Posted by: Diana Cassar-Uhl, MPH, IBCLC | February 21, 2011

Red tushies and green poop


I bet you didn’t think this blog was going to go below the belt!  I’m here, in your baby’s diaper, to talk a little about red tushies and green poop.

I know a bit about this because when my first December baby was born, her red tushie and green poop fit in with the Christmas décor, but didn’t seem … right.  She was exclusively breastfed, and at her two-week well-baby check, our pediatrician told me my breasts were so big, I was making too much milk, and I was overfeeding her.  He suggested I put my baby girl on a strict feeding schedule.  I laughed.  He had no idea how much she loved to nurse, and how impossible putting her on a schedule would actually be!

He told me her diaper rash was “normal,” even though we were changing her diaper frequently (sometimes as often as every two hours, an definitely immediately after she pooped), not using harsh detergents on her cloth diapers, she wasn’t allergic or sensitive to the absorbent materials in disposable diapers, and the diapers fit her well — no friction or other reason for discomfort.  We definitely didn’t have yeast. A yeast rash looks … angry.  It is red, raised, and covers most of the immediate area of genitalia, as well as “satellite” lesions that extend to the baby’s cheeks.  A yeast rash does not improve with diaper rash creams, and requires an antifungal agent to resolve. Talk to your doctor about probiotic supplements for your baby, especially after antibiotics or if you have/had thrush.  If your baby has a yeast diaper rash, it is likely that he has systemic yeast (candida) and you need to check for yeast in his mouth, as well as on/in your breast.  (Find more about thrush at this Thrush FAQ.)

Our little girl’s rash was a bright red ring around her anus.  Far from being normal, that red ring was a red flag! We began to notice that, after a particularly fussy or gassy period of time (pretty much every evening), that red ring became more pronounced and caused her pain.  Diaper rash cream may have been protective, but it stung her and made her cry (and broke our hearts).

My instincts didn’t agree with my pediatrician’s assessment that my little girl’s rash was normal and her green poop should be controlled by a feeding schedule.  I knew that breastfeeding was her comfort and something wasn’t right.  It was only 2002, but thankfully, a Google search of “bloody infant stools” came up hot for exactly what I needed: published research about protein sensitivity in breastfed babies.  I was surprised; I had no idea that half-gallon of milk I was consuming every two days (to wash down my mother-in-law’s incredible fruitcake, which provided my total subsistence during that bleary-eyed postpartum time) could pass into my milk and hurt my baby as if I was feeding her cow’s milk directly. Under normal circumstances, this doesn’t happen, but many mothers (apparently, I was one of them) have stressed or damaged digestive tracts.  Rather than breaking down and absorbing the nutrients we consume, our bodies instead allow these “invaders” to pass through our guts, to our bloodstream, and into our milk.  The most common food irritants are dairy (from any animal but cow’s milk seems to cause more problems than others), soy, eggs, and wheat.

While there is a wide range of normal in color for a baby’s bowel movements, a persistent mossy color can indicate something is up.  The green may also be tinged with blood (usually dark in color).  Consult your doctor immediately if you see blood in your baby’s diaper.  While bright-red blood typically indicates a fissure or other lesion near the opening to your baby’s anus, darker blood comes from further up and can indicate allergic/sensitive irritation or something more complex.  With or without the presence of blood, you may also notice that your baby’s bowel movements are frothy, foamy, or mucousy.  While this is fairly common, it is not normal and should be investigated.  This article from the Academy of Breastfeeding Medicine addresses allergic proctocolitis in the exclusively breastfed baby – feel free to print it out and bring it to your pediatrician for reference.

If your baby is older and eating solids, common allergens may be the culprit of colorful diapers.  Check out the Food Allergy and Anaphylaxis Network for more information.

Many reliable sources consider food sensitivities and red/green diapers related, and I have extensive elimination-dieting and diaper-watching experience as a mother of three breastfed diaper-fillers that confirms this.  In my practice, I have seen too many mothers and babies to count with this obstacle, and in nearly every case I’ve worked with, identifying and eliminating the offending food(s) resulted in a complete or near-complete resolution of the red ring AND the green poops, and reduced fussiness in the baby.

Another cause of green poop is oversupply/overproduction of milk, which can be related to an endocrine/hormone issue like postpartum thyroiditis.  If you have oversupply, it might be worth it to have your hormones checked, since it’s fairly common for things to get a little wonky in the postpartum period. In my experience, oversupply and a food sensitivity tend to happen together, so if you resolve an issue of oversupply and your baby’s diapers are still more colorful than seems normal, consider an elimination diet.

If the prospect of an elimination diet seems overwhelming for you, see this post and keep a few things in mind: first, it is temporary.  Most likely, you will be able to slowly re-introduce the problem foods into your diet after a few months.  Second, if you choose the alternative of weaning your baby to artificial baby milk, remember that those are made from the very allergens you are trying to avoid!  There are special preparations for very sensitive babies, but these are very, very expensive and rather than a few months of adjustment, you’re facing a financial investment through the end of your baby’s first year.  Third, many of us have been through this, and there are lots of resources and great products out there if you need to cut dairy, soy, gluten, eggs, or any other food from your diet.  You will survive and you might even find some new, healthier favorite options. You may be very pleasantly surprised to recognize that you feel better than ever after eliminating one or more of these foods, as well.

