Let’s talk about baby poop, pee and spit-up!

Parenting doesn’t come with a manual (how we wish it did) and all children are different, you might initially be quite alarmed by your baby’s bodily fluids. The good news is, your little one is right on track if he poops, wees, and spits up often. Especially in the first six to 12 months as his digestive system matures and develops. Here’s the lowdown on what to expect when it comes to baby’s poop, pee, and spit-up and when you should be concerned.

The subject of poop

From the minute your baby is born, expect that he might poop. A baby’s first poop is referred to as meconium. It’s generally dark, thick, and has the consistency of Marmite. It consists of the things your little one’s ingested throughout your pregnancy, explains registered doula and postnatal specialist, Magdaleen Moller. “This poop might also include mucus, amniotic fluid, lanugo, and bile. It’s generally a very dark green colour and is extremely sticky,” she explains.

Expert tip: Lather your baby with a thick layer of petroleum jelly. This works better than bum cream as you can merely wipe your baby clean after a poo, says Magdaleen.  A warm wet wipe or an old-fashioned face cloth is also better for your new baby’s skin.

Breastfed baby’s poop vs formula-fed baby’s poop

If you’re exclusively breastfeeding in the first six months, your baby’s poop might look like butternut soup with curdled pieces (almost like small pieces of feta cheese), explains Magdaleen. A breastfed stool rarely smells. However, if you’re formula feeding, expect your baby’s poop to be a khaki colour with a distinct sour-milk smell.

Formula-fed babies tend to suffer from constipation more often than breastfed babies as the stools become harder as time goes on. Breastfed babies seldom suffer from constipation as breastmilk is digested more easily unless your little one has an allergy to your breastmilk.

When to call the doctor  

If your baby’s suffering from constipation, it might be linked to a sluggish digestive tract, illness, not enough to drink, or a reaction to the type of formula he’s on if he’s formula-fed says Heidi Murkoff, author of What to Expect in the First Year. If constipation persists for more than a day or two, Heidi suggests letting your doctor know as this can be painful and uncomfortable for little ones.

Although it’s normal for breastfed poop to look runnier than formula fed poop, it’s important to know when your child has diarrhoea as this can quickly lead to dehydration. The good news is, diarrhoea is unusual in breastfed babies as there’s certain substances in breast milk that destroy many of the microorganisms that cause diarrhoea.

However, It’s best to call your doctor right away to determine what’s causing the diarrhoea (either a virus or bacterial infection) and to prevent dehydration, if you notice your child:

• Has very runny poop like water
• Has mucus or blood in his stool
• Is also vomiting
• Seems lethargic and won’t drink anything.

Talking about wee

The first few days after birth, your baby will drink colostrum, which is the first milk your breasts produce, explains Magdaleen. Colostrum contains antibodies, carbohydrates, protein, and fat. The main function of colostrum is to clear excess bilirubin that can build up in your baby’s liver, causing jaundice.

Because colostrum is thick, and it takes time to kickstart your little one’s system, he’ll only start producing multiple wet diapers from around day five when your milk comes in. A healthy baby should be producing at least six wet diapers a day. This means that your newborn won’t wee a lot initially, which is normal, says Magdaleen.  In fact, disposable diapers may not appear wet at all due to the super absorbency.

Normal urine 

Magdaleen points out that healthy urine is a light straw colour, clear and not cloudy, and doesn’t have a distinct smell.

If you notice tiny red crystals in your newborn’s diaper, don’t panic, warns Magdaleen. Although this is a sign of slight dehydration, it’s normal during the early days. It’s important to feed your baby regularly to stimulate milk production and keep your baby’s fluid levels up.

When to call the doctor

If you suspect your child isn’t producing enough wet nappies throughout the day and night, seems lethargic and wants to sleep a lot, or looks a little yellow, this could be a sign of jaundice, which can lead to fatigue and dehydration. In this case, speak to your paediatrician immediately.

Urinary tract infections are caused by bacterial infections of the urinary tract and require medical attention, explains Heidi. Although they’re painful and uncomfortable for little ones, urinary tract infections are common because the urethra is very short, giving bacteria easy access to the bladder.

Call your doctor if you notice your baby:

• Has a fever and is crying a lot
• Has foul-smelling urine
• Has cloudy urine
• Is more irritable
• Won’t drink much.

Spit

Did you know that at birth, your baby’s stomach is only the size of a cherry and can only take around 5ml of fluid at a time? Therefore, it’s normal for babies to spit up milk often. In fact, some babies can’t go without a bib for the first year.

Newborns will generally spit up directly after a feed which could be due to overfeeding, or stuck wind. By day 30, your baby’s stomach will be the size of a large egg and can take around 30ml fluid at a time. To prevent frequent spit-ups, feed your baby smaller amounts more frequently, and make sure to wind him properly after each feed. Later on, spit ups can be caused by certain foods and liquids, as well as teething since the mouth produces more saliva when teeth are erupting.

Your baby’s oesophagus

“When we eat and swallow, the oesophagus (food pipe) automatically contracts to push food down into the stomach. At the same time, a valve, known as the lower oesophageal sphincter (LES), relaxes to allow the food to pass through. Normally, the LES closes to prevent food and stomach acids from flowing back up into the oesophagus,” explains Johannesburg-based paediatrician Dr Dewald Buitendag.

Reflux is common in babies as the LES valve is still weak and may not close properly. This is why babies typically spit up or burp after eating. In some instances, this isn’t painful. In other cases, the ingested milk mixes with stomach acids and irritates the inner lining of the oesophagus when it travels back up, resulting in pain and inflammation.

When to call your doctor

Call your doctor if your baby:

• Is vomiting (projectile) and has an elevated temperature
• Vomits for more than 24 hours
• Cries continuously after spitting up or whenever you lay your baby down.
• Spits up any blood as this could be a sign of a serious infection. Yellowish-green bile present in the spit-up could also indicate a blockage.