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breastfed baby with green poop

Posted by on Feb. 19, 2010 at 3:18 PM
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Is there any reason that an exclusively breastfed baby would have bright green poop?  My daughter is six months, and has never had anything else.  She is a little sick, I don't know whether to call it a bad cold or a mild flu.  But the green poop started a little before that, close to two weeks ago, now.  I figured it was something I ate, but I just can't figure out what.  I've tried eliminating all sorts of things from my diet.

by on Feb. 19, 2010 at 3:18 PM
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PhilsBabyMama
by on Feb. 19, 2010 at 3:20 PM

 

Mostly when I've heard of EBF babies having green poop for long periods of time it's because they are getting too much foremilk.  You may want to look into block feeding (aka cluster feeding)

Here is some info:

GREEN STOOLS

The occasional green stool is not unusual in the breastfed baby. Consistently green stools, however, are not normal for the breastfed baby. Most doctors don't seem to recognize this as a potential problem because they often define "normal stool" as that of the formula-fed infant. Baby's stool can be a wide variety of colors and textures , and not all of these are cause for concern. It is helpful to know what is normal for the bf baby as well.

 

Consistently green stools in the breastfed baby can indicate:

  • an imbalance of foremilk/hindmilk, often resulting in frothy green stools.
  • a sensitivity to something in the mother's diet, such as cow's milk products.
  • a sign that baby has an illness. Babies with an intestinal virus or even a simple cold will sometimes have green, mucusy stools. Teething can also bring about green stools due to increased saliva (can also cause tummy upset)
  • a lot of green vegetables or something with green food coloring in mom's diet.
  • If baby has started solids, that could also account for the change in color (this is normal with the change in diet).

http://www.mother-2-mother.com/cc-baby-A.htm

 

Block Feeding

In normal situations breastfeeding experts recommend "baby led" nursing patterns. Baby should be allowed to finish the first breast, before burping and offering second side. This may mean baby will nurse, for example, 20-ish minutes on first side, burps, then may or may not be interested in the second side.

In situations where a mother has a very large milk supply, then a "block feeding" or "block nursing" pattern may be suggested. Occasionally if baby is nursing in a very, very frequent pattern - meaning that the baby is nursing hourly or even closer than hourly and experiencing marked fussiness and perhaps has consistently green stools - a loose block pattern may be suggested as well. (Note that frequent nursing - meaning about every 2 hrs from start of one feeding to start of next feeding - is totally normal)

What is Block Feeding?

Block feeding is a feeding pattern often suggested when mother has oversupply issues, and occasionally a loose block pattern is suggested for other situations where that type of pattern may help.

The suggestion would be to the mother to use one breast per session, and to keep baby to one side for a "block" of time. In mild cases of oversupply, that may be a 2 hr block, in more severe cases, it may be 3 hr block, or in cases where mom has a monster supply, and has gotten no results from the shorter blocks of time, then a longer block of time may be recommended.

An example of a 2 hr block pattern would be as follows: Mom starts out nursing at 8 am on the right breast. If baby indicates desire to nurse again at 8:45, then mom would nurse again from right side. If baby wants to nurse again at 9:30, she'd offer right side once more. At 10 AM she'd offer left side, and no matter how many times baby indicates need to nurse, she'd keep to left side until 12, then switch back to right side again.

An example of a 3 hr block pattern would be 8 am on right breast, 11 am switch to left, 1 switch back to right, 4 switch back to left, etc.

How Does Block Feeding Help?

In cases of oversupply, block feeding can help signal the breasts to slow down production of too much milk . Understanding how milk production works, helps mom to understand how block nursing can help gently slow production to a level that is more in line with baby's needs.

When mom is considering use of block nursing, it is wise to consult with a breastfeeding expert, such as a board certified lactation consultant. An expert in breastfeeding management can assess the situation and help mom determine if she might benefit from using a block nursing pattern, and if so, what type of pattern to use. Most experts recommend starting out with smaller blocks of time and increasing them if needed after a couple weeks.

How Long Does It Take?

Block nursing is not an "instant fix" for oversupply, but it almost always helps if given enough time to help. In mild cases of oversupply, for example, it may only take a few days to a couple weeks to see good results. In more severe cases it may take several weeks to a couple months to see good results, although almost always mom will see improvements in the situation within just a few days of implementing the use of the block pattern.

