A newborn baby usually passes urine for the first time within 12 to 24 hours after birth. Not peeing in the first 24 hours points to some urinary tract problem. As the mother and her baby need to stay in the hospital for 24 to 48 hours after a normal delivery, it becomes easy for the doctors to diagnose the condition early.
During the first 2-3 days, a breastfed baby may not produce much urine, and thus, may not have wet diapers. The peeing frequency increases as the intake of the mother’s milk increases over the next few days (the mother starts breastfeeding the baby frequently in a day).
It is completely normal for the baby to urinate anywhere between 1-6 hours (or 4-8 wet diapers) a day.
In the first 2 days of life, a newborn may pee dark yellow, orange, or even pink urine due to the excretion of waste products known as urates into the urine, which is normal. Certain foods, herbs, and supplements could change the color of the breast milk and cause the breastfed newborn’s urine color to get a pink, green, or orange tint. The doctor may be able to tell you what exactly is causing the change in the urine color.
What about the peeing frequency in bottle-fed infants?
The amount of urine that the newborn produces depends on the amount of fluid they drink.
If the baby’s feeding frequency goes up to more than 2 ounces of formula every 3 hours, they may urinate more, and the mother may see more wet diapers. If the baby is sleepy and consumes less liquid, the urination frequency gets lower.
What causes a newborn to pee less?
The newborn may urinate less if
- It is summer.
- The climate is extremely cold.
- They have a fever.
- They are not drinking enough liquids (breast milk or formula milk). The darker the color, the more concentrated is the urine.
Highly concentrated urine (due to less liquid intake) can cause the urine to appear pink and make the mother mistake it for blood in the urine. In such cases, mothers need not worry if the baby is wetting at least four diapers a day.
When to call the doctor?
The inability of the baby to communicate makes it difficult for the mothers to recognize the troubles that the baby is facing. Hence, it is necessary to either call the child specialist (pediatrician) right away or visit them if the mother spots certain signs in the baby that include:
- Fewer than four wet diapers in 24 hours
- Dark yellow/orange/pink/red, concentrated, smelly urine that is also less in quantity
- Actual red spot on the diaper
Signs of dehydration:
- Dryness of lips and tongue
- The sinking of the soft spot (known as sunken fontanelle) on top of the baby's head
- Poor feeding
The pediatrician assesses the child completely to see if the problem is due to a urinary tract infection or some other abnormality.
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Dehydration and diarrhea, Paediatrics & Child Health, 2003;8(7): 459–60