ConstipationDiarrhoeaIBSPodcast

Kid Poop Chart & IBS Explained

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I use the description ‘Kid Poop Chart’ a lot in my weekly Gut Health Clinic, so you might be wondering how to use it to analyse your child’s poo.

 

Your paediatric dietitian or paediatrician may also have shown you the Bristol stool chart.  So you probably want to know if it’s the same thing and how to use it to determine whether your child’s poop is normal or not.

 

If that’s the case, keep reading!

 

In this article you’ll find a visual guide that will clearly explain what the different types of poop are.  

 

This article will also explain how the kid poop chart compares to the adult Bristol stool chart and how to help your child pass normal poop.   If you suspect that your child may have constipation, diarrhoea or irritable bowel syndrome, then I’ll also explain what these are and what you need to do.

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Table of Contents

What is a kid poop chart?

 

A poop chart is essentially the Bristol Stool Chart that has been simplified for children.  

Your paediatric dietitian or doctor may show your child a kid-friendly version of the Bristol stool scale to help them talk about their poop.

It’s essentially a pictorial guide of the different types of poop to help your child find it easier to describe what their usual poop is like.

Visual aids like these can help your doctor make a diagnosis of constipation, diarrhoea or irritable bowel syndrome.

Note that it doesn’t explain how often your child should be pooping.

The poop chart also doesn’t highlight any other symptoms like abdominal pain that your child may also be experiencing.  

It does however, define the different types of poop in a clear and visually kid-friendly way.

What are the different types of poop?

 

Type 1Separate hard lumps 

Looks like rabbit droppings

Type 2 – Lumpy and sausage-like

Looks like a bunch of grapes

Type 3 – Sausage shape with cracks on the surface

Looks like corn on the cob

Type 4 – Like a smooth soft sausage like a snake

Looks like a sausage

Type 5Soft blobs with clear cut edges

Looks like several chicken nuggets

Type 6Mushy consistency with ragged edges

Looks like porridge

Type 7Liquid consistency with no solid pieces

Looks like gravy or thin sauce

What about toddler poop colour?

 

You’ll notice that most kid poop charts and Bristol stool charts generally don’t refer to the different colours of baby and toddler poop.  

 

So let’s go through what are the different colours of kid poop.  We’ll cover what’s normal and which toddler poop colour warrants medical attention.

 

Yellow/brown stools

Yellow and brown are the colours of normal stools.  If your baby’s poop has changed from yellow mustard to a darker brown colour this could be down to a change in what they’ve been eating.

Note that when toddlers have been eating darker coloured foods like chocolate or anything with food colouring, it’s natural that their poop changes to take on that colour.

Green stools

It’s very common for babies to pass green coloured poop.  This is especially noticeable if there has been a change to their infant formula.

Babies who have recently changed from standard infant formula to an extensively hydrolysed or amino acid-based formula for the management of cow’s milk protein allergy may find that their poop changes from yellow to green.

This is perfectly normal and nothing to worry about.

If your baby or toddler passes green stools with fever and becomes unwell, then do speak to your family doctor for advice.

 

Black toddler poop

One-off black stools could be down to food colouring but if this persists it could be a sign of blood in their stools.  Speak to your child’s doctor or paediatrician for medical advice.

 

Red toddler poop

Chances are that your toddler has been eating brightly coloured beetroot or other food containing red food colouring.

But if that isn’t the case, then it could be fresh red blood due to a tear when passing a poop.  If it’s only a small red streak within their poop, this could be down to a tear when your child pushed out a large stool.

If this happens regularly do speak with your family doctor or paediatric dietitian for help managing symptoms of constipation.

Picky eaters are particularly prone to constipation.  

Working with a paediatric dietitian can help resolve the problem. 

My small group coaching programme ‘End Mealtime Battles’ might be just what you need if your toddler or school aged child is a picky eater with persisting constipation.

 

White stools

White or very pale stools are not normal and should be discussed with your child’s doctor straight away.  

Problems with the liver or bile ducts can cause very pale stools.

This is a serious medical problem and may also be accompanied by other symptoms like vomiting and severe abdominal pain.

One pale stool isn’t anything to be worried about but if it’s frequent and is accompanied by any other symptoms seek medical attention immediately.

What is constipation?

When the majority of your child’s poop is hard, large or painful to pass, then when compared against this kid poop chart, your child’s poop will look more like type 1 (resembling rabbit droppings) or type 2 (like a bunch of grapes).

Definition of constipation in babies and toddlers up to 4 years of age

According to the Rome VI criteria, constipation in young children can be defined as below.

Your child must have experienced these symptoms for one month for at least two of the following symptoms.