Do I Need To Continue Using the Block Pattern, Once Supply Adjusts?

No, one doesn't need to continue using a block pattern once the situation is resolved. Mom can go back to using a "normal" nursing pattern of offering first breast until baby is finished, then burp and offer second side. If things continue to go well, there isn't a need to do any additional adjustments. If the symptoms of oversupply begin to return, she can resume a block nursing pattern once more for a while longer, and then later on can see if a "normal" nursing pattern will work.

As suggested above, it is recommended that mom locate a board certified lactation consultant (IBCLC) to assess each individual situation, provide assistance, information and support.

http://www.mother-2-mother.com/blockfeeding.htm

LeanneC
by on Feb. 19, 2010 at 3:35 PM

Green can be from a bug, absolutely... and she may have been fighting it before the symptoms appeared.

Or did you just start solids?   That will obviously effect poop...or it may just be normal.

I wouldn't worry about fore/hind milk imbalance, really... it'd be green and frothy... and bad smelling. 

So... don't worry too much, it's not really a problem.

LeanneC
by on Feb. 19, 2010 at 3:37 PM


Quote: Dr Jay Gordon

I have often asked parents not to bring poop samples into my office.  While there is a lot of information to be gleaned from studying full diapers, I think I can do most stool analysis on the phone or online unless an emergency situation occurs.

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.

A change of pattern can throw the most confident mom for a loop and can even confuse an experienced pediatrician.  Babies have blood in their stool fairly often and it virtually never is the sign of serious illness, but I pay a lot of attention to this because it alarms parents and requires that a reason be found.

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.

Sticky, tar-like and green or black
This is meconium. The first stools of a newborn will be this consistency and color. It is what is present inside the bowels of a newborn upon birth and will clear itself out within the first couple of days and represents the "byproducts" of building an entire human being for nine months.

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.

Light yellow to bright green, loose/runny, curdy, lumpy, seedy, creamy, mustard-like
These are normal breastfed stools.  The consistency, frequency and color vary from day to day.  My wife described the smell as "curried yogurt".  Opinions on this odor description differ widely.

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.

Hard, pellet - like, presence of blood or mucous
This is constipation in a breastfed baby and is so very rare that I cannot recall ever seeing it in a baby who is receiving breastmilk as a sole source of nutrition, as are most babies in the first six months.  It could be related to a food allergy.  Formula fed babies get constipated much more often and may even have harder bigger stools like older kids and adults.  Getting these stools softer is a balancing act of great proportions.  

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.

Red streaked stools
This usually comes from bleeding in the lower intestine or rectum.  Most often it is caused by rectal fissures which are tiny "cuts" around the circumference of the anus.  This can be a reaction to dairy in mom's diet.  Elimination of all dairy is the first line of defense in this situation.  I have seen countless babies who had blood in their poop which resolved when mom stopped all dairy products and returned with even a small amount of milk or cheese.  Other dietary changes may be needed for breastfeeding moms.  Formula fed babies lose blood from the lower intestine when they drink cow milk formula and some have the same losses on soy formula.  Occasionally, this "micro-hemorrhaging" can become visible as blood streaking on the surface of the stool.  Persistent or increasing blood in the stool or blood mixed with mucus (described as "currant jelly" stool in the texts) requires an immediate call to your doctor.  

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.

Green, mucousy stool
This can be a result of a virus. Often the only sign we see of a virus is in the green stool. This is evidence of malabsorption in the intestines. Watch for how many days and with what consistency it is occurring. With a virus, it will run its course over a few days and begin to improve.

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.  

There is something important to point out regarding frequency of stooling in an exclusively breastfed baby.  Many parents are concerned when after the early weeks where they may have been seeing a little bowel movement in almost every diaper, they suddenly begin to see days go by without any.  This is perfectly normal.  There is a great range of frequency of bowel movements with exclusively breastfed infants, ranging from a couple of times a day to several days.  There are completely healthy nursing babies that have a bowel movement once a week, once every ten days, or even a few that go a bit longer. If your baby is healthy, developing well, nursing well and the consistency of the bowel movement when it does make its appearance is soft or loose, then do not be concerned.  It is not constipation if it arrives in soft form.  Constipation would arrive in pellets and hard formed pieces.  

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.



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