A breastfed baby's urination pattern changes during the first week of life. In the first few days, your baby will not receive a large amount of milk, so there will be fewer wet diapers. As the days go on and your milk supply increases, your baby will produce more urine. It's important to understand what is normal in your baby's diaper. By keeping track of your baby’s urine output, you will be able to determine if your baby is getting enough milk.
A newborn baby will pass urine for the first time within 12 to 24 hours after birth. During the first few days of life, an exclusively breastfed baby may not have many wet (urine) diapers. Look for at least two wet diapers a day until your milk comes in. After day six, your baby should have at least six to eight wet diapers every 24 hours, but may have more.
A baby has a little bladder that holds approximately one tablespoon (15ml) of urine, so he or she may empty it very frequently. Some babies will urinate up to twenty times in 24 hours. If your baby is sleeping, you do not need to wake him up to change a diaper. A diaper change before or after each feeding, approximately every two to three hours, is sufficient.
What Is A “Wet” Diaper?
It can be hard to tell if your baby is producing enough urine. Disposable diapers are very absorbent, which can make it difficult to determine how much urine is actually in them. Here are a few things you can do to make sure your baby is having wet diapers:
- Pour one ounce (two tablespoons, 30ml) of water into a clean, dry diaper. This will give you a better idea of what a wet diaper looks and feels like.
- Place a tissue into the diaper to absorb the urine and make it easier to see.
- After you change the baby, take the diaper apart to check the under layers or gel material for moisture.
- Use cloth diapers. It is easier to tell if a cloth diaper is wet.
Brick Dust and Concentrated Urine
Very concentrated urine during the first few days of life can contain uric acid crystals. These crystals may cause a pink, red or orange colored powdery stain in your baby’s diaper called brick dust. It might be scary, but this is a normal occurrence in many newborns. After your milk comes in, by the fifth or sixth day, your baby's urine will no longer be concentrated. It should be colorless to a pale yellow in appearance and odorless.
Concentrated urine is very dark yellow in color. After your milk comes in, an occasional diaper with concentrated urine is okay; however, if your baby is having frequent diapers with concentrated urine, contact your pediatrician.
Notify Your Baby's Doctor If:
- You see brick dust stains in your baby’s diaper after the fourth day of life.
- The baby is having fewer than six wet diapers in a 24-hour period after day five.
- The baby is only a producing a small amount of very dark yellow, concentrated urine after day four.
These are signs that your baby may not be getting enough milk. The pediatrician can examine your baby’s health and discuss your breastfeeding technique. You may also want to contact a lactation consultant to help you with proper positioning and latch.
Blood In The Diaper
Baby girls may have a blood-tinged vaginal discharge during the first few days of life. This is call pseudomenstruation or false menstruation. It is the result of hormonal changes in your baby and is not a cause for concern.
Baby boys may have a small amount of blood in their diapers after a circumcision. The bleeding from a circumcision will usually last for a few hours, but you may notice small spots of blood in the diaper for up to a day. After a circumcision, the baby should pass urine within twelve hours.
Blood in your baby's diaper that is not from a circumcision or pseudomenstruation is not considered normal. If you see any blood or your baby is showing signs of painful urination, contact your baby's doctor right away.
American Academy of Pediatrics. New Mother’s Guide To Breastfeeding. Bantam Dell. New York. 2006.
Jackson, Debra Broadwell, PhD., RN, Saunders, Rebecca B., PhD, RNC. Child Health Nursing. J.B. Lippincott Company, Philadelphia, 1993.