A green color in the stool, which sometimes seems to be daunting or unusual, is considered in most cases to a normal gastrointestinal response, and does not require any special treatment. At the same time, there are situations where such change can indicate a pathological process, so it is important to know the differences and know when to contact the doctor.
In mammalian babies, one of the most common causes of green feces is only front milk drinking. Front milk is the milk that comes out of the breast at the beginning of breastfeeding – it contains less fat but more sugar (lactose), and looks more than watery.
When the baby does not breastfeed enough time to reach the rear milk, which is richer in fat, the excess amount of lactose enters the intestine, resulting in the stools may be green, watery and sometimes whipped. A simple solution to this situation is to allow the baby to breastfeed a longer period than the same side, before exchanging a breast, so that it also comes to the “back” milk.
In babies who are fed by milk substitutes, the green stool is considered a common phenomenon. Milk substitutes are usually enriched with iron, which can affect the color of the stool. This is a proper digestive response that does not indicate any medical problem. There is no need to replace a formula because of color change, as long as the baby is calm, well breastfeed, weight gain and does not suffer from other symptoms.
Iron supplements, which are recommended in Israel for all babies from four months, may also cause dark or greenish feces, the result of a chemical reaction between iron and the digestive system. Subscribed to the breast breastfeeding mother can also affect the baby’s stool color, but this has no danger, and the color is expected to change later.
With the transition to solids – usually around the age of six months – the stool colors continue to change. Foods such as peas, spinach, broccoli or pumpkin can paint the stool in green shade. This is a natural process, which indicates that the digestive system begins to process solid food, and there is no reason for concern.
At the same time, there are situations where the green color of the stool may indicate a medical problem. When the stool is accompanied by multiple diarrhea, extremely acute scent, blood, mucus, loss of appetite or weight, fever or exceptional irritability – medical examination is needed.
Too fast of the food in the intestine, as in situations of viral or bacterial gastroenteritis, can cause changes in color and stool texture. Also sensitivity to cow’s milk protein or lactose may manifest in green stool, especially when gas, colic or restlessness appears.
In very rare cases, prolonged green stools may also appear in infants suffering from small intestine absorption disease, such as celiac at older age, or chronic infections, but there are usually other signs in the background. In these situations, the feces may also be fatty, aqueous or very multiple. If there is such a clinical suspicion, the doctor will recommend blood tests, fecal culture and sometimes a thyroid function test.
It is important to remember that the color of the stool alone is not an accurate measure of the baby’s health. The doctor will always consider the broad context: the baby’s age, the type of feed, the duration of the green stool, the baby’s overall mood, appetite, weight gain rate and other symptoms if existing. Most parents are alarmed by the color, but in most cases – this is just a normal developmental stage.
Bottom line, green stools in babies are a very common phenomenon, and sometimes even expected. When there are no other signs such as multiple diarrhea, high fever, vomiting, feces or weight loss – no need to worry or consult your doctor. However, if additional symptoms appear, or if there is a fear of the parent – it is better to check and be safe. The digestive system of infants is still in the process of ripening, and changes in color, texture and smell of stools are a natural part of this development.