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 at least 3 dirty diapers (poopy diapers, soiled diapers, stools, whatever you call bowel movements) in 24 hours, they are gaining weight. 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, your baby will have enough dirty diapers. Volume is different too. 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. The quarter-sized are easier to clean-up. Usually the blow-outs they need a bath, along with increased other laundry! Either is normal. Both count as a dirty diaper.
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 and whatever is at the end comes out. This process is called peristalsis and continues for a period of time after feeding. (1) 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. As the transition occurs from meconium to a breastmilk stool, you may see black to greenish to golden yellow, with mixtures of those colors.
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 breast milk helps protect the intestinal tract of a totally breastfed baby. (2)
Before your baby is one week old, if they have no dirty diapers in 24 hours, have your baby’s weight checked with your healthcare provider that day. When there are no dirty diapers in 24 hours there is a 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 a written record 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.
- Behrman, RE, Kliegman, RM, Jenson, HB, Nelson Text of Pediatrics, 17th edition, Saunders Publishing, 2004, p 1229.
- Lawrence, RA, Lawrence, RM, Breastfeeding: A Guide for the Medical Professional, 7th edition, Maryland Heights, MO, Elsevier Mosby, 2011, p 33.