, we weren't able to see parents directly groups were all closed health services were limited or completely unavailable. So those places where parents could go and talk to other parents, and peer supporters or people who were involved in infant feeding and say, Is this normal, I don't know. We're posting more on social media. And it became more of seemed like we had this big influx of people worrying about poo. So I'd done a piece of work with our local infant feeding network on what to expect, and how to monitor the baby's well being at home if you can't get them to be weighed, you know, so thinking about the good signs of feeding and when to, you know, ask for more help. And that kind of became a vital resource for lots of parents locally during lockdown because it was something that we could refer to constantly. And shortly after that, I opened the baby poo gallery, 

Emma Pickett  06:10

you make it sound like you cut a ribbon, I hope the ribbon was mustard coloured.

Charlotte Treitl  06:16

I wished we'd made a little bit more of a fuss about opening it. But it was it began popularity very quickly. And we found that a lot of health visitors and midwives were using it to refer parents as a resource because, you know, I've collected hundreds of images from parents on what is and of course, what isn't normal for a variety of different things. So it's been a long journey. But also, you know, realising that whilst we do talk about poo as professionals, it's it's not something that anybody else was really talking obsessively about. And it's something that I just kind of hyper focused on, and I'm not squeamish about it at all. So here we are. 

Emma Pickett  06:58

Yeah, so I can imagine you've got well beyond your squeamishness, your phone inbox must be for pretty much solid poo. metaphorically and literally. Yeah, so so just a little warning for anyone who is squeamish if you're having your avocado on toast, or you're eating a chicken korma for lunch, or you're eating your porridge. This may not be the moment to listen to this podcast. But let's drill down into some of the sort of details. So you mentioned, you know, by day four, we expect X Y Zed. And I think that's the time when parents do get some information about poo. Yeah, I think we're quite good on saying, you know, what happens in the first week? How would you sort of talk through those first few days when you're talking to a new family?

Charlotte Treitl  07:35

So I think it's, it's, it's great to have an idea of what is normal and what's expected, but also to really clarify with parents that babies are not robots. And you know, we do have a variety of different experiences in those early days of breastfeeding, that could impact how often you baby pose or how long it takes a pillow to transition. But, you know, really, we should, baby should always pass that meconium and the first day, it should be coming out of them and continue to come out of them for the first couple of days. And for me, you know, not passing meconium and it should be for all healthcare providers, that baby hasn't passed meconium that's a really big red flag. And we should be investigating what's going on with that baby immediately. And once that meconium is, you know, it starts to pass because, you know, babies taking colostrum and the system starts to clear out a little bit. And we should then start to see that black tar still, which is that sticky Mykonian which is a bit of a nightmare to clean. Let's let's be honest, even if you're expecting it, it's it's yucky. Once that's started to transition, we would expect the pool to be kind of a greeny colour, maybe a bit brown. And again, there's no hard and fast rule with how green that is or how brown that is. And it's, it's kind of understanding what their range of colours is. So we want it to go from this black to green brown, and it should get lighter and lighter, ultimately, until we've got that thick sauce like yellow mustard, you know, much more plentiful stool, and that usually starts to happen around day three to four. But ultimately, it depends on you know, are you a first time parent? Are you a second or third time parent? Has breastfeeding been going really well for you in those early days? And how quickly has baby been able to increase their milk intake in those early days? You know, sometimes we see post transition, you know, a day or three are already going really yellow. But also it can be delayed. You know, it could be day five or six before we start to see those. Those thick, yellow, saucy pose that we kind of want them to do. We want babies to poo every day multiple times a day. It's, it's really important that they are peering and that the pool is a sub, you know substantial. And like I said, with with my eldest, those sort of green spin itchy, almost dry poos continued for well beyond the first few days, his posts were like that for a good two weeks, without it being kind of flagged as something that we should be alarmed about. So, you know, we we, we talk about mint like minimums of two posts a day or one per day. But actually, with the volumes of milk that babies are taking, we really should see quite a lot of posts. So most babies that are transferring milk, while eating regularly will do lots and lots of posts. And there's no, there's no problem with that. That's, that's okay. And some babies will do pose along the lower end of that scale, maybe two or three, but they're very big poos.

Emma Pickett  10:55

There is a bit of a difference on online about the minimum amount. So this so NHS talks about sort of two pools and 24 hours, and that's what UNICEF Baby Friendly talks about. And then in the CDC and wiki in the USA, they're saying minimum of three pills a day, which sounds like it's a bit more on lines with what you're sort of saying what do you normally say to parents?

Charlotte Treitl  11:13

It's really tricky, because there are obviously different guidelines. I just think from a biological perspective, the the volume of milk that they're consuming, and the you know, the content of milk that has all those indigestible factors, you know, there is waste in breast milk, that's, you know, this myth that there's no waste and it gets absorbed. And that's why the dog poo very often is, is you know, not it is a myth, it's an it's worrying to think that, you know, parents think that babies shouldn't steal a lot, like really regularly. And even for adults, you know, we have a range of what's normal. But from what I can gather from a sort of historical and evolutionary perspective, it doesn't make sense for us to carry out west for long periods of time. And you know, regular schooling is is important. I would like to see babies poo every day. And I know that's not really what we you know, certainly after,

Emma Pickett  12:09

I think, I think, certainly for the first week, and if we're talking about this first week, first few weeks, I don't think anyone would disagree with you on that. I think it's there's a universal view that newborns should be pulling at least twice a day. If not, if not more. Yeah. Yeah. I mean, I think everybody would agree with that. I mean, occasionally, I hear a myth where somebody's you know, health care professionals told them that even very young breastfed babies don't poo. But that is so rare. And it's such a red flag, we really have to investigate any newborn baby not pulling. And then the size is interesting, because I know in the UNICEF Baby Friendly guidance, it talks about, you know, the size of a two pound coin counting. But if I met a newborn that was pulling twice a day, the size of a two pound coin, I would want to do some investigation. I mean, I'm guessing you would, too.

Charlotte Treitl  12:52

Yeah, exactly. Yeah, I think, you know, if they were doing 12 pounds a day, the size of a two pound coin, I might be less worried. But I mean, a two pound coin is is quite small. Like you say I see a lot of poo. I see a lot of pictures of Pierre. And I've seen so much of it that, you know, thinking when when babies are feeding well, and taking lots and lots of milk, those pools are pretty substantial. And so for me a two pound coin is, is the bare minimum, and I would still want to investigate and look at the big picture and figure out, you know, is something impacting how much milk this baby is getting? Are they healthy? Are they happy? Are there any other red flags that we need to look for? Is is the parent in pain? Are they delaying feeds, using a dummy anything like that, that might indicate that baby's not taking enough milk? And of course, weighing them? Yeah. But yeah, I think it's it's great to have guidelines. But we don't want to dismiss things too easily. I think it's always worth investigating a bit more, I think, out Yeah, I would definitely prefer babies to do lots more poo than just a two pound coin.

