D is for Diapers

By diapers I don’t mean what kind of diaper you should buy or how to put one on your baby, I mean what your baby is making for you inside those diapers!  Whether you cloth diaper, or use Pampers or Huggies or some other type of diaper, isn’t of concern – although you may want to wait a few days to use cloth diapers.  What you see in your baby’s diapers will change during the first week of life.

Urine

Whether you breastfeed or formula feed the urine output will be the same.  You should have at least one wet diaper per day for every day of life up to day 4.  One wet diaper on day 1, two wet diapers on day 2, etc.  Starting on day 4 your baby should have five-six wet diapers a day.  It can be hard to tell if a disposable diaper is dry; consider using a diaper with the color-changing line or smell or weigh the diaper to check for a difference.  Having more than this many diapers is perfectly fine and considered normal.  However, if your baby does not have enough wet diapers each day it can be a sign of dehydration and you should increase the amount of breastmilk or formula you are giving them.  If breastfeeding, simply nurse your baby more often. 

The most important thing is the number of wet diapers – not the volume of pee.  If your baby is having no wet diapers, or too few, contact your pediatrician.  Urinating should never be uncomfortable, and if your baby seems uncomfortable when peeing you should contact your pediatrician.  Any blood in the urine is not normal, and you should contact your pediatrician.  Urine should be light in color, and if your baby has several diapers with dark colored urine, you should contact your pediatrician.  Urine in the first week may be very concentrated and have urate crystals; some have compared their look to brick dust.  Urate crystals cause a brick-red or orange powder looking stain in your baby’s diaper.  This should go away when your baby begins to drink more formula or your breast milk comes in.

Baby girls will occasionally have discharge that is blood-tinged immediately after birth.  This is from the hormones your baby has from you when in the womb, and is called pseudomenstruation.  Pseudomenstruation in girls and circumcision in boys is the only reason for slightly blood-tinged urine and should not continue past the first week of life; any other bleeding is a reason to call your pediatrician.

Be prepared when changing a baby boy’s diaper! When you open the diaper and expose his penis to the air it will likely cause him to pee. I would always prepare myself ahead of time, and have a wipe ready to place over his penis when I open the diaper and the clean diaper open and ready to swap out immediately.

Stool

During your baby’s first week of life, you should expect to see one poopy diaper per day for each day of life.  The first few stools will be meconium, your baby’s first stool, and can be very difficult to clean.  The more often your baby eats the sooner this stool will pass.  On day 3, this poop should begin to change and is considered transitional poop before changing to the regular formula or breastfed baby poop.  Once the meconium becomes transitional poop, it is safe to start using cloth diapers.  Many parents will still wait until this stool is finished as well because it can still stain the diapers.  On day 5, your baby should have passed all the meconium and transitional poop and it should now be the normal breastfed or formula fed consistency.  After the first week, your baby should have three to four, or more, stools each day.  Sometimes your baby may poop after each feeding session.  After 6 weeks it is perfectly normal for some breastfed babies to go several days without passing a stool, this is because their body becomes more efficient at digesting breastmilk.  At this point formula fed babies should still poop at least once per day. 

Meconium

This is black or dark green, sticky, and almost tar-like in consistency.

Transitional Stool

Green and less sticky than meconium.

Breastfed Stool

Yellow, mustard-like in color, watery and possibly seedy in texture. May smell buttery.

Formula-fed Stool

Soft, pasty in texture.

Tan or yellow color.

Your baby may grunt, cry, turn red, or strain when passing stool – this is completely normal.  As long as the stool is soft and not hard, your baby is not constipated.  Talk to your pediatrician before trying any juice or medication to relieve any perceived constipation.  Your baby may also experience diarrhea which is when the stool is very watery.  Diarrhea lasting more than one day or with blood, mucous, or fever is a sign that you should call your pediatrician.

While there is a typical color and texture to baby poop, there are also many variables of normal.  The color of your baby’s poop may be brown or green.  If the poop is chalk white or grey let your pediatrician know.  Black, dark stool after the meconium has passed can be due to cracked bleeding nipples and the blood the baby digests, this will not harm your baby.

It is always a good idea to wipe front to back, but with girls especially! The stool can get into the cracks and crevices of the vagina and labia, so make sure to wipe between all the fold and from front to back to avoid her getting a urinary tract infection or UTI.

First Time

Your baby may have their first pee on you during the immediate skin-to-skin, before the nurses even have a chance to put a diaper on him/her.  Both of mine did!  The first bowel movement will be within the first 24-hours after birth and will be the thick meconium stool.

Diaper Rash

Diaper rash can be a source of many tears – yours and your baby’s.  The best cure for diaper rash is letting your baby go without a diaper.  This can be a scary notion when you think about your baby rolling around on your carpet or hardwood floor.  Try doing this diaper free time outside, in the tub (without water), or on a towel.  If you aren’t comfortable with this method, try changing the diaper immediately when it gets wet to limit the amount of time your baby sits in a moist diaper.

There are many diaper rash creams available out there; none have seemed to work for me.  However, I swear by the Lemongrass Spa Healing Elements Balm!  It works wonders and clears the rash up in a day or two!  No matter what cream you choose, only apply a thin layer on dry skin to create a barrier between your baby’s bottom and the moisture in the diaper.  It is not recommended to use baby powder, even though it will dry the rash, because the powder particles are inhaled by the baby and can lead to asthma and other lung damage.

Weaning Stool

When you begin to wean your baby or introduce food, the poop will also change.  The poop will begin to have a smell similar to adult poop and a comparable texture as well.  If your baby begins to strain with bowel movements at this time it can be a sign that they need more water, breast milk, or formula in addition to whatever food you are serving or that you need to change the kinds of foods you are feeding him/her.  The smell and texture will vary depending on the amount and type of food you are providing.

Were you prepared for that first poop?!

Next week I will be blogging on the letter E… E is for Erythromycin.