Why Blowouts Happen, and How to Stop Them
Most blowouts go up the back. Loose newborn stool finds a gap at the waistband, so pull the back of the diaper higher than the front, check for gaps after fastening, pull the leg cuffs out and make sure the size fits her body, not just the weight on the box. If one gets out anyway, don't pull the bodysuit over her head; take it off down over her feet. Watery stools that keep coming, blood, or a baby who isn't herself need a doctor.
There's a particular sound. Then a pause, while everybody in the room silently works out whose turn it is.
The up-the-back blowout is a rite of passage and it arrives, without exception, on the day you've dressed the baby in something you like. It's also not random. Most of the time it's mechanics, and mechanics can be adjusted. Not every time, though, and the health signs are further down.
Why it goes up the back
Newborn stool is loose and it arrives with force. A diaper is built to absorb liquid downward and outward through its core, but very loose stool doesn't absorb at all. It flows, and it flows toward whichever gap offers least resistance. In a baby lying on her back, that gap is the waistband behind her.
Three things make it worse: a gap at the back waistband, a diaper too small in the rise so the back is low, and a baby who has just fed and is now horizontal, which describes most newborns for most of the day.
On the stool itself
The fit fixes
Almost every blowout escapes at the back, and the back is the part nobody checks.
Pull the back panel higher than the front, which is the most effective change available and costs nothing at all. Run a finger around the whole waistband after fastening, because if you can slide a finger flat into a gap at the back then so can everything else.
Pull the leg cuffs outward, since tucked cuffs cause leg leaks and a leg leak frequently becomes a back leak the moment you pick her up. Whatever brand you use, a leak guard folded inward can't stop anything. Size up if the tabs are fastening at the outer edge or the rise no longer reaches the belly button, because a diaper too small in the rise can't seal at the back however good your technique is.
Check the fit again after a feed. Babies change shape a good deal between empty and full, and the fit you set an hour ago isn't the fit you have now.
Is a blowout ever a health signal?
Sometimes, so rule it out before you blame the fit. Sudden, repeated watery stools may be diarrhoea. That isn't a fit problem. Blood in the stool, mucus that keeps appearing, fewer wet diapers, a fever, or a baby who's floppy or unusually sleepy all need a doctor, and fewer wet diapers matter most, because dehydration moves quickly in small babies and faster in this heat.
Explosive stools that keep coming back alongside poor weight gain, vomiting or trouble with feeds also need a doctor's look. A bigger size won't fix those. No diaper, ours included, has been shown in a fair comparison to stop blowouts outright, whatever the back elastic or the rise.
If you think it's diarrhoea
Routine newborn blowouts in a baby who's feeding and gaining well are simply what the first months look like. Breastfed newborn stool is loose by design.
Getting the bodysuit off
Baby bodysuits have envelope folds at the shoulders. They aren't a manufacturing quirk and they aren't there for stacking sizes. They exist so that a soiled bodysuit can be pulled down over the shoulders and off past the feet, without going anywhere near your baby's face.
Most of us find this out at about month four, after sixteen weeks of pulling dirty clothes over a baby's head. Now you know early. I found out from a friend at a playgroup and thought about it for the rest of the day, and I still don't know why nobody prints it on the label.
The out-of-the-house kit
A blowout at home means some extra laundry. A blowout at Takashimaya is a bigger job, and how big depends on what's in your bag. Carry a full change of clothes, because you should assume total loss. Carry a wet bag or a sealable plastic bag, since the nursing rooms here are excellent and are still not laundries. Carry more wipes or cloths than seems reasonable, then double whatever number you first thought of. Carry a muslin, which will serve as a changing mat, a screen, a towel and eventually as the thing you wrap the entire situation in. Have a spare top for yourself, which you'll start doing after this happens to you exactly once.
Sources: NHS: Nappy rash · NHS: Diarrhoea and vomiting · NHS: Changing a nappy · HealthHub: Ministry of Health Singapore
This guide is general information, written to help you understand a topic and ask better questions. It is not medical advice and does not replace your own doctor, midwife or paediatrician. Anything that worries you about your baby belongs with them.
Read next: How Often to Change a Newborn's Diaper · Diaper Sizes: When to Size Up
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