Emma Pickett  14:07

Two pound coin for anyone who's not in the UK is about it's about the size of an American Quarter, very slightly bigger than American quarter. So it's quite small, not not massive. So coming back to that, that the end of that first week then so if we've got the poor transitioning to the paler poo, so day three, day four, if we've still got meconium happening, day five, day six, that's a baby that's going to need some investigation, because something's really not happening. Absolutely should be. But let's imagine everything is going to plan and we're at the end of that first week, you mentioned that mustardy yellow is the sort of thing we often talk about, but what is the kind of normal colour spectrum for for those newborn stools?

Charlotte Treitl  14:43

so some of those yellows can be more orange, they can be more brown. You know, parents will say, Oh, it's not it's not quite yellow, some are really bright yellow. There's a real big variety and what that normal yellow colour looks like and then of course, the kind of nappy that you Using bizarrely makes a really big difference to what colour it actually is. And cloth nappies absorb more of the liquid of stools, and they can look like they're dry a bit darker as well. So it varies. And sometimes they are a little bit green.

Emma Pickett  15:20

Yeah, well, let's talk about green in a minute. That's a bit. That's a big one. Lots people are worried about green. Just coming back to the end of that first week, you mentioned about the liquid portion. instals. And I think I think a lot of parents worry this, this concept of CD poo and Kurdi poo like, um, I quite often say to parents that if it's like paint, that can be okay. Yeah, we there was actually a pampers campaign. Other brand brands of nappy are available that talked about newborn stores being like paint and I was actually quite glad to hear that because I think parents get very focused on this, this CD Kirti business. I mean, what is it when we see sort of white seeds in a newborn poo?

Charlotte Treitl  16:00

Yes. So we're looking at curds, undigested milk, undigested milk solids, and it's really normal to see them and it's really normal not to see them. And it doesn't really tell us much about what's going on with feeding other than that baby's body is deciding not to digest some of the fat that it's consumed. 

Emma Pickett  16:21

Okay, so actually to not have it maybe means that your baby's absorbing potentially more of the fat, but equally, if you do have it, you're just giving them more fat than they need, possibly so. So when someone says, oh, no, I haven't got 30 stuff. That must mean my milk isn't fatty enough that that's not based on anything?

Charlotte Treitl  16:37

No, not at all. Again, we've got to look at that big picture. You know, if, if we've got a baby that's doing tiny two pound coin pose that might be yellow, but only a couple of those a day and mums in pain, and babies not feeling very often, and maybe it's lethargic, then those there's a few red flags built up there once we start investigating what's going on beyond the poo. But yeah, I would always say don't worry about kids. And sometimes you have people that worry about too many cards. Like I've seen nappies that literally look like rice pudding with the sheer volume of curds have come out of a baby. And I think, you know, we've got to remember that milk is a biological substance, it's always changing. It's adapting to your baby's needs and babies needs might change, you know, day to day, and might take a little bit more time to catch up with what those needs are. It's okay as long as the baby's okay. So, you know, we don't need to worry about whether they're Archerd whether there aren't kids, and actually what you're saying about pooping like paint, even that shimmery shiny poo, I get lots and lots of parents worried that it's mucus, or that it's excessive mucus because the poo is really shiny. And I'm like, it's just just the poo. It's just got a lovely sheen to it. It's great. You're doing really well. It was just, it's a really volumous pool. So it's going to have a shine too. It's reflecting.

Emma Pickett  18:04

I just got I just had a flashback just then, a flashback of my son, I'm gonna He's gonna need Luckily, there's no way he's gonna listen to this. So my son is now 19. And when he was a tiny baby, I took him to the cinema for the first time. You know, those baby screenings? Yeah. And that was his time to do his Poon army. And it went all the way up the back of his neck and on in his hair, and, and I remember the shine, I just literally had like, flashback, post traumatic flashback of remembering, peeling it off him and this kind of glimmering Yellow Sea of stuff. Yeah, so yeah, Shine does not always mean mucus and does not always mean something problematic. Yeah, thank you for sharing that. So. So daily poo, I think everybody who's trained in lactation would agree, absolute minimum of daily poo for the first six weeks. I think everybody who's trained is on that same page. But then we get a little bit of a difference of opinion after about six weeks. And I think we need a bit more research on this because I think we've got people talking about it without necessarily having a lot of research to back up what they're saying. And so Jack Newman, for example, Dr. Jack Newman, who everybody who's trained in lactation is familiar with his books are really popular, you know, he's a really down to earth sensible bloke helps tonnes of families in his clinic in Canada. He talks about working with babies that didn't pull for 21 days, I think what in one case, 21 day is regularly working with babies not pulling for seven to 10 days after those first six weeks. And then you've got people saying, you know, it's it's normal to maybe skip a couple of days, that's still not constipation. It's what comes out after that, that defines constipation. And then you have people saying, everybody, including babies should be pulling every day and I saw a post today on Instagram with a lactation consultant from the state saying everybody should pay every single day and some lactation consultants in the UK who I enormously respect also that's definitely their view sounds like that's your view to that pose should be continuing daily.

Charlotte Treitl  19:59

I think so. But actually, there's no evidence, either side of this debate. And I've looked. And there's other people who've been interested in pool for, you know, many years before I even qualified who have looked and have said there is no, there's no real research to backup anything other than, you know, we should really be stealing daily. And from an evolutionary perspective, it makes sense. But obviously, there's, there's more of a range with adults where, you know, we're told anything between one you know, several times a day, and once a week is normal, as long as you're healthy, and you can pass that stool without problems. I would definitely like babies to poo every day. But I think I also appreciate that there is a range of normal after six weeks. And really, what I'm looking for after six weeks if the stalling has slowed down, or reduced somehow, is to just check what's going on day to day with feeding. And yeah, I've seen babies who've barely pooed for weeks. I've seen babies who, who really, really frequently and parents panicking about that.

Emma Pickett  21:18

Yeah, so they definitely panic the other way too. And that six weeks, hang on, someone told me it would slow down, they're still praying five times a day. And that costs money. If you're having to wash nappies and pay for energy or having to, you know, buy disposable nappies. It's yeah, and you were hoping for that less frequent poo. 

Charlotte Treitl  21:34

Yeah, and expecting that, you know, because the told it'll slow down, and then the baby's still pulling it every single feed. Well, is that a problem?

Emma Pickett  21:41

And especially if they're told that, you know, your baby system gets more efficient, and they're better at digesting and they don't they use up all the breast milk, and then your baby's still pulling five times a day? What does that mean, your baby's digestive systems not maturing? They can't do it properly. I mean, so it's your kind of pathologizing you know, normal baby frequent?

Charlotte Treitl  21:59

And is it diarrhoea? You know, that's a question that comes up a lot. You know, when my babies are pulling eight times a day, do they have diarrhoea? And like all, diarrhoea is a whole other... 

