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Newborn Appearance: Diaper Area/Genitals

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What's happening in that diaper?...It's not just poop! Here are some common sights in a newborn's diaper area that you may not know about:

  • Maternal hormones may cause a whitish vaginal discharge and/or a small amount of blood from a baby girl’s vagina. Do not be alarmed. This should resolve in within the first week of life.
  • You may notice a pinkish discoloration on the diaper after your baby urinates. Uric acid crystals are common in the first couple days of life and are due to a harmless substance called urate. Sometimes this occurs when the urine is very concentrated, therefore, continue to encourage feedings. If uric acid crystals continue after the 4th day of life, be sure to notify your baby’s pediatrician as this may be a sign of dehydration.
  • The first couple of days, your baby’s stool will be thick, black and tarry. This is called meconium and should transition into normal stool by the 3rd-4th day of life. Once stool has normalized, a breastfed baby will have frequent yellow, seedy stools which may be watery whereas a formula-fed baby tends to have less frequent stools which range in color, from green to brown. If meconimum is still present on the 5th day of life, be sure to notify your pediatrician as this may be a sign of inadequate feeding.
  • Approximately 2% to 5% of term boys and 33% of premature boys are born with undescended testicles, also known as cryptorchidism. The undescended testicle will naturally descend into the scrotum within the first three to six months of life. Hormone therapy or surgery may be necessary if the testicle(s) has not descended by 6 months of age.
  • Male newborns may have extra fluid in their scrotum which is called a hydrocele and usually resolves without intervention. If necessary, there are two treatment options available: (1) aspiration, which is the removal of the excess fluid using a needle, or (2) surgery.
  • Inguinal hernias occur when the intestine or another organ (e.g. ovary) protrudes through a weakened muscle wall in the groin area. An inguinal hernia can occur in both female and male babies; however, there is a higher incidence in male babies. Approximately 3-5% of term babies and 9-11% of premature babies are born with inguinal hernias. Incarceration and strangulation of the hernia are the most common complications. Surgical treatment is required for inguinal hernias.
 
 
Sources:
Davidson, D., London, M., Ladewig, P. (2012). Olds' Maternal-Newborn Nursing & Women's Health Across the Lifespan (9th Edition). Boston: Pearson.
Docimo, S.,Silver, R., Cromie, W. (2000) Undescended Testicle: Diagnosis and Management. American Family Physician. Nov 1;62(9):2037-2044.
Gleason, C. & Devaskar, S. (2012). Avery's Diseases of the Newborn (9th Edition). Philadelphia: Elsevier Saunders.
 

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