OBSTETRICS/MATERNITY:

 Bowel Movements and Diapering

Voiding

Usually, newborns first pass urine within 24 hours after birth. If new mothers do not see a wet diaper during the first day, they should notify their pediatrician.

If a woman is breastfeeding, it is normal, for the first few days, to see one wet diaper every seven to eight hours. Once mom’s milk is in and the baby is nursing regularly, seeing six to eight wet diapers a day means baby is getting enough to eat.

Babies who are bottle-fed will usually void after each feeding and usually more during the first month. The urine should be pale in color. If there are orange-colored areas on the diaper, representing concentrated urine, the baby needs more fluids.

Stage of Stool

• Meconium. Dark green or black tarry stool passed for the first one to three days.
• Transitional. The next stool, seen once the baby has been feeding, will be loose in consistency and greenish / yellow in color.
• Stools of Breastfed Babies. Loose, yellow stools with cottage cheese-type particles. By the end of the first week, the baby will be stooling frequently--perhaps with every feeding or three to eight times a day.
• Stools of Formula-Fed Babies. Less frequent and more formed than breastfed stools. Bottle-fed babies will usually have one to three greenish-yellow, pasty stools.

Stooling patterns and frequencies vary for every baby, so new mothers should learn what is normal for their newborn.

Call the pediatrician if the first meconium stool is not passed within 36 hours of birth, or if the baby has diarrhea or difficulty passing stools.

Parents are encouraged to change their baby’s diaper before a feeding or whenever their newborn needs it. The handling and stimulation of a diaper change before a feeding will help wake up the baby and prepare him or her for a feeding.

How to Change a Diaper

With warm water, moisten a dry cotton wipe (found in the crib supply drawer during the hospital stay). Hold baby’s legs with one hand and use the moistened wipe to clean the diaper area with a front-to-back motion. Lift the baby’s legs and place a clean diaper underneath him or her. Fold the front edge of the diaper below the umbilical cord  to help the drying and healing process of the belly button.

On boys, lift the scrotum and clean around it. On girls, clean the stool from the vaginal area by wiping from front to back, to prevent any transmission of normal stool bacteria to the cleaner vaginal area. Between the vaginal lips, the cheesy white material called vernix does not have to be removed. Just keep the area clean of stool. The vernix will dry up and disappear within two weeks.

Sometimes girls will have a vaginal blood-tinged mucous discharge during the first week of life. This is caused by maternal hormones that crossed the placenta. This discharge is normal will disappear in a few weeks.

Tips to Keep in Mind:

• When applying a clean diaper, fold the front edge of the diaper below the umbilical cord to help air dry the cord
• Do not use baby powders and/or ointments on baby’s skin
• At the first sign of redness and diaper rash, try changing diapers more often and leaving the diaper off to allow air drying. Discontinue use of rubber pants and use an ointment such as Desitin or A&D to provide a protective coating for the skin.
• If baby is fussy between feedings, check for a wet or soiled diaper