Emma Pickett  22:10

Yeah, let's talk next about what's diarrhoea and what's constipation. But just to finish this conversation around, is daily pulling what we should expect, I guess the reason I'm a little bit nervous about the people who confidently say everyone should poo every day is we've got so many parents who are nervous about their milk production. And, you know, perceived insufficiency of milk supply, as I know, you know, is more of a problem than actual insufficiency of milk supply. So if you say to a parent, it's seven weeks, every baby should be pulling every day and their baby isn't. Yeah, you're gonna get parents using formula? Yeah, not they're not going to get that investigation, they're not going to meet a lactation consultant, or breastfeeding counsellor who's going to support them to investigate and say, Actually, everything looks okay. Don't worry, you're all good. They're just going to start using formula, or they're going to increase the amount of formula they're using. So so how can we have that conversation? safely at the Instagram I post I saw today just said baby should be pulling every day. And there was a little meme of a little kind of comedy face that said, I'm really angry when people say babies don't who every day. Yeah. And I thought, okay, but someone who sees this as just going up their formula? Yeah. Because they're going to worry about their baby, what, what do you say to sort of that message? 

Charlotte Treitl  23:20

So I think it comes down to this word should, doesn't it? And and when it is appropriate for us to use the word should we know that babies should poo every day, up to six weeks? We know that because we have the evidence to back it up. We know because that's the critical period for establishing breastfeeding. And we know that it's the time when red flags are going to show themselves in the stools. After six weeks, when I'm talking to parents, and they say I'm worried about my baby's poo, they're not putting them up food for a couple of days. Obviously, we just need to reassure parents that you know, right, let's figure out what's going on. Is your baby happy? Are they content? Are they appearing to be in discomfort? How is feeding going how has feeding been going and have that investigation? But you're right it's it's not always possible to have an investigation with somebody said to make blanket statements can be really harmful. And I always say to people, whilst I would prefer babies to purr everyday, they are not robots, and they do not follow, you know, generic instructions all the time. And I tend to talk about what a range of normal looks like. And I'll usually start with well, when when they pulled last What did it look like? And how big was it and kind of work back from there and try to dig into that with the parents because if the poo the last poo wasn't very big, it was green. It was brown it was mucus say they were not happy about the they've never been happy about the pills or they weren't happy about the last few pills and then suddenly this baby's reduced the number of stalls that it's passing. Then we need to dig deep and find out what's going on. But I think as helpful as guidelines are, we do need to always be able to put our hat and monocle on and become curious and investigate what is happening beyond the stool? 

Emma Pickett  25:17

Yeah, yeah, definitely, definitely. You mentioned before about is is baby sort of comfortable and happy would be interesting just to explore a little bit about what's normal in terms of a baby's discomfort just before pulling. So especially those babies that may skip a day, or a couple of days, you know, when they're just about to poo, they may not be thrilled about it. Now, you mentioned your son early with his little cork. That obviously wasn't normal.

Charlotte Treitl  25:41

No, not normal, just to clarify that.

Emma Pickett  25:43

We'll talk about that in a bit more detail. But, but is it normal for babies to be a bit uncomfortable? So I know there's this thing called disc ease? Yeah. Am I saying it right? Tell me a bit more about that. And what is normal?

Charlotte Treitl  25:54

So this case, yes. Sounds really like scary, doesn't it? It's a bit of a scary word for actually something that is really not harmful at all. But also it sounds scary in the baby. It sounds like they're having a really tough time. And but actually, it's just the disorganisation of the the muscles that they used to pass a stool. But they can grunt and squeak and look like they're bearing down and like they're really really pushing. And it's, it's, it's just yeah, it's just kind of a disorganisation of those muscles, which comes with immaturity, and it gets better as they get older. And some babies have like, not necessarily disk easier, but make very obvious signs that they're going to poo and maybe pull a face or Grunt or something and, and that might continue long term, which is great for predicting when they're going to do a POC, you know, you can get your nappies ready. My little one is the same he, he never appeared to be in pain with Sterling, but he definitely did a lot of grunting and grimacing and pulling a face, it looked like he was gonna be sick, actually, the first that he pulled, when he was pulling in his pose, we're always soft and easy to pass, no problems with them always lovely liquid ones, but he still made a big fuss about them as if they were as if he was passing a golf ball. And there's a difference between pain and process, I think and disguise your sounds and looks a bit scary. But if the stole that comes out of that baby's soft, and liquid, then you can probably confidently think it's not necessarily that they're in pain, it's just they're a bit confused about what's going on, and maybe overstimulating or a bit scary for them. 

Emma Pickett  27:38

So that act of relaxing and pushing at the same time. Yes, it's just, it's a bit of an art. We might assume that pooing is instinctive, but actually there is a little bit of a process to it.

Charlotte Treitl  27:47

Yeah and how many adults don't use the toilet properly? I know that sounds like a really weird thing to say. But constipation and even you know, knowing how to sit properly on a toilet is something that affects lots of adults. You know, there's a lot of bearing down that doesn't need to be done. And it's yeah, it's a skill, it's a skill that babies learn. Obviously, it's a natural process as well, but the muscles have to learn how to work in sync with one another. And generally displays here is just babies responding to the body signals, it's not necessarily that they're in pain or they're struggling. My biggest concern with babies that aren't stalling or appear to be struggling to still is whether the you know, obviously, if the abdomen is hard, or swollen, that's definitely a clear sign that something might not be right for that baby and they need a medical examination. But also if what comes out is firm or compacted that that would be an issue. 

Emma Pickett  28:49

So what's what's your firm, is peanut butter okay, in terms of texture?

Charlotte Treitl  28:53

Peanut butter is absolutely fine within the realms of of normal and certainly for mixed fed babies, we would we would exclusively formula fed babies, we really, you know, Formula companies talk all the time about how they're trying to make formula as close to in inverted commas, breast milk as they possibly can, they're trying to follow the format. And so really, we should hold formula to the same standard for stooling if it if they're going to say it's going to respond in an infant the way that breast milk should and then the foods that come out of them should be held to the same standard but we know that that's not what happens with a lot of formula fed babies those stores can be more paste like thicker peanut buttery. Sometimes they come out as a little like actual little sausage still, but are still still soft, but but they're just kind of compacted but that to me a compacted still even if it's even if you could squish it in the nappy would still be that that

Emma Pickett  29:56

shouldn't this is this is really not for people having breakfast, but it shouldn't So once it comes out, you wouldn't expect it to hold its shape. You'd expect it to fall out of its shape. Yeah, essentially.

