Color of the Day: Solving Bowel Movement Mysteries

Color of the Day: Solving Bowel Movement Mysteries

  • Posted by Dr. Jay Gordon

Stools in breastfeeding babies are predictably green, brown, yellow or orange. There is a wide variety of color and consistency of bowel movements.  In my glamorous job as a pediatrician, I discuss this hot topic every day.

We shouldn’t be any more surprised to see a variety of bowel movements in our babies than we would in anyone of any other age.  In breastfed babies, the mom’s diet can affect the color or consistency of a baby’s stools, particularly if the baby is showing an allergic reaction to a certain food or food group.

Greenish or Yellow/Brown, grainy or seedy
This is the transition between meconium and a regular breastfed stool and begins as mom’s milk is coming in on the second, third or fourth day of life.  There may be three stools each day, ten, or even twenty.  Occasionally, even a baby in the first week of life will skip a day and have no bowel movements at all.  Call your doctor to discuss this even though it is normal.  This does not require a dietary change or supplementation of a breastfed baby.

 

Frequent Watery Stool often “Greener” than usual
How can you spot diarrhea in a baby who has loose frequent stools every day?  This type of poop is “diarrhea” in a breastfed baby.  It can be due to a virus, a bowel infection, stress, anxiety or a food intolerance.

Black stools often accompanied by constipation
This is the result of iron supplementation. Iron fortified infant foods and infant vitamins can cause constipation. A healthy breastfed baby does not need iron supplementation. The iron in breastmilk is much more bioavailable than any other form.

Green, frothy stools
This can be a result of a hindmilk/foremilk imbalance. A true imbalance is rare. It is often seen accompanying a forceful letdown. Lactation consultants will help moms find a nursing pattern which works to combat this problem.  If letdown it too forceful in the early weeks, the solution can be to allow milk to leak into a cloth diaper during letdown, then latch baby back on.  Feeding two to three times off the same side may also show improvement. Caution should be used with same side feeding as it can decrease supply.

Another cause of malabsorption in the intestines can be teething. The profuse saliva of a teething baby can cause irritation in the intestines interfering with proper absorption.  When babies teethe, we can see lots of drooling.  Large quantities of saliva is swallowed which can irritate the intestines causing runny, acidic stools. This can also cause a rash in the diaper area.

In summary, stools in breastfeeding babies are predictably green, brown, yellow or orange.  It is runny and has curds almost every time.  It changes color with viruses, may have a small amount of blood (call your doc) and may come once a day and even taper off to once a week or more after a few weeks of age.  Formula feeding babies may show a little trickier set of changes involving constipation and diarrhea.  This is just one small reason to strongly recommend and support breastfeeding your baby.

215 Comments

  1. Rachael

    my 7 week old is exclusively breastfed and recently went 2 days without napping during the day tho slept about 3-4 hour stretches at night, then, yesterday and today, he barely woke up long enough to eat, and in fact, didn't seem to really finish any of his "meals" because he was just so so tired. tho he would wake when we changed his diaper and was responsive and happy.

    I was assuming he slept so much because he didn't sleep for 2 days, and then was just exhuasted.

    but then I noticed that the majority of his diapers (every 3 out of 4) have been ranging from sticky green poo to now being sorta mucousy and seedy green poo. then tonight it looked as tho he had a tiny bit of bright red mixed in with the mucousy green poo.

    he has seemed to have alot of gas issues since birth, and tho we have been using the store brand mylacon, he still seems to wake up with bad gas bubbles and cries alot because of the discomfort it seems.

    my mother in law mentioned that maybe he is lactose intolerant and will not be able to be breast fed? i have never heard of a baby being allergic to his own mother's milk but she said that maybe that is what is wrong with him because he has been a fussy baby since birth.

    I have limited my dairy since he was born, but yesterday my husband made me a sandwich with 3 pieces of cheese on it and then brought me icecream…

    i didn't realize this could affect the baby so drastically…

    i feel terrible.

    (i am definitely puzzled how/why a 7 week old baby didn't nap for two days and seemed so restless and startled easily, and then just crashed for 2 days! i've never seen such a young infant awake for such a long time…)

    should i be freaking out over the green mucousy poo???

    1. Cheryl Taylor

      Typical growth spurt behavior has more frequent nursings for 24-48 hrs and then more sleeping for 24-48 hrs. http://drjaygordon.com/breastfeeding/growthspurts

      No babies are not allergic to their own mother's breastmilk. He is merely reacting to a protein that is traveling through your breastmilk. You can continue to breastfeed. You just need to identify which food is bothering him and eliminate it.

      Instead of just cutting back on dairy I would suggest eliminating all dairy sources for at least one month. It's the most common food allergy and elimination of dairy from your diet is likely to see symptoms resolve. If the green BMs persist after that month of elimination there are 6 other most common allergens that I would recommend considering eliminating next. GI problems, green BMs, reflux, eczema and nasal congestion are commonly seen symptoms when there is a food allergy to dairy. http://drjaygordon.com/pediatricks/dairy.html

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