My Four Month Old Son Has Diarrhea

Hi B.,
as a Lactation Consultant I can tell you that if your son has normal stooling pattern (that is the number and volume of poops has not changed dramatically) and has normal urination (the number and color of pees has not changed dramatically) then he is probably just fine.

Babies often develop some greenish color to their stools when they have slight gut irritation. This can be a mild reaction to something in your diet; a reaction to teething (possibly from swallowing excess saliva); an overload of lactose (milk sugar, usually from not draining the first breast well before changing, or when mom has way too much milk); a mild gastric bug; or other reasons.

It is not significant unless baby is distressed; true diarrhea is present with the risk of dehydration; there is significant amounts of mucus in the stool (small amounts or some stinginess is normal); there is noticeably blood in the stool (don't go looking for it but if you see streaks of blood then call baby's physician); or baby is not growing and developing well.

By the sound of it you are not in any of the above categories of concern that would require closer evaluation. The only thing you mentioned of concern was 4 wet diapers a day. I would expect him to have at least 6 to 8 pees every 24 hours. If the wet diapers are very wet then that may be fine and you did indicate he may be having more. If you are fortunate enough to see him pee outside a diaper then you will be able to check he has a good stream of clear, almost colorless to pale yellow urine and will know he is well hydrated.

In the mean time - greenish is ok as long as the baby is otherwise ok. This is a very common concern particularly for first time moms.

If you want to talk with a lactation consultant then you can find one through the listing at www.ilca.org. Most of us are happy to provide some free reassurance and counseling over the phone and will be able to ask some more questions to determine if further evaluation is needed.

As an ex ped ER nurse - follow your gut feeling (I mean true gut feeling not general worry or concern) - if you truly believe something isn't right with your baby then act on it an insist on a full evaluation. You know your baby better then anyone else.

K. H.

Hi B.,
Sometimes green poop is caused by the baby getting only the front milk and no hind milk. Do you feel like he empties your breast before you switch him to the other side?

Also, my friends baby tends to have poop on the greener side and a little more runny... and she is totally fine and healthy. It is probably nothing but you never want to be too casual about something you feel may be serious. I'm sure someone out there has had this experience and can give you better feedback than i have :), good luck.

Hi I hope your doctor at least tried to put your son on pedialyte (I know that is spelled wrong) so your so won't get dehydrated but that is extremely important when a baby has diarrhea for that amount of time. My youngest is 30 so I know my news is probably very outdated but I do know diarrhea will cause dehydration if not taken care of simply for the fact that i now have a colostomy and that is what happens to a baby, child, or an adult. Please ask you doctor to make sure of this, it can be very dangerous! I know when my son had it we dropped the milk and went to pedialyte right away so the that the electolytes and such in his system didn't get all out of wrack which is what that is for when you have diarrhea, hope this helps but as I said, my youngest is 30 years and allot has changed. I will pray for you, that hasn't changed and the lord knows all sitautions. I hope besides that you are enjoying your baby so much, this will be one of the best times in your life and it goes way way to fast as it is. Take care and good luck.

A. J.

I've learned that it's not an issue until a child has signed of dehydration. If it were something serious, your 'mom sense' would tell you. Go with your doctor's instinct or get a second opinion if you still feel something is not right.

I agree with you...I think the doc is being too relaxed about this. Any diarrhea (no matter the color) is never a good thing...especially at his age and for that length of time. I would be concerned about dehydration and would wonder if he was absorbing any nutrients????? Poor thing :(
Be persistent, you are the mom and his only advocate. Trust your gut instinct. Maybe get a second opinion. Is there another doc in the same office you could see? Good luck!

Hi. My son went through the same thing - I was told that he was not getting enough hind-milk. I was switching breasts too soon, so he was mostly getting the foremilk. I made sure to keep him at one breast longer so he emptied it. Also, I paid very close attention to what breast he last nursed on - I always started the next feeding with that one. I pinned close pins on my shirt for whichever breast he would be nursing on in the future. I hope that helps.

I had this issue with my first daughter and was told that it was a sign of too much foremilk in my breastmilk. My daughter wasn't getting any of the hindmilk. Other signs are faster weight gain and the baby wanting to eat frequently because the foremilk isn't as filling. Does this sound familiar? I ended up having to express some milk before feeding her and switching to one sided breastfeeding (I had been feeding off of both breasts every feeding) If you think this might be the problem, ask your doctor what he/she recommends. Hope this helps!

B.,

I just wanted to respond to your concern, I am a pediatric nurse and have seen a lot of children battling this virus. It is called virus gastritis which is basically the stomach flu. The color of the stool is of no concern. It is green because it it going through the baby's system so quickly and pulling bile along with it. Bile is green.. thus the green color stool. There would be a concern if there is blood or mucous seen in the stool. Reassuring to know that he has 4+ diapers every day which means he well hydrated. You will probably see that his stool will return to normal soon. If however it does not, it would be good to see the doctor next week. Hope that helps. God Bless.
P.S. Mother of 2 age 6 and age 4
I.

