Green Stool in Infants: Is It Time to Change Formula?

Green stool

My baby is currently 2 months and 6 days old and has been drinking Abbott formula.
His stools are green, very thick, and have a strong odor.
He does not have a bowel movement every day.
The pharmacy staff mentioned that the high iron content in Abbott formula could cause green stools, which is not good for children.
Should I change the formula? I'm really struggling because the pharmacy staff keeps saying Abbott is not good, but I see that my baby, aside from not having daily bowel movements and having green stools, does not show any signs of discomfort.
Is it okay for a baby not to have daily bowel movements? P.S.
Thank you, Dr.
Lin, for answering so many of my questions last time.

judy, 30~39 year old female. Ask Date: 2004/09/12

Dr. Lin Wenxian reply Pediatrics

Director Lin Wen-hsien of the Pediatrics Department at Tainan Hospital, under the Ministry of Health and Welfare, responded that the number of children being born to parents in Taiwan is decreasing, averaging less than two per family.
As a result, each baby is cared for with great attention to detail, and certain aspects of daily life are particularly emphasized.
For instance, one of the most frequently asked questions by parents to healthcare professionals is what type of milk to give their babies.
In my opinion, the first choice should always be breast milk, as breastfeeding offers numerous benefits for both the baby and the mother.
Healthcare professionals, hospitals, and society should make every effort to support mothers in successfully breastfeeding.
Formula milk should only be given when absolutely necessary.
As for which brand of formula to choose, I believe they are all quite similar.
Any formula that has the mother-and-baby logo (a green mother holding a red baby, with the text "Breastfed babies are the healthiest" above and "Concerned by the Ministry of Health and Welfare" below) meets the health department's inspection standards and is suitable for infants.
You can visit the health department's website to check which brands of formula have passed inspection and registration.

Regarding the frequency and consistency of bowel movements in infants, there is a wide variation.
It can range from once every couple of days to several times a day, and both slightly soft or slightly hard stools are acceptable.
It is typically not until the age of two or three that bowel movement frequency and consistency become more similar to that of adults.
Green stool may indicate the presence of bilirubin or unabsorbed iron, which is related to the normal gut flora and different formulas.
If the baby is healthy, gaining weight appropriately, and showing no signs of discomfort, then their condition is likely normal.
Of course, we also welcome you to visit the Pediatrics outpatient clinic at Tainan Hospital for a health check-up.
Tainan Hospital wishes you good health and all the best!

Reply Date: 2004/09/12

More Info

When it comes to understanding the phenomenon of green stool in infants, particularly in your case where your 2-month-old baby is consuming a specific formula (Abbott's Similac), there are several factors to consider. First and foremost, it’s essential to recognize that the color and consistency of an infant's stool can vary widely based on their diet, including the type of formula they are consuming.

Green stool in infants is not uncommon and can occur for various reasons. One primary reason is the presence of iron in the formula. Many infant formulas, including Similac, are fortified with iron to prevent iron deficiency anemia, which is a common concern in infants. The excess iron that is not absorbed by the body can lead to green-colored stools. This is generally considered normal and is not typically a cause for concern, especially if your baby is otherwise healthy, gaining weight appropriately, and showing no signs of distress.

In your case, you mentioned that the stool is thick and has a strong odor, which can also be attributed to the formula. Formula-fed infants often have different stool characteristics compared to breastfed infants, including a firmer consistency and a more pungent smell. This is due to the different types of proteins and nutrients present in formula compared to breast milk.
Regarding the frequency of bowel movements, it is also important to note that infants can have varying patterns. Some may have several bowel movements a day, while others may go a few days without one. As long as your baby is not showing signs of discomfort, such as straining excessively to pass stool or having hard, pebble-like stools, infrequent bowel movements can be normal.
If you are concerned about the green stool and the odor, it may be worth considering a few options. First, ensure that your baby is adequately hydrated. Sometimes, dehydration can lead to harder stools. If your baby is not drinking enough formula or is not showing interest in feeding, it might be beneficial to consult with your pediatrician.
Additionally, if you are contemplating switching formulas, it is crucial to do so under the guidance of a healthcare professional. While some parents may report that certain formulas lead to better stool consistency or color, every infant is different, and what works for one may not work for another. If you decide to switch, look for formulas that are labeled as gentle or designed for sensitive tummies, as these may be easier for your baby to digest.

Lastly, if the green stool persists or if you notice any other concerning symptoms, such as fever, vomiting, or signs of dehydration, it is essential to seek medical advice. Your pediatrician can provide personalized recommendations and may suggest tests to rule out any underlying issues.

In summary, green stool in infants, particularly when consuming iron-fortified formula, is often normal and not a cause for alarm. Monitor your baby's overall health, feeding patterns, and comfort level, and consult with your pediatrician if you have any concerns or if you consider changing formulas.

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