Your baby’s first weeks- wet diapers

Many parents have questions about their baby’s wet diapers. Over the first week of life the baby’s urine output increases. When the baby is 2 days old they should have 2 wet (urine) diapers per day (meaning per 24 hour period). When they are 3 days old they should have 3 wet diapers per day. When they are 4 days old they should have 4 wet diapers per day, etc. up until they are 8 days old. From that point on they should have 7-8 wet diapers per day. We are careful about monitoring urine production especially within the first 1-2 months of life. If babies have fewer than 3 wet diapers per day we would be concerned about dehydration. This can occur if the infant is not feeding well or if they are sick. If your baby has fewer than 3 wet diapers during a 24 hour period please reach out to your pediatrician.

What color should the urine be?
The urine may be light yellow to dark yellow color. If it is frequently dark yellow this means your baby’s urine is concentrated and may be a sign that your baby needs to drink more breast milk or formula.

How can I tell if my baby is making urine when the stool is liquid?
This is a question that pediatricians are asked frequently. It can be difficult to tell because you can not always see the urine in the diaper when there is liquid stool. Many newborn diapers have a stripe on the front of the diaper that only changes color when urine is present. The color does not change when just stool is present.

My baby seems to be wet all of the time. Are they making too much urine?
Some babies produce urine every hour. Some produce urine more frequently than this. Some void urine once every 2 to 3 hours. This is all normal.

I noticed a small orange-pink spot in the diaper. Is this blood? Should I be worried?
During the first week of life you may notice a small orange-pink spot in the diaper. It is sometimes mistaken for blood. This is not worrisome. This colored spot is due to uric acid crystals and is a sign of concentrated urine. This typically resolves after a few days, once the infant is feeding frequently and is getting a good volume of breastmilk or formula. When this spot occurs outside of the newborn period it indicates concentrated urine and possible dehydration. Reach out to your pediatrician if this occurs more than once after the first week of life, or if your baby is not feeding well, is producing fewer wet diapers or is fussy.

I saw a drop of bright red blood, not orange-pink crystals. Now should I be worried?
Well, that depends. Sometimes female babies have blood in the diaper for the first few weeks after delivery. This is due to hormone changes after delivery and is not usually concerning. You may also notice some white mucus in the vaginal area for the same reason. If there is a diaper rash with some skin breakdown, where it looks like small scrapes or sores are present, sometimes this can cause some blood in the diaper area near the site of these marks. This can happen when the skin is irritated from frequent bowel movements or infrequent diaper changes. Apply a good barrier cream and call your pediatrician if this is happening.

If there is blood in the urine, especially if it occurs with fussiness, crying during urination or fever, this can be a sign of a urinary tract infection which can be serious in babies. Do not hesitate to reach out to your pediatrician right away if this occurs.

If you have any questions or concerns about your newborn reach your to your pediatrician. We are always here to help.