Green stools in babies: Could twins green stools be caused by mom's diet?

I have twin boys. Nursing has been interesting as each has their own pattern. Both of my boys are good nursers. Last week the heavier twin, Joseph, began to have green watery stools and was very fussy all day, even while nursing. I was told that the green stools could be caused by a lack of fat in my diet. I am not on a weight loss diet. Are green stools anything to be concerned about?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Congratulations on your success nursing your two little guys! It sounds as if you have a very abundant milk supply -- an especially wonderful asset when nursing twins.

You don't need to be concerned about occasional green stools in breastfed babies who are healthy, happy and growing well. Green stools can be the result of a foremilk-hindmilk imbalance. This may sound complicated, but it really isn't. When your little guys receive a large quantity of your more plentiful foremilk, this high lactose (sugar) feed is thought to pass quickly through their digestive tract, resulting in green stools.

When a baby receives a large quantity of foremilk he may want to feed frequently. (Low-fat feeds, of mostly foremilk, are very rapidly digested.) Fussiness (colic), gassiness, unhappiness at the breast and breast refusal can also result. When a nursing baby's mom has a very abundant milk supply, green stooling can be quite common.

To help remedy this situation, and allow your babies to get a more balanced feed, you might try offering one breast per two to three hour period for each baby. (For example, Matthew would stay on the left breast, and Joseph on the right breast for their 9am feed. If your babies want to nurse again an hour later, return them to the same breast. At 11am when they want to nurse again, Joseph would switch to the left and Matthew to the right.) Since each baby may have a different sucking pattern, switching back and forth between sides during a feed may keep your little ones from accessing your rich hindmilk.

Foremilk gradually transitions to hindmilk throughout a feed, and the timing of this transition depends on how full your breasts are, the effectiveness of your baby's suck, as well as how long since the last feed. Allowing each baby to control his feed will help to assure that each baby is getting just what he needs.

Your Pediatrician is absolutely right. Green stools in an infant have nothing to do with a nursing mother's dietary fat intake. If you are already eating a healthy diet, are comfortable with your weight, and you are not losing more than one to two pounds a week, there doesn't seem to be any reason to change your current eating pattern. See my letter, Calories Needed for Lactation, for additional information.

Green stooling that is very frequent -- occurring between 12 and 16 times a day -- and that may be watery and foul smelling, are common with diarrhea. If either of your babies is sick or experiencing diarrhea, it is important that they be promptly evaluated by their Pediatrician. Best wishes in mothering!

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