Charlotte Treitl  30:06

Yeah, I think up until six months from, you know, from six months when babies start having family foods, and the the change in the gut microbiome is pretty profound. At that point, we will start to see more compacting and kind of clumping of food and in the stool, but before then, with an entirely liquid diet. We should expect liquid stools, ultimately, and yes, it might be firmer than than a source and it could be spreadable. spreadable is is a is another kind of goal term for poo. spreadable, I think that's okay. And but again, you know, we're talking about this, this whole big range isn't, it's not just, it has to be this or it has to be there. So like, you know, there are lots of things that, like butter is can be liquid at warm temperatures, but it's really firm, when it's cold. Things react differently. And it's still butter. It's just looks different. So we've got to think about the whole, you know, what is normal for this baby? Is this post something that we're doing all the time? And are there other red flags for health concerns or feeding concerns around those stools? Or is this something new that's come completely out of the blue? And that mom sent me a picture and in my inbox, because they are completely freaked out? 

Emma Pickett  31:33

Yeah. And I guess when they send that picture, there's probably some subconscious stuff going on when they're picking up on something and being a bit different. 

Charlotte Treitl  31:40

And yeah, and generally, you know, they'll say, Well, they've been feeling a bit less or, you know, sometimes it's down to they've had antibiotics or they, you know, that we have a lot of concern about allergy. And lots of parents worry about babies having allergies based on the stools that they do. And yeah, there's so much variety in what isn't isn't normal, and even allergy pills look so different depending on what is happening in that unique microbiome. So yeah, yeah,

Emma Pickett  32:09

let's investigate allergy for sure in a minute, because I know that's what a lot of the reasons people are going to come to you. Just to finish off talking about constipation. So constipation, doesn't mean straining doesn't necessarily mean a baby grunting. They might look like there's an enormous effort to produce what's coming out. But what comes out is spreadable good word. Let's use that word. Yes. And what about diarrhoea with a breastfed baby? What does that look like?

Charlotte Treitl  32:32

It's usually clear or clear, very thin liquid, it stinks. It really stinks. Some people really like the smell of breastfed baby poo. It's really yeasty and sweet and it's inoffensive to a to a parent. And other people just, you know, depending on their level of comfort and tolerance for for smells, find all baby poo. Absolutely, you know, it stinks. It's horrible. But there's a really distinct difference between the smell of a poo of a baby that's not well, compared to, you know, a generally healthy functioning. Got so diarrhoea would be really frequent. Often it comes you can hear it, it comes out really fast. Or it's it's, it's it's noisy. And yeah, very watery or thin. 

Emma Pickett  33:17

Yeah, I mean, literally looks looking like water, almost like clear water with like bits of leaves in it or you know, some sort of tiny bit of fragment, 

Charlotte Treitl  33:23

it's essentially the same as what it looks and feels like for an adult to have diarrhoea, it's pretty similar. And it's, it can be a very noisy affair, and often leads to nappy rash. So if your baby's got a sore bum, that might be another sign that something's not quite right with the store.

Emma Pickett  33:41

And when you say frequent, what would you say? I mean, so like, we've talked earlier about how you know, eight pills a day could be normal for a breastfed baby. Is there a number that when we start to tap into Let's investigate this or not, so you can't be hard and fast about it? 

Charlotte Treitl  33:55

Yeah, I don't, I don't think there's a there's any kind of rule about it, but it's, it's almost for some babies, it's like, you'll change them, and then they'll go again, or they'll, they'll just appear to another do shots. They'll be really fatty, and then they just keep doing. And for some, it is really, you know, there's a lot of volume to it. But they tend to be very unsettled. If it's if it's diarrhoea, they're not well, so they might have a fever, they might be more fussy, more clingy, they might want to feed more, they might be sleeping more or be more lethargic, or be off. You know, certainly for older babies over six months, they might be off food or not wanting to play not wanting to interact too much other than just being kind of cuddled and loved on. 

Emma Pickett  34:40

Yeah, this is obviously when we're going to be calling doctors and getting medical support involved as well. Yeah. And that sort of liquidity poo obviously is going to dehydrate quite quickly if a baby's producing all that liquid. And that's what that's one of the benefits of breastfeeding and it's a great hydration solution. And actually, one thing maybe If you're exclusively breastfeeding, it's incredibly rare for a baby to get diarrhoea or gastro type infection because they're more likely to be protected from that. And, you know, it's more likely to happen if you're formula feeding or mix feeding. But yeah, if I guess everybody would know at that point, if something doesn't feel right, especially especially if your baby's sleepy or lethargic, we're not feeding. Yeah, time to call the doctor and get some help. You mentioned before about how you can hear a diarrhoea poo. Obviously, you can also hear a non diarrhoea poo. I mean, we've all been in that. And then the lactation consultants situation where like, everyone goes, whoa, and the conversation stops, because there's noise from this tiny person the size of a bag of sugar. Yeah. Is it normal to for poo to sort of travel a metre on the changing table? Is it normal for poo to go up the back of someone's baby grow like it did for my son 19 years ago in the cinema? I mean, is that is that normal? To have that kind of explosive quality to it? 

Charlotte Treitl  35:52

Yes, it can be. Yeah, it's, it's really common, and everybody will have an explosive explosive power story, I'm sure. Most people will do you know, if a baby's comfortable, it's gonna come out. And you know, it can come out at force. And it's liquid so travels quickly. And you know, gas flatulence is normal in babies as well. So it's not necessarily a problem. And actually, it's just the, the reason that it travels and goes up to the back and everything is because it's coming out really fast. And there's a lot of it. So it hits the nappy, and then it's got nowhere to go. It's just, it's, it's an unstoppable force meeting and an immovable object.

Emma Pickett  36:35

And we've got them tied into these nappies. As you say, they've got to go somewhere. Now, from the changing table, it goes on your nicely painted wall when you've decorated your nursery. Yeah.

Charlotte Treitl  36:45

Mom's carpet.

Emma Pickett  36:47

Yeah, when you said before about your eldest son, and your mom was sort of sitting watching him had a horrible vision, she was gonna get cut, splattered. So no, lose that story. And then with that, with that happening? And what about frothiness? And mucus? What do you say is normal in terms of those things?

Charlotte Treitl  37:03

So mucus is a really funny one, because there's such a huge range of what is normal for mucus. But I'll talk about frothy because it just kind of leads on nicely from what we were talking about. flatulence, it's not always an issue for us, it's just means that the stools come out really fast. Usually, it's, it's just, it's just bubbles, it's, yeah, it's not really anything to be concerned about. Unless it is just bubbles that's come out of your baby, in which case, that would be an indication that something is not quite right with their gut bacteria. But it's not generally something that I would be concerned about. And actually, you've normally wouldn't see them. If you maybe took a little bit longer to change the nappy, it'll be gone. By the time you open up and start investigating, I would never really worry about froth unless it's coming along. All the symptoms, and other feeding issues that might be might be a red flag. But mucus is probably the thing I get the most messages about. Everybody produces mucus in the gut, it's normal, it helps us lubricate the digestive system, it helps us pass the stool. And but the range of normal, again, is massive. And a lot of mucus doesn't necessarily mean a big problem. And that's really difficult. Because, you know, we're told that mucus is kind of something that we need to look for in a big volume, it could be a problem. But a lot of the time, it's, it's a problem only if it's a problem, which is really vague. But actually, if all else is well, it's probably nothing to worry about. And I think for lots of parents, that's hard, because we do worry about our children. And if something is change, and something isn't right, and we want to investigate it, and we want, we naturally want to find what the cause of it is, because if it is a problem, then we can resolve the problem. But sometimes things just are and there's no real explanation for it. And it's not always something that we need to worry about. But certainly I would always encourage parents to ask somebody and speak to somebody experienced and qualified to talk about their babies poo, if it is heavy with mucus, and certainly if there are other symptoms alongside that they have concerns about and also if that mucus has appeared out of nowhere, if it's a new symptom, if it's a if it's a change, and now suddenly it's in every single nappy. I think sometimes they get more mucus when they've been exposed to bacteria. You know, any kind of change to the microbiome can have all kinds of weird and wonderful effects on on the stool. 

