Newborns & feeding
What is in the diaper: a plain guide to newborn poop
Black and sticky for the first days, then green, then mustard yellow. Breastfed babies may go after every feed or once a week. Three colors need a call: white, red and black after the first days.
Parents photograph diapers and bring us the pictures, and they are right to: the diaper is one of the few windows into how a newborn is doing. Here is what we look for.
The first week
Days one to three: meconium, black or dark green, sticky like tar. It is the material swallowed in the womb and it clears as milk comes in. Days three to five: transitional stools, greenish and looser. By day five: the color that will last, mustard yellow and seedy for a breastfed baby, tan to yellow-brown and pastier for a formula-fed baby. If meconium is still the only stool on day five, the baby may not be getting enough milk, and we want to see you.
How often
In the first month, after most feeds is common. From about six weeks a breastfed baby may go several days, even a week, between soft stools, and that is normal if the baby is feeding well, wetting six or more diapers a day and comfortable. Formula-fed babies usually go at least once a day. Frequency matters much less than consistency.
Grunting, straining and red faces
Newborns push, grunt and turn red with a perfectly soft stool because they have not yet learned to relax the bottom while pushing. That is not constipation. Constipation means hard, dry, pellet-like stools, and it is rare in breastfed babies.
Three colors that need a call
- White, gray or clay-colored: possible problem with the liver or bile ducts; we want to see the baby the same day
- Red: streaks can come from a small tear at the anus or a milk-protein reaction; more than streaks needs a visit
- Black after the meconium stage: possible bleeding higher in the gut
Green, orange, and every shade of yellow and brown are fine. Mucus in small amounts is fine. Curds and seeds are milk fat.
Diarrhea and vomiting
Watery stools that are suddenly more frequent, especially with fewer wet diapers, vomiting, fever or a baby who is not feeding, need a call. Newborns dehydrate quickly. Spitting up small amounts after feeds is not vomiting; forceful vomiting, or green vomit, is.
What to bring to the visit
A photo of the diaper, a note of how many wet and dirty diapers in the last 24 hours, and how the feeds are going. Those three things answer most questions in a minute.
