Poos, wees and nappies

When you have a baby, you spend a lot of time changing nappies and cleaning little bottoms.
Is my baby's poo normal?

The colour of baby poo (faeces or bowel action), how firm or runny it is, and how often a baby passes poo can all vary a lot, and usually it is 'normal'.
The first bowel action after a baby's birth is a dark green-black sticky substance called meconium.

The poo gradually changes over the next few days to a lighter colour, sometimes with some mucus in it, as the baby adapts to his diet of breast milk or formula.

The poo will vary a lot with how your baby is fed.
Breast-fed babies have soft, unformed poos that may look a bit like seedy mustard, often a yellow-orange colour, but sometimes greenish.

A baby's poo may shoot out with some force, and may look frothy at times.

In the first few weeks, breast-fed babies usually pass bowel actions several times a day, perhaps every feed time.

After a couple of months, this may settle to once or twice a day, or once every few days or so, but generally the poo, when it comes, is still soft (so this is not constipation).

Some fully breastfed babies may go for up to 7 days or more before they do another poo without the baby being constipated. This is quite normal.

The poo of a fully breastfed baby smells quite sweet. It changes to a more offensive smell only when other foods or milks are given.

Bottle-fed babies tend to have firmer poos, and pass them less often in the first few weeks.

They vary a lot in colour and how firm they are.

They may be greyish-yellow, or even grey-blue, or some shade of brown.

They may be anything from fairly liquid, to paste-like, to very firm and dry.

Any change in formula or the addition of new foods to the baby's diet is likely to change the nature of the bowel action, and this is quite normal.

When an older baby is having solids, especially vegetables, these can come out the other end looking quite undigested. Again, this is normal and will gradually change as the baby's bowel becomes more mature.
Is my baby constipated?

Babies often appear to put a lot of effort into doing poo. They go red in the face, grunt or cry and strain with great concentration, then pass a normal soft poo. This is not constipation, and as the baby gets older he will have less of a total body involvement in normal body functions.
Constipation refers to the poo being hard and dry so that it is difficult to pass.

The baby may become quite upset.

The poo will be like firm pebbles.

Sometimes you may notice a streak of blood on the poo from a small tear in the anus. If this happens, talk to your doctor or child health nurse.

Fully breast-fed babies do not get constipated unless there is a health problem, and the health problems causing constipation in breast-fed babies are rare. Even when they are not getting enough milk, the poo tends to stay soft.
Constipation can occur with bottle-fed babies.
Make sure the formula is being made up correctly (follow the instructions on the can), and try giving some boiled water. Tummy massage may help too (clockwise).

Have a look at the topic Constipation for some ideas about how to help a formula-fed baby with constipation.

Your doctor or nurse may have some other suggestions.
How do I know if my baby has diarrhoea?

When babies are having a lot of runny poos anyway, parents often wonder about this.
It may be diarrhoea if the poos become more runny and are passed more often than normal for your baby.

They may be quite watery, like urine.

There may be an infection in the gut (gastroenteritis) or elsewhere in the body, and runny poos may be accompanied by vomiting.

The baby may appear unwell, and not want to feed.

It is important to seek medical help quickly if diarrhoea continues or is severe, especially if there is vomiting.
How many wet nappies will there be each day?

Young babies pass urine very often, many times every day, and will often do a wee when their nappy is taken off or as you go to put a dry one on.
The baby has no control over this at all and she is certainly not doing it on purpose.

They wet less often as they get older, but still at least 6 to 8 times a day, and often more.

Plenty of urine, making a lot of wet nappies, is a sign that the baby is getting plenty to drink, which is reassuring.

Disposable nappies can absorb a lot of wee without feeling wet, so how wet a disposable nappy feels, or how often you need to change a nappy is not always a reliable guide to whether a baby is getting enough to drink. A better guide is how heavy the nappy feels.

In hot weather or if the baby is not feeding well for some reason, the urine may be darker and more smelly than usual. An extra feed or a drink of water may help, but if there are other reasons to think the baby may be unwell, seek some advice.
Baby urine is very clean and doesn't usually smell much unless it remains in the nappy for a while. When this happens, bacteria will produce ammonia from chemicals in the urine. This has a definite smell and can irritate the skin. This is why it is important to change the nappy regularly and wash the baby's skin.

Stains and crystals on the nappy

A little light pink, orange or even red stain on the nappy is seen occasionally.

It is caused by crystals made by a reaction between urates in the urine (which are normal) and chemicals in the fibres of the nappy.

These crystals can appear when the baby is totally healthy, but they are more likely if the baby has not had enough to drink (is slightly dehydrated).

You are more likely to see it if you have a boy baby, because his wee is more likely to be all in the same place on the nappy.

The baby did not pass the crystals, so they did not cause him or her any pain.

If there is a red or brown stain that looks at all like blood, or your baby seems unwell and is not feeding normally, your baby may have a urinary tract infection and you need to have it checked by a doctor.
Sometimes there can be small yellow or brown 'crystals' on the inner surface of a disposable nappy. These are water absorbing crystals and come from the inside of the nappy, not from the baby.
How can I avoid nappy rash?

Some babies seem to get rashes in the nappy area very easily, however well they are cared for, and others get few rashes.
The best way to keep your baby's bottom as rash-free as possible is to change nappies often so that urine and poo is not in contact with skin for too long.

Clean your baby's skin gently with water on a cloth.

If you use baby wipes, choose ones without alcohol to avoid stinging, especially when there is a rash present. Hand wipes for adults usually have alcohol in them, and should not be used for babies.

After cleaning, put on some zinc cream or other nappy cream to keep wetness away from the skin.

It can also help to leave the nappy off for a while during playtime to allow air to get to the skin.

Some people claim that if a baby has a nappy rash it may be helpful to use disposable nappies which draw the urine away from the baby's skin, keeping it drier.

It is very easy for thrush to grow in the nappy area once the skin has become red and damaged. This will show as a very red area with spots around it. Special creams are available which clear this type of rash quickly, so see your doctor or child health nurse if your baby develops a rash that doesn't clear in a day or so.
If you have a particular problem, see a doctor