Emma Pickett  39:50

So things like swallowing lots of saliva if you're teething. 

Charlotte Treitl  39:52

Yeah, yeah, absolutely. Yeah. The Yeah, the chin changes the pH balance and the gut, antibiotic expert. OSHA, other types of medication that might even pass through into milk as traces or direct consumption of medication, a cold, you know, they're swallowing that mucus because they can't blow their nose. So, you know, sometimes that excessive mucus comes from them having a cold or cold symptoms that we might not be fully aware of, you know, sometimes we ever say, or they've got me because and then up in will, when we investigate us to you know, do they have a cold or they've been on wellness, they will baby's not unwell, but the toddler is, or the older sibling is, might be prepared, then because your baby might, you might be exposed, it might be the same sort of exposure, and your baby might start showing more symptoms of being unwell due to that exposure. But as you said, breastfeeding is so protective for illnesses for babies, that the symptoms are maybe less profound. So mucus isn't always a problem in of itself. And, yeah, it's only a problem if there's other things going on. I don't want to discourage anyone and say, you know, it's not a problem. Because it can be it absolutely can be a symptom of something. So talk something or something is changing, and something needs investigating. So I'm more than happy to have a look at mucousy poos at anytime,

Emma Pickett  41:21

anytime, day or night, 24 hours a day, seven days a week. She's the poo guru, we need to get you a cape with a big pile of poo on it. And that's not it doesn't sound like a good idea. So I know some of the questions we're talking about. Now we're we are both I know very mindful of the fact we're ibclcs we're not doctors, we are always going to be signposting parents to talk to paediatricians and talk to their GP if we've got any medical concerns, but if someone has sent you a picture, and it's mucus plus something else, like for example, if someone sent you a picture, and there was some blood in the stool, what are some of the things that could be going on that might that might cause that.

Charlotte Treitl  41:55

So fresh frank red blood that we would typically see, you know, if we cut our finger that that fresh blood that we would normally see is more typical in a, in a stool, we do see old blood in stool sometimes which is blacker or brown, and a bit less obvious, it can look a bit speckly in the nappy, Frank red blood is generally something that's happened at the end of the digestive system, it's new, so it can't have travelled far. And the most likely explanation for it is that the there's been some irritation in baby's bottom before they've passed it on while they're passing the stool, and a little bit of blood has come out with the stool. And it may be that if the, if they've got mucus, that the the level of acid in their stool is higher, and therefore it's more irritating for them to pay and it might be causing some skin damage the same way that you know, sometimes they get dribble rushed up there from teething and drift dribbling everywhere, and they get that Red Dry Skin and it makes the skin sore. And if it's not treated or cared for appropriately, it can crack and then it can bleed. So it's kind of similar in that respect that the irritation can can cause bleeding. If it was a lot of blood, that's absolutely a straight to any job and take the nappy, you know, wrap it up and take it with you a little bit of blood, a speck of blood or some suspended in the mucus or whatever, absolutely, you do need to get medical attention. And I wouldn't necessarily rush straight to a&e because you might be in for a long wait. But definitely ring your GP speak to health is to get seen as soon as possible by somebody just for a full wellness check. And just make sure that there's nothing else going on that might be indicated by that. Commonly we see blood when there's like say when there's an allergy, or when there's something going on in the stomach or the digestive system that's causing irritation that is then damaging the skin internally that is then causing a little bit of a bleed when we see those specks of brown, dark black Old Blood. Again, that would be you know, you need immediate medical attention for that because it means there's some bleeding happening further up in the digestive system. And I wouldn't even know where to begin helping somebody with that it would just literally be in your belly needs medical attention. Now.

Emma Pickett  44:17

Although having said that with a lactation consultant hat on, you might say are your nipples bleeding? Yes. You've got significant nipple damage. Yes, it may be your baby is digesting some of your blood and that could be what's going on. Not that we dismiss it that straightforward. Absolutely.

Charlotte Treitl  44:34

Yeah. And it comes as part of that wider sort of conversation. But if all if everything else is ruled out, blood should always be investigated by a GP or, you know a specialist. It's not, I'm not a medical provider and I'm not any kind of expert in poo. I'm just fascinated by it. I'm interested in it and enjoy learning more about it and kind of helping be you know that investigator

Emma Pickett  45:00

I know you wouldn't call yourself an expert but I don't know who else gets to call themself a pool expert. I'm sure once you've seen X number of 100 pictures, you get some sort of licence I'm gonna I'm gonna give you a licence Charlotte even if you're not going to give yourself. So talk we've talked a bit more about allergy. So when a baby is struggling with an allergy, what did those nappies look like? What are the nappies that you're getting sent that like that?

Charlotte Treitl  45:22

So, again, this is a huge, huge variety. Sometimes they start out just green. Sometimes they're neon green sin, really bright neon green stools? 

Emma Pickett  45:34

And why are they green? Is that too technical question? What causes that greenness? 

Charlotte Treitl  45:39

Basically, it's a lack of absorption of the of the milk properly, and are travelling rapidly through the body because the body is trying to expel the thing that it's not happy with. And it's not had time to process it. So it's just sending as much out as it can as quickly as it can.

Emma Pickett  46:00

And that green is the bile that was put in to digest and didn't have time to get reabsorbed essentially. So it just was essentially Yeah, the other end.

Charlotte Treitl  46:07

And it just, it's rapidly coming out and the stomach isn't happy. Anybody as an adult who has an allergy or intolerance will recognise that feeling of oh, God, it's happening. The stomach feeling like it's dropping, and the discomfort and it's no different for babies really. I've seen very dark brown thick, like clumpy pose, even like the kind that you'd expect for weaning babies or toddlers. I've seen nappies thick with blood black, for me that the indicator as well as the smell that goes alongside it, it's very, very repugnant. It's really revolting. It nearly always sends a parent into a panic. The green ones seem to panic parents a lot less than the than the brown and mucousy and bloody stools. And like I say, there's such a huge variety of what is going on. But I think alongside the smell and an unhappy baby, you would want to investigate for analogy, but there's no, there's no, there's no one thing I can find somewhere that says this is exactly what analogy will present like in a stool because it varies so much person to person and how severe it is or how much of it they've consumed and how long since they consumed it and that kind of stuff. So my biggest concern would always be if a baby is not doing Biello liquid still but passing a dark brown or even bright orange, really bright orange of neon greens. Those are the the outliers that I would say this is this is more of a clear indicator to me that there is an allergy or something causing dysbiosis. And they got that neath investigating pretty quickly.

