In the first few days, your new born may pass urine as often as every 1-3 hours or as infrequently as 4-6 times a day. If the baby is ill or when the weather is hot, it’s normal if her usual urine output to drops by half. Urination should not be painful. In case you notice any signs of distress in the baby while urinating, tell your paediatrician, as this could be a sign of a urinary tract infection.
In a healthy baby, the urine is light to dark yellow in colour. A darker colour indicates your child is not drinking enough liquid.) Sometimes you might see a pink stain on the nappy that you may mistake for blood. This pink stain, in fact, usually is a sign of highly concentrated urine. If the baby is wetting at least four diapers a day, there usually is no cause for concern, but if the problem of staining persists, inform your paediatrician.
The presence of actual blood in the urine is never normal, and your paediatrician should be notified if you see a blood stain in the diaper. It may be nothing more serious than a diaper rash, but it might be a sign of an underlying problem. If this (bleeding) is accompanied by abdominal pain or more bleeding in any other area, go to the doctor immediately.
The first few stools, that the baby passes, are referred to as meconium. This is the thick black or dark green substance that filled her intestines before birth. Once the meconium is passed, the stools will turn yellowish green in colour.
If the baby is on mother’s milk, her stools will soon resemble light mustard with seed like particles. The consistency of the stools may range from very soft to loose and runny. If the baby is on formula feed, her stools usually will be tan or yellow in colour and firmer than that of a baby’s who is on mother’s milk.
Whether your baby is breastfed or formula-fed, dry and hard stools indicate that she is either not getting enough fluids or losing too much fluid due to illness/ fever or heat. Once the baby is on solid food, hard stools indicate that she’s having too many constipating foods, like cow’s milk or cereal, before her system can handle them.
Here are some other important things to keep in mind about baby’s bowel movements:
- Some occasional variations in colour or consistency of the stools are normal. For e.g, the digestive process slows down because the baby has had a large amount of solid food that day (or foods which require more effort to digest)the stools may become green in colour; or if the baby is given an iron supplement, the stools may turn dark, almost blackish. In case of a minor irritation of the anus, blood streaks may appear on the outside of the stools. But if there are large amounts of blood, mucus or water in the stool, call your doctor immediately.
- As an infant’s stools are usually soft and a little runny, it’s not always easy to say when a baby has mild diarrhoea. The telltale signs can be an increase in frequency (per feeding if the baby has more than one bowel movement) and a watery stool. Diarrhoea may be because of an intestinal infection, or may be due to changes in the baby’s diet. If the baby is breastfed, a change in the mother’s diet can also cause diarrhoea in the baby.
- The major concern with diarrhoea is it can lead to dehydration. In case of a fever in an infant less than two months old, consult the paediatrician. In case of a fever in a baby over two months old, and the fever lasts more than a day, check her urine output and temperature and report to your doctor. Make sure to feed your baby frequently.
In the early days, the frequency of passing stool varies from one baby to another. Some pass a stool soon after every feeding. This is a due to a gastro colic reflex that causes the digestive system to activate whenever the stomach is filled. By the time the baby is three to six weeks old, some breastfed babies have as little as only one bowel movement a week and still are normal. This is because breast milk is almost fully absorbed by the child’s digestive system and leaves very little solid waste to be eliminated. Hence, infrequent stools may not be a sign of constipation and shouldn’t be considered a problem if the stools are soft and your baby is otherwise normal, nursing regularly and is gaining weight steadily.
If your baby is on formula or top feed, she should at least have one bowel movement in a day. In case she has fewer than this and seems to be straining or has hard stools, she may be constipated. You may want to ask for your paediatrician’s advice on how to handle this problem.