  • Passes two or fewer stools per week
  • History of withholding poo
  • History of painful or hard bowel movements (in kid poop chart will appear like type 1 or type 2)
  • History of large bowel movements in children
  • Presence of large faecal mass (poop) in the rectum (when examined by a physician)

 

In toilet-trained children (additional criteria)

  • At least one episode per week of incontinence (despite being toilet trained)
  • History of very large poop that can block the toilet

For tips on how to manage constipation in babies and toddlers, see ‘How To Help Constipation In Babies & Toddlers’

What is diarrhoea?

If your child mostly describes their poop as type 6 (resembling porridge) to 7 (looking like gravy) from the kid poop chart, then their stools are more on the ‘loose’ to watery.

Rome criteria for diagnosing functional diarrhoea

Must have all of the following symptoms described below:

  • Daily, painless watery poop (4 or more episodes per day)
  • Symptoms have lasted for over 4 weeks
  • Symptoms began from 6 months to 60 months of age

What is paediatric IBS?

 

Irritable bowel syndrome (IBS)  is a digestive problem in children and adolescents where constipation or diarrhoea is one of their main problems.

 

IBS is therefore a collection of symptoms as outlined below:

  • Abdominal pain (usually central or lower tummy pain that improves after pooping)
  • Bloating with or without a visibly distended tummy
  • Excessive wind
  • Diarrhoea with urgency (with or without nappy rash)
  • Constipation with soiling and/or with the feeling of incomplete emptying of the bowel

What does IBS poop look like?

IBS poop can vary from constipation or hard poop type 1-2 on the kid poop chart.  In these children, their constipation will be their most prominent symptom.

 

For children with IBS type diarrhoea experience loose/watery poo described as type 5-7.  

 

In IBS it is therefore possible for children to predominantly experience only one problem like constipation or diarrhoea.

 

Other children may notice that their poop fluctuates between normal (sausaged shaped that is soft and easy to pass) to being hard and difficult to pass or loose and watery.  

Can kids have mixed type poop?

Yes, absolutely.  In both adults and children with IBS, it is possible for symptoms to fluctuate between constipation and diarrhoea.

What causes IBS in children?

The exact cause of IBS is not known.  Family history is one known risk factor.  This means that if you or another family member has IBS then your child has a higher chance of also being diagnosed with IBS.

 

Factors thought to contribute to IBS in adults include:

  • Altered bowel motility
  • Visceral hypersensitivity
  • Impaired perception and processing of pain by the brain
  • Low grade inflammation
  • Alterations of gut microbial flora



What are the other symptoms of IBS?

IBS is often diagnosed after ruling out other more serious gastrointestinal conditions like coeliac disease and crohn’s disease.

 

Your family doctor may ask you about your family history.  Children with a history of food allergy and other members of the family diagnosed with IBS are more likely to also suffer from IBS.

 

Other symptoms associated with irritable bowel syndrome include:

  • Lower tummy pain
  • Diarrhoea with urgency (+ nappy rash in younger children)
  • Constipation with a feeling of incomplete evacuation
  • Problems with soiling
  • Bloating (the feeling that there is an inflated balloon inside the belly)
  • Excess wind or gas
  • Distention (the tummy is visibly distended)

How does IBS present in toddlers and young children?

  • Your child may seem to be withdrawn or irritable.
  • They may have ongoing unformed poop (mostly loose)
  • You struggle with potty training
  • You notice irritability and a recent change in their mood or behaviour



How is IBS diagnosed in children?

ROME IV diagnostic criteria is used to diagnose children with IBS after ruling out other more serious medical conditions related to the gut.

 

Criteria for diagnosing children with IBS

 

  • Abdominal pain for at least 4 days per month associated with the following:
    • Related to pooping
    • A change in the frequency of pooping
    • A change in the appearance of stools
  • In children with constipation, the pain does not resolve with resolution of constipation (for example with the use of laxatives)
  • After appropriate investigations and assessments symptoms cannot be fully explained by another medical condition

Bottomline

The kid poop chart can be a brilliant conversation starter for getting kids to talk about their poop.  It can also help explain what the different types of poop are and what type of poop is more likely to fall under constipation and diarrhoea.  If you suspect that your child’s persistent constipation or diarrhoea is linked to IBS, then do speak with a paediatric gastroenterologist or enquire about my IBS Kids Programme.

Let Me Help

Would you like to meet a children’s dietitian who has successfully helped families solve their nutrition problems from around the world?

Whether you are worried about picky eating, suspected food allergy or need help for your child with constipation and diarrhoea, I’ll help you manage these with confidence.

For bookings and enquiries email me on bahee@ukkidsnutrition.com or book a quick call for us to chat about how I can help you here.

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