Emma Pickett  48:04

And dysbiosis just means bacteria but not being balanced.

Charlotte Treitl  48:07

Yes, yes, exactly. 

Emma Pickett  48:10

Okay, so green poo, let's talk about green poo, which is a big conversation in this area of babies and lactation. So Dr. Jack Newman again, he says he wishes all new parents could be issued with sunglasses, so they don't worry about green poo, which I can see where he's coming from, because people often panic about green poo. And sometimes health professionals are worried about green poo. And I have met families who were told to end exclusive breastfeeding, and even move to special formulas because their baby was producing green poo when nothing else was going on. So although we've talked about how green poo can be associated with allergy, let's also highlight the fact it can be normal. Is that Is that a fair assumption?

Charlotte Treitl  48:48

Yeah, that's a totally fair assumption. And the odd green poo is definitely not something that I would ever consider a red flag, if it becomes more frequent. Or if it's happening a lot all the time without any loss or with other symptoms or without any explanation of why it's happening, then, yeah, I would definitely want to figure out what's going on. But otherwise, the old green poo is it's not generally something to worry about it maybe that baby has just had more hydrating feeds than long, full milk profile feeds are and is having a lot of short feeds. And we see that typically in summer. You know, when when babies are in, they're hot and bothered and they want more drinky feeds, they might spend more time just having short feeds and therefore not getting a full fat profile of the milk which is absolutely fine because, you know, they've maybe don't want to sit and have a really long feed, they just want to hydrate and it's not an issue to have the odd green poo. Definitely not and parents should be reassured about that. Even if it's once a week it would not even necessarily be so something to worry about. But if you have a green poo, and there's something else going on, definitely, if you have other symptoms or other things that are making you feel a bit insecure or unsure about what's going on with feeding or with the baby, then ask, if anything, just to have have that reassurance can make a really, really big difference. So just to chat through everything, and a lot, a lot of parents who do send me these green pose, they don't always realise that there are other things going on that are related. You know, they don't necessarily see some of the other symptoms of perhaps an allergy that that might be happening, you know, the maybe respiratory, the baby's being congested, and skin things, you know, once you put all the picture together, and you can see that there might be something else going on, it might not just be that this baby's having the occasional green stool, it could be a sign of something else happening. But no, I will not be worried at all about the odd green poo. It's also something that's quite often associated associated with tongue tie babies, again, because if they're not able to transfer milk, they might be able to transfer high volumes of milk, but maybe not necessarily stay on the breast long enough to get that really rich fatty milk as the breast is emptied. And I'm using inverted commas because we know the breast is never fully emptied. And I really wish we had perfect language to explain this to parents. And I'm trying really hard not to use the terms that I think you know that I'm trying really

Emma Pickett  51:32

the different kinds of milk because that way you're referring to Charlotte? Yeah, yes. And there is a spectrum there is not that kind of milk that begins with an F and that kind of milk will begin to the age. The fat content varies depending on the fullness of the breast. 

Charlotte Treitl  51:44

Exactly, yeah. And tongue tie babies, you know, and actually, babies can gain weight really, really well on a very high sugar, high lactose diet. And quite rightly, they should because milk is very high in lactose. But persistent green pose, even in a baby that is gaining weight really well might be an indication that there's something functional to look at. I hope my cousin won't mind me mentioning but she had her third baby quite recently. And so third breastfed baby, everything's going really well. He's really chunky, really lovely, but really persistent green pose. And when we kind of dug into it a little bit, she was singing, you know, he will come off the breast. And he's quite fussy, and I'd seen him at the breast being a little bit fussy. And we thought maybe it was a supply thing that needed to settle down, you know, third breastfed baby, you know, she's a veteran now. And then we talked a little bit more as he got a bit older, and it was quite obvious that we needed to refer to be seen for a functional assessment. And he did end up having a for anatomy. And so

Emma Pickett  52:47

that's a tongue tie division.

Charlotte Treitl  52:49

Yeah. And she messaged me, actually, and she said, his paws have gone yellow. And she was delighted. So I'm gonna do some stuff on social media around that at some point soon. But that was quite a profound difference for them. 

Emma Pickett  53:04

That's that's a useful component story. I'm sure she won't mind telling that story to help others. So if a baby's then taking a lot of that lactose rich high water content, beginning of a feed type milk, yeah, they may take more lactose and they're able to digest Yes. And some of that undigested lactose can cause that faster gut transit, which means green green poop. Is that Yes. Is that the right description of what that is? 

Charlotte Treitl  53:28

Absolutely correct. And also, alongside that, we might see symptoms of like, maybe Tommy gurgles and farting and discomfort and bringing the knees up and feeling a bit uncomfortable. Not in all babies, but for some babies that, you know, the struggle with the excess lactose can cause symptoms. And it's not, then that that's an allergy or lactose intolerance. It's just, it's they're not receiving that full profile of milk that we would like them to see. And there are a few fixes for that.

Emma Pickett  54:01

Yeah. So if you if you're worried. Yeah, I mean, if you're worried about that, what's happening then? It may be to do with overproduction. It might be as you say something stopping that baby getting the end part of the fee. Yeah. And positioning, qualified and react. Exactly. Yeah, it could be positioning, stopping and getting that lead part of the feed. Could be the weight gain is absolutely fine. And everyone's happy. And the green pill is not a problem at all. But it's worth chatting to someone qualified and breastfeeding support. If you've definitely if you've got any worries, are there any baby poo colours that are instant red flag so apart from blood, anything where someone sends you a picture and you go Yikes, that is there's a problem. There's something going on with the liver or whatever it is any other instant red flags? 

Charlotte Treitl  54:37

Yeah, anything along the pastels spectrum. Generally, so if the if it's yellow, but it's pale, pale, very pale, chalky, sort of colour, white, silver, grey. All those are signs that this there's a problem with bile production or with liver function. And again, take that nappy with you and go straight to any need to get urgent medical attention for for babies that have those stools. Also, red jelly. So like pure red jelly stools. So interception is basically when there's a twist or a blockage in the bowel, and the digestive tract when the the fluid and the foods are able to pass through. And that can result in these red jelly like stools. And that really does need urgent medical attention. Because if it's if it cuts off blood supply to the intestine, that part of the bowel will start to die. Which sounds really, it is really scary. And I don't want to terrify anybody this is very, very rare. But if your baby at any point passed a stool that looks like jam or jelly, immediately go and especially red, immediately need medical attention. Those are the big, big red flags, but they are pretty rare. 

