When your baby is born, an elimination obsession develops. If someone told you how focused you would be on the contents of your baby’s diapers, you would never have believed them! Numbers, amounts and colors, oh my! Little did you know diapers would occupy so much of your time and energy!
Your baby’s output is a very important indicator of how feeding is going. Who’s paying attention? Everyone! The baby nurse, pediatrician, lactation consultant, and you! There is a lot of confusion about exactly what output is considered normal and what is worrisome. Let’s take a look at some pee and poop basics that can help reassure you that breastfeeding is on the right track.
For our purposes here, DOL means day of life, which is equivalent to the exact twenty-four hour period. So that means we count the first DOL starting from the hour your baby comes earthside and through the following 24 hours.
First DOL (birth to 24 hours old)
We expect to see one pee and one poop to ensure that the urinary tract and the bowels are functioning as they should be. The poop will be black, thick and sticky, and is what we call meconium. (Time saving tip: smooth some coconut oil over baby’s bottom after the diaper change to save time for the next poop.) The urine should be odorless and colorless. Sometimes with little girls, you will see some mucous discharge and a small tinge of blood in the diaper. This is normal, and is the result of mom’s hormones. However, if it seems worrisome at all, please check in with your pediatrician!
Second DOL (24 to 48 hours old)
We are looking for two pees and two poops on the second day of life. The pees should not be concentrated, although you may see a bit of color that looks like “brick dust”. More than likely, the poops will still be meconium, so keep that coconut oil nearby!
Third DOL (48 to 72 hours old)
We expect to see at least three poop and pee diapers (do you see a pattern forming?). The diaper count should be increasing! Urine should never be concentrated, so if you notice a dark yellow or orange color, persistent “brick dust”, or a strong odor, please contact your pediatrician! Newborn diapers are pretty cool these days with their little blue indicators (“Hey! We’ve got pee here!”) but they don’t indicate amount. If you’re unsure whether the pee amount is sufficient, pour about 2-3 tablespoons of water into a clean diaper. How the diaper weighs and feels is what a good newborn pee should be like. Moms should start feeling changes in their breasts and noticing milk “coming in”, so the meconium should begin to get thinner in consistency as well as lighter in color. The poop should be at least the size of a U.S. quarter (Smears from toots do not count!) If by the end of the day, if you don’t notice ANY changes in baby’s poop, especially if accompanied by not enough pee diapers, contact your pediatrician.
Fourth DOL (72 to 96 hours old)
We expect mature breastmilk to be in by days 3-5. If milk is increasing but not fully “in”, we expect at least 4 pees and 3-4 poop diapers. If mom’s milk is in, we expect to see the same amount of pees and poops as we do on the fifth DOL (see below).
Fifth DOL (96 to 120 hours old)
Breastmilk production should really be on the rise, and you should be changing a minimum of 8 heavy (remember our 2-3 tbsp diaper!) pale yellow pee diapers. With mom’s milk in, there will probably MANY more, but we would like to see a minimum of 4 yellow-ish, seedy poops the size of a U.S. quarter or bigger.
If numbers and amounts do not add up, pees are concentrated, you notice “brick dust” in baby’s diapers, poops are not changing from black, tarry meconium to a thinner, lighter consistency by the end of day 3, contact your pediatrician. Then, contact your local IBCLC to make sure breastfeeding is on the right track!