Hi B.,

I'm not sure if this will help or not, but my almost four- month-old son has had green poop before also. What to Expect the First Year says that it can be a sign of a stomach bug or something like that, but my son was having it on and off and I didn't think that was it. One of the lactation consultants at Maternal Expressions said that it can be from the baby getting more foremilk and less hindmilk if you have an oversupply of breastmilk or a fast letdown. In that case it's not too much to worry about unless he's not gaining weight fast enough. I would always take his temperature when he had the green poop though, just to be sure. I would trust your intuition though...if you think he's sick he probably is.

BTW, I am 37 and also a 1st time mom to a 4-month-old son. :-) Good luck to you!

Hi B.-

This may be a bit personal but do you have a lot of breast milk? Lots of leaking and feeling engorged? If this sounds familiar you may have an over supply problem. We produce two kinds of milk- fore milk and hind milk. If you have a lot of breast milk or if your baby is only snacking (on the breast for five or ten minutes at a time more frequent instead of longer sessions) then the baby gets a lot of fore milk and not as much hind milk. Fore milk has a lot of lactose in it and it can cause gas and green diarrhea. Sometimes the diarrhea even looks foamy. Hind milk is higher in fat and and important for growth and brain development. This may not be your issue at all, it could also be a virus. If any of this sounds familiar contact me through this email and I may be able to help more or set you up with some one who can. I am a doula and assistant midwife and have three kids of my own. Good luck and follow your gut about your baby and the doctor.

April D

mine would have runny and leaky diapers several times a day. I thought the doctor was also not worried enough. My little one got over it though and is fine. It came and went a few times during the first year. I wouldn't worry. If you are still worried, your doctor is there for you. Tell him you think he's being too complacent and ask what else can you do to releive the problem. He will suggest things I'm sure.

Hi B.! I'm assuming you aren't feeding solids and the breast milk is all he gets. Most breast milk babies have loose stools until solids are started around the 5th or 6th month. Also some breast fed babies have a stool every time they nurse and others have one only every 4-6 days... so, are you sure it's diarrhea? If he doesn't have a fever and is acting normal in every other way then I suggest you not worry about it. He's peeing and pooping--things babies his age do best (besides smiling and cooing at their mothers).

Your pediatrician doesn't seem too worried either. You could also call a Le Leche League member for some information. They are very knowledgeable about the different things that occur with nursing! Above all--don't give up nursing. As long as he's gaining weight and looking and acting healthy he's most likely okay. The color of his poop may have something to do with what you've been eating.

Congratulations on having this little one! Instead of worrying--do research! You're the one who knows the most about your baby because you're with him all the time.

Hugs and blessings!

C Kuhn

my twins (8 mos), also breastfed but getting solids, had a similar experience recently & the pediatrician said there was a stomach virus going around. We did the BRAT diet (bananas, rice, applesauce & toast) but it seemed to just run its course on its on. I offered them some pedialyte (per our dr.) during the course of the diarrhea to ensure they weren't getting dehydrated.

My son who is 9 months old had the same diarrhea twice. He did not have a fever, has a good appetite. He is drinking formula now. I thought my doctor was also very casual about it which i did not like. The first time he had diarrhea, it lasted for 2/2.5 weeks in Dec. In early Feb, it only lasted 5 days and this is what we did. For 12 hours, he only took Pedialyte (as much as he wanted). Then we did half pedialyte, half formula for a day. We also stopped any solid foods. on the 3rd day, he drank full milk. Because diarrhea can make the baby lactose intolerant, we gave him lactose free milk. Since you are breastfeeding, I don't know how that changes things. My son has very sensitive skin so his butt was very raw and red and we used triple paste cream. I hope this helps.

My son had pretty bad diarrhea for about eight days when he started getting his first teeth. Our pediatrician also just had us observe him and if the diarrhea had continued we would have had a stool sample tested. Fortunately it just stopped on its own. Our pediatrician said that teething may cause diarrhea because of the baby's constant swallowing of drool (saliva w/bacteria.)

Dear B., My daughter also had diarrhea about 3-4 months, and this is usually the time babies develop food intolerances, if any. She had milk and soy and egg allergies. I am not sure whether it is the same with your baby, but try cutting out dairy from your diet, and see whether that makes a difference. This includes milk, cheese, yogurt, butter, whey, casein, and careful reading of food labels, unfortunately. Our doctor told us that it may take up to a week for the system to clear out dairy, and to see any effect, but for us, the effect was pretty soon (like a day or two). Also, it is sometimes hard to judge whether a baby has diarrhea or not, since the poop is watery. It would be clearly diarrhea if the baby poops several times a day or many consecutive times. Also, if you see mucus (stringy substance) in the poop, or blood, then it would be definitely a food intolerance. Green poop may be a symptom of the food going through the system too quickly, and sometimes will go away on its own. All the best. K.