Emma Pickett  56:02

And that Yeah, and that white pastorally thing just to clarify, if you go to sea depot, the seeds might be white, that's not the same thing, not the same thing. We're talking about the whole thing being Yes, white grey, silvery path very, very, very pale coloured chalk. Chalk is the word it's useful. Yeah.

Charlotte Treitl  56:19

And also, if if the stool if it's a compacted stool, if it's really really firm, if it's an constipation and and firm stools is incredibly rare in in breastfed babies, but it can be a sign of Hirschsprung disease. If the baby is not passing stools, as they should, if the if the liquid becomes compacted, so definitely need investigation there.

Emma Pickett  56:47

And then let's imagine that family is introducing formula. So they were exclusively breastfeeding their introducing formula, what's what would we see happen in the periphery, if that's going to happen.

Charlotte Treitl  56:56

So typically, introducing formula can make the poo thicker, it can sometimes change the colour, I've seen a formula poo go more like olive green. And again, it should stay yellow. But you know, there's a range of what is normal for Formula babies, some formula feeds, there's no change at all really in the stool, or it looks pretty similar to how it did before, it's that maybe it's a bit thicker. That spreadable poo is more common in formula fed babies and mixed fed babies. And they might still less frequently and formula is slightly harder to digest. Certainly when they're first introduced a formula, we might see a slowing down of the stool as the as the digestive system learns to cope with this new thing that it's been introduced to. But we should still expect the stalling to be frequent. And if if like my little boy, that formula is causing that cork or that blockage, or those firm, firm stores, and it's maybe just looking at the volume of formula that they've been given or making sure that it's made up correctly. Often it's down to kind of not getting the ratio of water to powder, right? And then it's making it harder to digest. So making sure that we're being really careful about how we make up the formula safely, and maybe reducing the volume. So they're getting kind of little and often rather than big, bigger volume feeds. 

Emma Pickett  58:32

Okay, thank you. So, let's imagine we've got to six months we've started solids. I know some parents are a little bit surprised what happens to poo when solids begin, how would you describe what they're gonna see?

Charlotte Treitl  58:45

It's probably the most interesting time first for poo, you are going to see undigested food, you are going to see bits of things that your baby's found on the floor and put in their mouth. Like stickers and googly eyes. We've definitely had a few pictures of those googly eyes and nappies. You know, the sweet corn is not the only thing that comes out solid. And it's essentially, we still want the poo to be soft, we still want it to pass easily. But it's going to change it's going to be less liquid, it's, you know, it might and it's not an instant, it's not the first time they have food, it's going to immediately be different. And it might be that they pass a fully liquid stool with like a little bit of carrot in it. Depending on what the first few days that they've been exposed to, we might just start to see bits of undigested food in the liquid and then the liquid might start to kind of change to that clunky, brown sort of soft stool that we would typically see as they get exposed to poor foods. But the reason that we see all those undigested foods just because they're not chewing, or they're not chewing as much as they would, as they get more teeth and as they get older and as they learn to chew more. Chewing is a skill and It takes time to develop. And often babies, they just kind of shuffle food and then do a few little Chews and then swallow and, and especially if they enjoy their food, they'll take a lot of it in and maybe don't spend time chewing the food and we know our digestion begins in the mouth. So that's why it kind of just goes straight through, it doesn't necessarily digest it takes time for the body to build up the bacteria that it needs. And the digestive maturity to be able to handle digesting all those foods. So don't be alarmed if you get a nappy that is just resins.

Emma Pickett  1:00:38

I think I just had another flashback. Yeah. Yeah. And then let's talk about months going by some some months go by some toddlers as a maturity, their digestive system matures still continue to have quite loose pues. And there's this thing sort of called toddler diarrhoea and people are worried about loose continuing what what is normal for for an older child.

Charlotte Treitl  1:01:00

So older children that are breastfed, certainly, we would still see very loose stools or looser stools, which is absolutely fine. It's you know, they're getting a lot of really good liquid. You know, it's, it's a readily digestible, nutritious product that they're consuming. So it's not a worry for them to still have loose stools and the amount of food that the is relatively small, we have these ideas of how much food toddlers should eat, wildly inaccurate. And there's some really good resources out there that will explain to you what a toddler portion should actually look like compared to what we think it is. And you know, when we think about, you know, we make them a sandwich, and we give them some vegetables and maybe give them a younger or whatever, and they might only have a few bites of each thing, but that's okay. You know, we worry about the volume of food that we get into our children, unfortunately, children are very intuitive about their own hunger signals. So toddlers will have loose stools, typically. And that's okay. It's only a problem. If, again, if it's if it's very loose, if it's very liquid, and if there are other signs that there's some illness or upset going on, certainly, if they're still breastfeeding, and certainly, if they are tandem feeding, it's really, really

Emma Pickett  1:02:16

Yes, talk tell us about pregnancy, what's gonna be happening.

Charlotte Treitl  1:02:19

So if you have a toddler, and then you're pregnant again, and you know, we might, that toddler might still continue to nurse throughout pregnancy, and your milk will change again, go back to colostrum, around 2020 weeks of pregnancy, generally. And as a result of that, your baby, your toddler may start having very, very loose stools again. Because colostrum in particular does have that laxative kind of effect. And it's very, very rich for toddlers. But it's perfectly fine and perfectly healthy for them to consume colostrum. It's not going to affect your milk supply. As your baby is born, it's not going to change the, the profile of the milk that your baby's born, your body's going to, you know, give your baby the milk that that they need as well. But certainly tandem feeding, get a lot of parents say, Oh my God, my, my toddler's poo is gone. Absolutely horrible. It was just getting to the point of being firm, and then passing more more of those sausage type stools. And now suddenly, they're just pooping everywhere.

Emma Pickett  1:03:32

The massive nappies of that yellow stuff, which, again for a while, yeah, it can be a bit of a shock. So I think it's definitely important to highlight that what I know was slightly getting out of the pool gallery remit here, but do you have some recommendations for sort of potty training resources? And you're a bit closer to this than I am my kids are much older than yours. What are your sort of current favourites when it comes to potty training? 

Charlotte Treitl  1:03:54

So I think Sarah Ockwell-Smith's got a pretty good potty training book, which is a good resource for parents, it's easy to read, it's easy to get ahold of, it's easy to follow. But I think, in general, it doesn't have to be complicated. I think it looks different for lots of different families, because some people want to be more regimented about it, because they want to get babies or toddlers potty trained before they go to nursery or before they move up at nursery or before they before another baby comes or there's these sort of perceptions of time, you know, they should be potty training, they're to now or they're three now and they should be using the toilet or all these kinds of things. And that's actually different for girls and boys. We put a lot more pressure on girls to potty train earlier, which may or may not surprise people but ultimately, I'm a really go with the flow kind of parent and I think when your toddler can tell you that they need to go that's the best time to start. And they can tell you when they've done a poo from quite a young age and they can tell you that they need that they've they've done something and then Pay for quite a long time before they can actually tell you that they're predicting that it's going to happen soon. If you've got a toddler like mine him who makes those faces and noises when they're about to poo, it's really obvious. So you might be able to start potty training sooner in that respect, but it's something that I don't talk a lot about with families, because I tend to work more with younger babies. But there are some really good, there are some really good Instagram pages about potty training as well. So there's, there's a lot of really good stuff out there. But I would always just encourage parents to steer clear of anything that's telling you that you should or shouldn't be doing something at a particular time. And certainly that, you know, you have to be really regimented in how you approach potty training, there's lots of different ways to encourage children to use the toilet. And you don't actually need to go straight, you know, to a potty you can go straight to the toilet, you can get them see inserts, or little step ups to the toilet that that toddlers can use and you can you can just bypass the actual potty bit completely if you want to.

