Breastfeeding A to Z

How Many Dirty Diapers in 24 Hours When Breastfeeding?

Information listed by your baby’s age

Week 1

The best way to tell if your baby is getting enough to eat without a scale is their dirty diapers.  If a baby has a minimum of 3 dirty diapers (poopy diapers, soiled diapers, stools, whatever you call bowel movements) in 24 hours, they are gaining weight. (1)  Three is a minimum, but they could have a dirty diaper every single time you change them.  Anything between three dirty diapers and every diaper (sometimes several in the same diaper change!) is normal.

Basically, if enough goes in–enough comes out!

If your baby eats enough breastmilk, your baby will have enough dirty diapers.  The amount of stool in a dirty diaper varies.  A quarter-sized spot in the diaper counts just as much as if they blow it out the sides.  The amount in the baby’s dirty diapers is not as important as if they have dirty diapers.  Frankly, the quarter-sized versions are easier to clean-up!  Usually the blow-outs require a bath, along with increased laundry!  Either is normal.  Both count as a dirty diaper.  You may just have a preference.

Wondering why your baby’s dirty diapers most often occur when you are feeding?  It happens because when your baby starts to suck, it causes the rest of their intestinal tract to squeeze (actually it is contracting and relaxing the muscles in the intestinal tract to create a wave, but squeeze still describes it) and whatever is at the end comes out.  This is called peristalsis and continues for a period of time after feeding. (2)  This is why you might need to change a diaper between sides when breastfeeding or at the end of the feeding, and then in a little bit you may have to do it again!

The dirty diaper will be changing from dark tarry meconium–the stool they have stored up during your pregnancy to a more yellow-mustardy color.  It may appear greenish or sometimes even tan.  Breastmilk is easily digested and the dirty diaper of a breastfed baby may look like it is just colored liquid which sinks into the diaper, or it may appear to have little cottage-cheese curds in it.  It will not look like yours.  Some parents are concerned that their baby has diarrhea because of the frequency and consistency of their baby’s dirty diapers.  Diarrhea is very rare in a totally breastfed baby; this is because breastmilk helps protect the intestinal tract. (3)

Before your baby is one week old, if they have no dirty diapers in 24 hours check your baby’s weight that day.  When there are no dirty diapers in 24 hours for a baby that young, there is concern the baby is not getting enough calories.  It is also possible they are just storing up for a big blow out.  Best to have baby’s weight checked that day to see what is going on.

Sometimes, if you have help and more than one person is changing baby’s diapers or you’re tired and can’t remember–it helps to keep track of feedings and diaper changes.  You can keep track for a few days if it helps.  After you know your baby’s gaining weight and feedings are going well you won’t need to keep track anymore.

References:

  1. Hagreen, J, Clinical Guidelines for the Establishment of Exclusive Breastfeeding, International Lactation Consultant Association, June 2005.
  2. Behrmann, RE, Kliegman, RM, Jenson, HB, Nelson Text of Pediatrics, 17th edition, Saunders Publishing, 2004, p 1229.
  3. Lawrence, RA, Lawrence, RM, Breastfeeding: A Guide for the Medical Professional, 7th edition, Maryland Heights, MO, Elsevier Mosby, 2011, p 33.

 

Week 2 

Dirty diapers are still your best gauge of whether or not your baby is getting enough to eat.  It is still the range of normal to have at least 3 dirty diapers in 24 hours and as many as every time you change a diaper in a day–or anything in between.

Basically, if enough goes in, enough comes out.  The stools will still be a yellow-mustardy color, unless you have given your baby something besides breast milk.  For additional information on breastmilk stools, see week 1 section above.  If any formula has been given, the stools will often decrease in number, have a different smell and be darker and greener in color.  If you change what food goes in your baby, it changes what comes out the other end.

 

Week 3

At 3 weeks of age, it is still normal to be changing 3 or more, dirty diapers in 24 hours. (1)  This could be 3 or it could be 12.  Again, babies are individuals, but as long as you are changing at least 3 dirty diapers in 24 hours your baby is getting enough calories from their feedings.  Dirty diapers are still your best marker that your baby is gaining weight.  If they do decrease the number of dirty diapers before they are 5-6 weeks old, make sure that they are still gaining weight.

Be aware, around the time your baby is 5-6 weeks old they may start to slow down with the number of dirty diapers thy have every day.  The change can be drastic.  You can go from changing a dirty diaper every feeding to seeing one dirty diaper a week! (1)  This is normal.  This usually happens between 5-6 weeks of age–but no one told your baby this.  Occasionally, a baby may change their dirty diaper habits before they are 5-6 weeks old.  This is just to make you aware of the possibility.  If you are concerned, have your baby’s weight checked.

Often parents think their baby is constipated if they stop having dirty diapers as frequently.  Constipation is not about how frequently you have a bowel movement it is about the consistency.  Constipation is rare in breastfed infants. (2)  Their stool will still be loose, maybe slightly thicker than before, but unless you have rock hard little pebbles, you have a baby who is stooling or having a dirty diaper normally–they are not constipated.  They are just going longer between having dirty diapers.  This change is due to your baby’s intestinal tract maturing.  Instead of their bowl movements being stimulated every time they start to suck there is now often a delay.

References:

  1. Mohrbacher, N, Stock, J, La Leche League International The Breastfeeding Answer Book, 3rd revised edition, Schaumburg, IL, La Leche League International, Jan 2003, pp 39, 158, 268.
  2. Wilson, WH, Lowdermilk, P, Maternal Child Nursing Care, 3rd edition, St. Louis, MO, Mosby, 2006 p 1504.

 

Week 5-6

It was mentioned above at three weeks of age, to be on the lookout for a decrease in your baby’s dirty diapers or stools.  It is normal at 5-6 weeks of age to start to have fewer dirty diapers. (1)

For some babies this is a dramatic change, others it isn’t so noticeable.  Some baby’s continue to have a dirty diaper with almost every feeding, others will only have a dirty diaper once per week, or you may get something in between.  Any of these patterns are within the range of normal.  It can be a surprise, if all of a sudden your baby goes from having a dirty diaper every time you change them to skipping days or going a whole week without one.  Remember too, your baby will continue to grunt, groan and makes faces when they have a bowel movement.  This is because as their intestinal tract is squeezing things through–called peristalsis, they are not always thrilled about the process.  They are just reacting to it.

  1. Mohrbacher, N, Stock, J, La Leche League International The Breastfeeding Answer Book, Schaumburg, IL, La Leche League International, 2003, p 39.

 

2 Months

At 2 months of age, your baby can be having a dirty diaper (stool/bowel movement) with every diaper change or one a week–or anything in between.  As long as the stool is soft, you don’t have rock hard little pebbles this is a normal pattern for an exclusively breastfed baby.

If you have begun to use something besides breastmilk in your baby’s diet, you will notice a change in the stooling pattern.  If iron-fortified formula is added, the frequency, smell, color and texture will change.  If you change what goes in the baby–it changes what comes out the other end.