# Assessing Newborn Intake and Output (Nursing)

by Jacquelyn McMillian-Bohler

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00:01 When we think about what the baby's actually able to really take in, knowing the baby's stomach size really helps to really make this make sense.

00:10 So let's take a look.

00:11 So around day 1, the baby's stomach is about the size of a cherry, which is really tiny.

00:18 So now think about how much milk you would put inside a cherry.

00:21 It's not very much.

00:23 Day 3, we're about the size of a walnut.

00:25 Around one week, the baby's stomach is the size of an apricot, and about one month the size of a large egg.

00:32 So you think about the potential for overfeeding happen that could if we try to give the baby a really large bottle of milk.

00:39 So unlike the breastfed baby, where we're doing supply and demand, the baby may continue to eat and overeat.

00:45 And that can cause a lot of problems with digestion, so we have to be mindful of what the baby might need.

00:52 So let's take a look at the caloric intake and what's in breast milk and in formula? So the caloric density for breast milk and infant formulas is typically the same around 20 kcal/ounce.

01:05 If however, the baby's a preemie or maybe has trouble growing, then in formula preparations, sometimes the kilocalorie per ounce amount can go up to 24 kcal/ounce.

01:18 Remember that colostrum has a slightly lower fat content than mature milk.

01:22 Well, now it makes sense when we think about the caloric intake.

01:26 It's only about 17 kcal/ounce as opposed to mature milk which is 20.

01:33 Oh, poop! Let's talk about it because we need to know about it.

01:37 Let's break it down.

01:39 And let's think about what poop looks like based on what the baby is eating and what they're doing.

01:45 So meconium is sticky and it's green, maybe sometimes black.

01:51 And it's sticky that I say it was sticky, because it's so so sticky.

01:55 But meconium is actually accumulated intestinal cells, bile, and all kinds of things that are formed while the baby's in utero.

02:03 So then when the baby's born, it's time to get all of that out.

02:07 So they poop it out.

02:08 And it sticks to everything.

02:10 The same sticky, meconium is sticky, it's also very normal, then we think about transitions tool.

02:16 So this is where things kind of get interesting.

02:19 So sometimes what you'll notice is the meconium is going to be mixed with stool that is sort of yellow, so you'll get a little bit of both.

02:26 And this happens about day 2 or 3.

02:28 Remember, we got to take something in in order to get something out.

02:32 So as we begin to do that and as we begin to increase the amount of formula or breast milk at the babies taking in, you're going to see the stool transition.

02:41 Okay, so if we have a baby that is breastfed, what you're actually going to see are things that look like sesame seeds.

02:48 Now, clearly the baby is not eating anything with sesame seeds, but somehow when the breast milk is broken down, that's what it looks like.

02:56 Who knew? Formula stool on the other hand is more form so it's a little bit mushier than we see with breast milk stools.

03:05 So what's different? Well supposedly, formula stool smells worse.

03:10 I think all poop smells bad.

03:12 And so I really don't want to get into a competition of which one is worse and it's not really a selling point.

03:18 But that's what they say.

03:19 So formula stool is going to look different than breast milk stool because it doesn't have those seeds in it.

03:26 So more mush less seed.

### About the Lecture

The lecture Assessing Newborn Intake and Output (Nursing) by Jacquelyn McMillian-Bohler is from the course Newborn Nutrition (Nursing).

### Included Quiz Questions

1. 2.5-5 oz
2. 5-8 oz
3. 2-4 oz
4. 8-10 oz
1. Meconium
2. Transitional stool
3. Breastmilk stool
4. Formula stool

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