Does your baby show signs of discomfort after feeding? In this episode, Dr. Carole Keim MD goes over practices to best help your baby through peeing/pooping, gas, colic, and other tummy troubles. If your baby has colic, there are ways to help digestion and alleviate discomfort. Vomiting in infants can be a bad sign; she explains how best to keep your little one hydrated with no treatment for vomiting or diarrhea.Dr. Carole Kiem MD details different conditions your baby may experience within their first year, such as diarrhea, constipation, vomiting, and reflux. Watch out for blood in the diaper; she goes over the potential causes, from stool to urine or even a “false period” in baby girls. Check out this episode for more information about tummy troubles.We will cover: PeePoopPotty training an infantBurpingGasColic - dx and txSpit ups / GERDVomiting - gastroenteritis, pyloric stenosis, no txDiarrhea - tx, when to be concerned, signs of dehydrationConstipationBlood in the diaperPee (0:21)Allow up to 24h for the first void.A few pees for the first few days; by day 3-5, mom’s milk surges, and baby voids with each feedVolume is difficult to discern, and the color is sometimes pale - diapers with urine stripes are helpful.Rust-colored urine in the first 2-3 days (uric acid crystals)If a baby less than six mos voids less than 6x per 24h or goes more than four h between voids, they may be dehydrated (nighttime doesn’t count!). Babies >6 mos should void at least once per 6h.Poop (2:48)Up to 48h for first stoolMeconium (and what it means if passed in utero)Transitional stoolsYellow seedy stoolsOver the first 4-6 months becomes brown and toothpaste-consistencyFormula-fed babies may have brown, yellow, or green stool; tends to be smellierHydrolyzed formula -> gray stoolsRule of 7’sOnce they eat food, their poop becomes like adult poopPotty training from birth / Elimination communication / Diaper-free method (6:27)Involves reading baby’s cues and giving cues when it’s time to pottyCan start as early as birth; I recommend around 1-2mos of age after the discoordinate stooling phase.Decide on a phrase and/or hand signal to useBring your baby to the potty (over the sink, potty chair, or toilet adapter)Make a sound to indicate it’s time to go (“psss” or grunt)Easy catches: babies who go during diaper changes, right after waking up, after eating, when you see them poopingIt takes several months; ok to wait until later. Toddlers: takes about 6 mos for daytime and another 6-12mos for nighttime.I love it because there are fewer diapers, less discomfort for the baby, less diaper rash, and it is easier than toddlerhood.Burping (12:28)How toWhen to (breastfed, formula-fed)Why? Decreases gas, colic, spit-upsThey can stop when they burp on their own (around 4-6 mos)Gas (14:20)Normal to fart a lot, loudly, and have smelly gasBreastfed babies may get more gas when mom eats cruciferous vegetables, beans, garlic, and caffeineCheck with your doctor before you start eliminating foodsSimethicone - how it works, when to give it, how oftenColic (16:21)Rule of 3s: 3h per day, 3 days per week, for 3 weeksAlmost all babies get some colic symptoms at some point.Tummy TimeBicycle legsBelly massage - clockwiseBack rubs - counterclockwiseMedicines: simethicone, probiotics, gripe water; can consider chamomile, licorice, or mint tea - dilute, 1/2oz per dayAlternative health: chiropractic, acupuncture, ayurveda - I can’t formally recommend them, but they are sometimes helpful; choose your practitioner carefully.What doesn’t work - is the sensitive tummy formula. No formula will treat colic.Spit ups / GERD (20:47)Reflux = stomach contents go up into the esophagus.GERD = reflux is so bad that the baby has poor weight gain or loses weight, chokes, arches in pain, or has other problemsLESSpit-ups are not forceful.Tx: decrease volume and increase the frequency of feeds (BF vs. formula), burp baby well, anti-reflux formula/breast milk thickeners, add 1 tsp rice cereal to 2oz formula/breastmilk (this is the ONLY time we put rice cereal in a bottle), use gravity, medications such as ranitidine make the stomach produce less acid but don’t decrease the volumeCall your doctor if the baby spits up more than half of their food, if they look like they are in pain with spitting up, if they appear to choke, or if it starts to become more frequent and the baby seems hungry after spitting up.Check out healthychildren.org for more info.Vomiting (28:09)Forceful: Involves abdominal muscles and a retching movementProjectile vomiting goes about 2-3 feet, but spit-ups can tooThe baby is upset afterwardAlways a red flagNo treatment other than to keep hydratedDiarrhea (29:48)Hard to tell in newborns/infants because their poop is so soft/liquidIf you’re worried, call your doctorStool that is so watery it soaks into the diaperA marked increase over what your baby normally doesMarked increase or “blowout” poops more than twice in a rowA foul odor that was not there before, sometimes with a change of colorFever/blood - go to ER if 6mosNo treatment other than to keep hydrated​​Signs of dehydration: decreased urine output, fussy/lethargic, dry lips/tongueConstipation (34:11)Infants: the first year of life; does not apply to children >1yr. We will do that episode in a few months.1 mo: discoordinate stoolingAbout 3% of infants get true constipation: hard stools like pellets, pain with BM, and rectal bleeding.Tx: prune juice 0.5-1oz (15-30ml), once or twice per day; water if they are taking solids/purees; consider eliminating dairyBlood in the diaper (39:01)when it’s normal: pseudomensesAbnormal: any other time, call your doctor immediately! Urine = kidney problem, stool = infection or allergy. UA/ HemoccultFoods that mimic blood: watermelon, beets, tomatoesI hope this helps you guys know what’s within normal range and when to be concerned.  Remember: It is ALWAYS ok to call your doctor’s office with questions if you’re worried.  Babies are really different than adults, so it can be hard for new parents to know whether something is serious or not. I wrote the Baby Manual for that reason, and I know parents refer back to it often through the first year of life to check whether they need to be concerned.  Resources discussed in this episode:The Baby Manual - Available on Amazonhealthychildren.org--Dr. Carole Keim MD: linktree | tiktok | instagram Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

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