Green Stool and Constipation in Infants: Expert Insights

Q: Green Stool and Constipation in Infants: Expert Insights

Hello, Aunty： It is best for your child's gastrointestinal condition to be examined by a pediatric gastroenterologist. <br>Since formula milk contains a large amount of water, it is not recommended for infants to drink plain water. <br>Unless advised by a pediatrician, do not cha

Green stools and constipation issues?

Thank you, doctor, for taking the time to answer my questions.
My child is currently one and a half months old and will turn two months on October 20.
He weighs about 5.7 kg and is consuming Abbott Similac formula.
Since birth and up to one month, his stools were yellow and oily, but there were 1-2 days every two weeks when he had difficulty passing stools.
After massaging his belly, he would have a bowel movement.
However, in the past week, I suddenly noticed that his stools have turned green.
After seeing a doctor, I was informed that this is due to the higher iron content in Abbott formula, which can cause green stools.
The oiliness is attributed to the added vegetable oils in the formula.
As for the occasional constipation, it was suggested to use a powder called "Bifidobacterium" to help improve it.
I have several questions for the doctor:
1.
I asked a pharmacist, and they told me that every brand adds vegetable oil to promote the absorption of DHA, so the oil in formula is normal.
Is this true?
2.
Some pharmacists told me that if constipation does not improve after using the Bifidobacterium powder, it would be best to switch formulas to address the source of constipation.
However, other pharmacists advised against switching formulas while the child is constipated, suggesting to wait until the constipation improves before making a change.
I am confused about which advice is correct.
3.
I read that the daily water intake for infants under six months should be limited to 110-130 cc of plain water to avoid putting a strain on the kidneys.
However, one pharmacist suggested that I should let my child drink more water to help with constipation, claiming there is no restriction on water intake for children.
Which statement is correct?
4.
A pharmacist recommended that I purchase glucose powder with added Bifidobacterium for my child.
After starting to drink water, my child had slightly improved bowel movements, but after 1-2 weeks, constipation returned.
Is the added bacteria still effective?
5.
What is the difference between Bifidobacterium powder and "Ruo Yuan" tablets? Which one is better for relieving constipation in children? The Bifidobacterium powder I purchased only specifies the dosage for adults (3 times a day, 1 gram each time), and the dosage for children is not clearly stated, only suggesting to adjust based on the child's age and condition.
This leaves me unsure of how to proceed! One pharmacist advised me to give one-third of the adult dosage three times a day.
Is this dosage and frequency appropriate? I am very concerned that incorrect dosages could harm my child's gastrointestinal tract.
Please provide me with the correct dosage and frequency.
Thank you once again for taking the time to read my questions, and I appreciate your help.

A Gu Gu, 20~29 year old female. Ask Date: 2006/10/14

Dr. Wang Jiayi reply Pediatrics

Hello, Aunty: It is best for your child's gastrointestinal condition to be examined by a pediatric gastroenterologist.
Since formula milk contains a large amount of water, it is not recommended for infants to drink plain water.
Unless advised by a pediatrician, do not change formula easily, and please avoid using over-the-counter medications.
Wishing you and your baby all the best! Hualien Hospital Pediatrics cares about you!

Reply Date: 2006/10/14

More Info

When it comes to understanding green stool and constipation in infants, it’s essential to consider several factors, including diet, digestion, and the normal variations in bowel movements that can occur in young children. Your concerns about your 1.5-month-old baby, who is currently on Abbott Similac formula, are valid and common among parents. Let’s address your questions one by one.

1. Green Stool: The green color of your baby's stool can often be attributed to the iron content in the formula. Iron is an essential nutrient for infants, especially for those who are formula-fed, as it helps in the development of red blood cells. However, excess iron that is not absorbed can lead to green stool. Additionally, the presence of plant oils in the formula can contribute to the oily texture of the stool. It is generally considered normal for formula-fed infants to have variations in stool color and consistency, as long as they are feeding well and gaining weight appropriately.

2. Constipation and Formula Changes: The advice you received from different pharmacists regarding constipation and changing formulas can be confusing. If your baby is experiencing occasional constipation, it is often recommended to try gentle remedies first, such as tummy massages or ensuring adequate hydration. Changing formulas can sometimes help, but it’s crucial to do so cautiously. If your baby is thriving and gaining weight, it may be best to monitor the situation for a bit longer before making any changes. If constipation persists despite home remedies, consulting your pediatrician for tailored advice is advisable.

3. Hydration: The recommendation for water intake in infants under six months is indeed limited. Generally, infants should not be given more than 110-130 cc of water per day, as their kidneys are still developing, and excessive water can lead to a condition called water intoxication. However, if your baby is constipated, small amounts of water may be beneficial, but this should be done under the guidance of a healthcare provider. It’s important to balance hydration with the recommended limits to avoid any potential kidney strain.

4. Probiotics and Supplements: The use of probiotics, such as Bifidobacterium, can be beneficial for digestive health and may help with constipation. However, the effectiveness can vary from child to child. If you notice some improvement initially but then a return to constipation, it may be worth discussing with your pediatrician whether to continue or adjust the probiotic regimen.

5. Differences Between Medications: Regarding the differences between "表飛鳴" (a type of laxative) and "若原錠" (another type of laxative), they may have different active ingredients and mechanisms of action. It’s essential to follow the dosing instructions provided by your healthcare provider or the product packaging. For infants, dosing can be tricky, and it’s best to err on the side of caution. The suggestion to start with a third of the adult dose may be reasonable, but again, consulting your pediatrician for specific dosing recommendations based on your child's age and weight is crucial.

In summary, while green stool and occasional constipation can be common in infants, it’s essential to monitor your baby’s overall health, feeding patterns, and growth. If you have ongoing concerns about your baby's stool color, constipation, or any other health issues, it’s always best to consult with your pediatrician. They can provide personalized advice and ensure that your baby is healthy and thriving.

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