During the first months of life, I noticed my son’s poop changing from its regular yellow/brownish color to a green frothy poop. It came and went periodically with no reason that I could see. I knew that there were many causes of a green stool and started to worry that he might have an infection. In looking for an answer, I found several helpful resources that discussed multiple possibilities:
- Jaundice (in the first few days of life)
- Food sensitivity to Mom’s diet (usually causing mucousy/bloody stools, spitting up a lot)
- Foremilk/hindmilk imbalance (usually causing a frothy, watery stool)
- Intestinal virus (usually causing a mucousy stool)
- Mom’s medication
I began working my way through the list to find the most likely cause for my son. In examining him, I could see that he was perfectly healthy and gaining weight well (VERY well!). I was able to rule out everything but foremilk/hindmilk imbalance.
What, you ask, is a foremilk/hindmilk imbalance? Well, it happens when the infant is receiving more foremilk than hindmilk, which can result in green stools. In an interview for Baby Center, Vicky Pigott describes it this way:
If your baby’s stools are green and frothy she may be taking in too much lactose (the natural sugar found in milk), which happens if she feeds often, but doesn’t get the rich milk at the end of the feed to fill her up.
How do you fix a foremilk/hindmilk imbalance? Thankfully, the answer is simple – nurse longer on one breast. Foremilk is produced at the beginning of a feeding and is higher in milk sugar and lower in fat. It goes through the baby’s system more quickly and produces more gas. Hindmilk is higher in fat, digested more slowly and is less likely to cause gas. Sometimes, adjusting your breastfeeding technique can help.
Lactation consultant Janet Vandenburg explains that gas in babies can also be caused or aggravated by foremilk/hindmilk imbalances and a strong let-down. Vandenburg describes the importance of letting the baby stay on the first breast until he is done and either falls asleep or lets go on his own. This method of nursing, also called “block feeding,” can be done temporarily until the baby’s stool returns to normal.
I followed Vandenburg’s advice and tried nursing on one side, multiple times if necessary, until the breast had been emptied and then switching sides on the next feeding and repeating till the other breast was emptied. It can be a little painful setting up this routine because of engorgement, but you can feel free to pump to help relieve the pressure till the routine is established. It only took a couple of days to get this down and now no more green stools.
You may need to consult your physician if the green stools continue for longer than 24 hours after making the necessary changes to provide your baby with more hindmilk. The source of the problem may be due to another cause.