Emma Pickett  1:06:03

Yeah, I like your message about sort of going with the flow, which sounds like we're talking literally as well as men up literally. Yeah, I think if anyone reads a resource, and it leaves some thinking, Oh my God, that's really scary that I'm gonna have to take a week off work, I'm gonna have to, we can't go on holiday, I've got to stay in the house. If something makes you feel scared, it's probably not the right resource for you. Yeah, go go and find find something that that feels more relaxed and feels more natural.

Charlotte Treitl  1:06:25

Completely agree. And it's a process as well. You know, there'll be lots of people who say, you know, you can follow my method and your child will be potty trained in six days. Great, okay. But like you say, if that means that those parents have to stay at home, or have to carry a potty around with them everywhere. And I always felt uncomfortable with my, my little boy, you know, and no judgement to any other parents, because I know everybody has their own way of doing this. But I have seen people literally whip out potties in the middle of supermarkets and car parks and things I always thought prefer privacy for my little one that I wouldn't, I wouldn't go to the toilet here. So we took a very relaxed kind of approach with him, where if I knew we were doing a long car journey, he'd wear a nappy, even if he didn't wear a nappy for most of the day. And we just say, it's just in case you need to go and we can't stop. And that's fine, you know, is a process and there are occasions where your child might need to wear a nappy or might need to be kept closer to home if they're if they're not ready to go out without needing to use the toilet in the middle of the supermarket. But it doesn't have to be that once you get rid of the nappies. That's it. You know, there's lots of different approaches to potty training, I think you need to do what feels right for you, and what's going to work around your existing family life and routine. 

Emma Pickett  1:07:47

Yeah, definitely. And just a quick shout out as somebody who talks a lot about natural turn breastfeeding, it is not true that natural turn breastfeed is potty trained later, or it affects their ability to potty train or you can't change breastfeeding patterns and put boundaries in place at the same time as potty training.

Charlotte Treitl  1:08:02

There's it's there's no impact on box training at all. Absolute nonsense.

Emma Pickett  1:08:07

Is there anything we haven't talked about when it comes to poo that you think we should talk about? Is there anything we haven't covered?

Charlotte Treitl  1:08:12

Well, the only thing that, that we haven't talked about, and it's something admittedly, that I don't know a lot about, but is elimination communication. And it's I think it's gaining popularity, actually, not a lot of parents do it. And that I'm aware of I mean, there might there might be I don't know what the stats are on, etc. But I think if you've if if you are able to observe your little one and see the signs and then that they are going for a week, or that they need a way or a poll, and you can figure that out pretty quickly. And that's great. But I also want to reassure parents that you don't have to know everything at a micro level about your baby and it is okay to carry on using nappies and potty train later. Or if you want to use the easy method from birth or from later on. There's lots and there's lots of different ways to get that information and figure out how to do that. But it's definitely becoming more popular. I think we'll hear a lot more about it over the next few years. I think it's it's, I had a moment my group recently who she said that her parents actually did that with her. You know, 20/30 years ago? 

Emma Pickett  1:09:22

Yeah,I think historically, it was probably more popular. If you had to like launder big, massive Terry towelling nappy and you had you know, your hot water basin and your fire to heat your water and stuff you EC is going to be very appealing. I suspect it's sort of thought fell out of favour during the disposable nappy era. 

Charlotte Treitl  1:09:39

And now it's coming in kind of gaining more popularity with the the understanding of more about climate change, and then obviously, cost of living and everything and just, it might appeal to parents for a lot of different reasons, but also want to acknowledge that it can come with a certain degree of privilege to be able to do it because Certainly for international audiences, there might be parents who have to go back to work very early after they've had a baby. And it might not be achievable to them. It's wonderful if you can do it. And if you're very passionate about it, go for it. But I don't want other parents to feel like it's something they should aspire to. And therefore feel guilty about not being able to do for whatever reason, or not wanting to do you know, parenthood is very individual journey. And you can pick and choose the bits that you like, and the bits that work for you, and leave out the rest and for other people who want to do it that way. 

Emma Pickett  1:10:37

Yep, that's a good place to leave it. Thank you, Charlotte. Thank you what the headlines spread the ball massive range of normal however, if this was a drinking game, every time we said the word normal, there would have been someone taking a drink, there was a lot of the word normal, so big range. But if you're ever worried about a poo, no one minds having a picture of who sent to them as provided they're expecting it. So yeah, reach out for some breastfeeding support or contacted lactation consultant, contact Charlotte So Charlotte try to but that's spelt t r e i t l, we'll put your link in the show notes for your website and your Instagram. We'll put the link to the poo Gallery in the show notes as well. Thank you so much for your time, I really appreciate it. And on behalf of all the parents that you've helped in this area, massively grateful that you've developed this resource. And also on behalf of all the breastfeeding supporters who can use it as well. It's really very valuable. And if you've held stayed with us, well done listening to an hour and 15 minutes on poo. Excellent, excellent job. And I'm sure I will touch base with you again shall in the future because I know you're doing lots of important work in the whole area of lactation. So thank you for everything.

Charlotte Treitl  1:11:43

Thank you. Thank you for having me. It's always great to talk crap with people.

Emma Pickett  1:11:50

You talk about brilliantly. Thank you very much. 

Charlotte Treitl  1:11:53

Thank you.

Emma Pickett  1:11:59

Thank you for joining me today. You can find me on Instagram @EmmaPickettIBCLC and on Twitter @MakesMilk. It would be lovely if you subscribed because that helps other people to know I exist. And leaving a review would be great as well. Get in touch if you would like to join me to share your feeding or weaning journey, or if you have any ideas for topics to include in the podcast. This podcast is produced by the lovely Emily Crosby Media. 

Emma Pickett  1:12:31

One final thing, I have a discount code for my podcast listeners for my last two books, the one on supporting breastfeeding past the first six months and beyond and the one on supporting weaning or the transition from breastfeeding. If you go to the UK Jessica Kingsley press website which is uk.jkp.com and put in the code M M P E 10. That's mm for makes milk P for Pickett E for Emma one zero, you'll get a 10% discount on checkout. Thank you.