Diaper-Duty Essentials: What's Normal?
A slightly TMI (but totally need-to-know) guide to your baby's by-products.
A Healthy Obsession
You may not love changing diapers, but you're hardly alone if you obsess about what's inside them. Doctors say that pee, poop, and gas rank among new parents' top concerns because they're some of the few tangible ways to tell if your baby is healthy and getting enough nourishment. "Having something to keep track of helps parents feel in control," says Bryan Vartabedian, MD, a pediatric gastroenterologist at Texas Children's Hospital, in Houston. Use our guide to know when everything's okay -- and when to check in with your doctor.
What's normal: Baby poop is all about variety -- in color, consistency, and frequency. At birth, your newborn will excrete meconium, a dark and sticky substance that looks weird but is totally normal. After the first week, her poop will change in color and consistency. If you are breastfeeding, it will be yellow, seedy, and runny. Formula-fed babies have stools that are tan-colored and soft. Your baby's poop will become browner and smellier as she starts eating solids. Parents often worry about green-colored stools, but the hue alone isn't problematic: It usually comes from waste moving more quickly than usual through the digestive tract. In the first few months after birth, your baby can have up to four bowel movements a day, but they'll become less frequent after she reaches about 6 weeks. "Don't fixate too much on the number of dirty diapers," says Tanya Remer Altmann, MD, a pediatrician and author of Mommy Calls. "As long as your baby is eating well and has been growing steadily, parents can relax."
What's not: Tell your pediatrician about any mucus in your baby's diaper and about poop that's red or black (a possible sign of gastrointestinal bleeding or a milk allergy) or that's white or chalky (this can indicate liver problems). You should also tell your doctor if your baby has signs of constipation (like hard, pelletlike poops) or poop that looks like grape jelly, which could indicate an intestinal blockage. Doctors differ on what constitutes diarrhea, but a good rule is to see if your baby's stools suddenly become much more frequent and much more watery, says Dr. Vartabedian. If your baby is less than a month old, gets diarrhea, and is acting fussy or sluggish, tell the doctor right away, says Gwenn Schurgin O'Keeffe, MD, editor-in-chief of PediatricsNow.com. Otherwise, it's okay to wait a few days and give her extra water or diluted juice to keep her hydrated, as long as she is exhibiting no other symptoms. But be sure to check in with your pediatrician if your baby's diarrhea persists.
What's normal: Baby pee is much like grown-up urine. In the first few days after birth, however, you might see a reddish-pink dust in your baby's diaper. It's just a chemical reaction between his early urine (which can be more concentrated) and the diaper, and there's no need to worry, explains Dr. O'Keeffe. After the first week of life, expect at least six wet diapers a day.
What's not: If your baby is acting fussy, having fewer wet diapers than usual, producing crystallized urine, and crying but not making tears, he may be dehydrated. This is usually a sign that he's sick, but it also may be an indication that he's not getting enough breast milk or formula. Either way, you should talk to your doctor: Some pediatricians recommend giving over-the-counter pediatric electrolyte solutions to very dehydrated babies, says Dr. Altmann. Cloudy or foul-smelling urine may be a sign of a urinary-tract infection, which is usually accompanied by fever, sluggishness, and vomiting. Call your pediatrician if your infant is showing any of these symptoms.
What's normal: Gas can make your baby fussy, but it's not usually dangerous. It's normally caused by digestion or when your baby swallows air during feeding or crying. A lactation consultant may be able to suggest a better breastfeeding position. For formula-fed babies, try specially shaped bottles. Gas drops or a warm bath might also help. And keep in mind that, if you're breastfeeding, the foods that give you gas can have an even more dramatic effect on your baby.
What's not: There are some times when gas is a symptom of a more serious problem. If you notice your baby arching and crying during feeding time, he may have acid reflux. Reflux makes feeding uncomfortable, causing babies to pull away from the breast or bottle and swallow air instead of milk, making them gassy. If your baby's stomach looks bloated and feels harder to the touch than normal, and if he seems miserable and you can't calm him down, call your doctor.
It's important to find a setup that's comfortable, convenient, and safe.
- Choose a sturdy table with plenty of storage
- Make sure the table has straps and a firmly attached guardrail at least two inches high on all sides. It'll keep your baby in place while you reach for a diaper, but you should never leave her unattended -- even for a split second.
- If you don't have access to a table, use a thick, washable pad to change your baby on the floor or in her crib.
Originally published in the April 2009 issue of Parents magazine.