There is certainly no harm in getting a second opinion especially if you are not eating dark green vegetables. If you are then it may be nothing to worry about as your dr suggests. You are the parent so listen to your own wisdom and check it out til you are satisfied.

diarrhea is always a scary thought. have you thought of the possibility of teething? with my daughter when she would cut teeth she would get the worst diarrhea and it would last until that set of teeth came through.sometimes for a month or more at a time. just a thought, but if you think it's more then don't take my word on it. you're the mom, you know you're baby best. good luck!

When my daughter was 4 months old or so, her poop turned suddenly very green and she seemed uncomfortable. It was hard for me to know if it was diarrhea, because it's always so soft, but when I tried to collect a stool sample, it was impossible because it was just liquid that soaked right into the diaper. I went to the doctor and they gave me these bags that I put on her bottom inside of the diaper to collect the sample. We brought it to the lab for testing and they said she didn't have any kind of bacterial infection or anything. I wasn't very satisfied, but in time, the color changed back to normal. Then she moved into a time (still going on) of pooping once every 4 to 7 days! At first I was alarmed, but apparently it's normal for breastfed babies. It has continued like this (she's now 8 months old and started solids a little over a month ago) and she's perfectly happy and comfortable. If only it could last like this!

Anyway, good luck with your son. (I have a cousin named Mason.)

Hi B.,

I'm a LLL leader and just want to confirm what some other moms have said about the foremilk/hindmilk imbalance. That can absolutely cause green poop and is nothing to be alarmed about. It's best to let your baby nurse completely on one breast and when he has completely emptied that breast (as much as a breast is ever "empty), switch him to the other breast and let him continue to nurse until he indicates he's done. Then just start the next nursing session on the breast he ended with. I used to wear a hair scrunchie on my wrist to remind me which side to start on the next time. By the way, there's nothing "magic" about making sure he takes both breasts at the same feeding. If he's satisfied with one, that's fine too. Also, http://www.llli.org/ is a great place to find a wealth of information, including a local group if you're interested. Memberships are always available but NEVER required to attend meetings.
-Margaret

Sometimes the stool can change when they are teething.

My daughter had the same thing. I was told that she was getting too much of the fore/early breast milk. So I made an effort to get her to nurse for a atleast 10 minutes and this seemed to take care of the problem after a few days. Good luck!

I have found that the consultation of a Certified Lactation Consulatant can be invaluable. We have a wonderful one at our local hospital. You may have one in your community as well. I have her on my speed dial! I couldn't have gotten through the first year of my son's life without her. They are some of the only health care professiosnals that truley know about nursing and infant nutrition. Good luck!

Be careful about your pediatrician's advise. While this may very well be just a virus, I'd rather see you err on the side of caution, than being too casual.

Let me explain why I take this stance. Our old pediatrician (Dr. Wenner - who I would never, ever recommend) was FAR too casual about our son's digestive issues, and let him vomit 3x/day for a whole month! I brought him in every week, and eventually our poor little guy went from 65th percentile down to FTT (Failure-to-Thrive).

If your pediatrician won't take your concerns seriously, get your child to a GI (Gastrointerologist) specialist right away!!! Do NOT take any chances with your son's health.

I highly recommend Dr. Adel Abi-Hanna at Dr. Marjorie McCracken's group in Los Gatos. He has a wonderful bedside manner, and helped our son immediately.

Best of luck to you.

I remember the first le leche league meeting i ever attended... there was a mom there with pretty much the same exact problem. she was so worked up over it she had changed pediatricians like four times!!!

I honestly don't think it's too much to be worried about. If you've started the baby on solids i would stop and not try again until six months old. Try some resources like kellymom.com, mothering.com and/or le leche league for more support!!

good luck...wish i had more advice to offer but hang in there and don't blame yourself!!

It sounds like your son is eating ok, is going to the bathroom, and the major concern with diarreah is dehydration... but you aren't describing the signs of dehydration so your son's Dr. is not being too casual about it, he probably wants to wait and see what if any other sypmtoms will show and see if it clears up by itself. If not, then he M. suggest some adjustments to your diet that M. help. I never was able to breast feed, so I don't know what changes to your diet would be helpful - but I do know that your diet is important to your childs physical responses - Like some foods will cause gas etc. My kids tended to become constipated and we used old wives remedies to help with that... I know my mom used to suggest things like rice milk as a supplement when the stomachs were having problems - thats just the water from making rice put into a bottle - I always found that helpful with my kids. Maybe more rice in your diet will put that into the breast milk and help your son. Just a thought.... Hope he's ok - good luck.

M. - mom of 2 kids 6 & 9

My doc had to analyze my son's poop to find out he wasn't breaking down the proteins in my breast milk, and we had to switch to Alimentum formula, because it is already broken down. This happened at 4 weeks though, and I hope that's not what's happening with your son, but I thought I'd offer it up for consideration.