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Responses

  1. [...] rash, gas, skin rashes, and extreme fussiness may be common symptoms, but they are NOT normal!! (More about this here)  Many pediatricians dismiss these occurrences as “part of being a baby” (mine did), but you [...]

  2. Excellent.. am sharing!

  3. Been there done that. thanks for your tireless research for us very tired moms and our precious babies.

  4. Hi! Great post! Thank you! My 1year old son has been fussy since 5 months old, seemingly in pain but misfit at night. I did an elimination diet and he stopped all spitting up, but still has night fussiness, (wakeful and restless sleep). He has pretty consistently drak green poops, and today has a red rash concentrated to right around his anus. Poor guy. Is this an indication of a certain kind of allergy? I eliminated dairy and wheat, but have recently added eggs and wheat back in my diet, (he eats solids but is also breastfed). We didn’t see a huge improvement with my eliminating those things. Should I try all grains??
    Thanks again!!!

    • Hi Sara,

      Thanks for your comment — I’m so glad you found the post helpful. The symptoms you describe in your baby may be related to a food allergy or sensitivity. I recommend talking with your pediatrician about your concerns and letting her know what you’ve already done that has helped.

      For a lot of moms, gluten is the culprit, since for these mothers, it irritates their digestive tracts enough that other offending proteins pass through the small intestine and into the bloodstream/milk. It’s definitely an issue of a maternal sensitivity (even if undetected or asymptomatic) resulting in a baby problem.

      If you haven’t already, see my post here about elimination diets. http://dianaibclc.com/2012/01/08/so-what-can-i-eat/

      Also, be sure to watch your baby closely when you introduce a new solid food. Since he’s eating solids now, the problem might not be with you, but with whatever new item he’s eating. Don’t feel in any hurry to get new foods into him — your milk is terrific and the rest is purely experimental for now. :)

      Good luck!

      • Thank you so much for your thoughtful reply!! I’ll check out your diet posts too:))

  5. This kind of information is very helpful, thank you! I have a little 3 month old girl who consistently has gas pain in the early morning (4 a.m. or later) that wakes the house up and doesn’t stop until she gets up for the day, even if I try to feed her or comfort her in other ways. The past week she’s had gassy episodes during the day, too. My pediatrician has dismissed it as “normal” and promised it should be clearing up between now and 4 months. It sure doesn’t seem to be!

    She did have dark green poop, but that seemed to stop after I followed LLLI’s directions for getting rid of oversupply. She has a consistently red line along her tush, but not a ring. She’s never had blood in the stool. Is there a medical reason to believe I should be trying an elimination diet?

    • Hello and thanks for reading!

      I’m not a doctor, but I feel like eliminating a commonly irritating food (like dairy) for 2 weeks can’t hurt and might help — so it’s worth a try, in my (not medically professional) opinion. The Academy of Breastfeeding Medicine’s resource does address blood in the stool as an indication, but for my babies, my eliminating dairy (and other foods) significantly took care of most of their gas, pain, and other issues. If you try it and it doesn’t work, you know that wasn’t your issue! :)

    • Its yeast.use a strong probiotic.i guarantee the issues will disappear.You may have a yeast die off though where it may get worse before it gets better.Hang with it.Thre tons of info online on this topic.Yeast destroys us inside.Not many believe it exists, but my daughters stool sample made me a believer and the huge change in her overall.

  6. [...] here and there. If those nights are most nights, though, the gas and fussiness are accompanied by green poop and a red “allergy ring”, and especially if there’s a lot of mucous, blood, and/or a marked foul odor, it’s time [...]

  7. [...] may have been told that your baby is fussy, has a skin rash, is gassy, spits up, has diaper rash, a red ring around his anus, or green poop because of something you’re eating, oversupply, or foremilk/hindmilk imbalance.  You may also be [...]

  8. Hi to the women up there who said red ring around anus.that is yeast, and it can cause an array of issues.Use a probiotic on your child.It helped us immensely.Make sure it has at least 2 billion organisms.Culterelle,klaire labs,kirkman, and pearl make excellent ones.

  9. Thank you so much for this post. I think the pediatrician thought that your daughter was getting too much foremilk, which is why he mentioned the green poop thing. But I know that is only one cause, and even then it’s not consistently green. My daughter nursed constantly and had normal poop. My two sons nurse/d on a schedule, and they both had/have consistent green poop and red anuses. They both have eczema, too.

  10. [...] seems to be a good indicator of an irritated colon, as does mossy-green poop in breastfed babies (this site discusses the subject in some detail). So anything that will help the colon heal would [...]

  11. [...] Bottom, Green Poop In researching coffee enemas, I discovered a post called Red Tushies and Green Poop. I wish I could have read this when Manny was a baby (can you believe he’s 3 1/2 now?!). No [...]

  12. Hi! I just found this post and wow… thank you! My son is twelve months. I stopped breastfeeding him at 4 months because I had to go back to work and I just could not stand the breast pump :( I have never been a huge fan of dairy, milk, butter, cheese, I just am not a fan. Once I started my son on formula that is when the troubles began. He was diagnosed with asthma, constantly constipated, fussy, would go 3-6 days between stools, and always had green poop and the red ring. I mentioned it to his pediatrician at every visit. He never said a thing. Said to just give him more juice, more fiber in his diet, etc. Once he hit the one year mark I started him on whole milk, two days later he had an asthma attack. I had read that cow’s milk can cause more mucus production so I switched him to soy milk. The next day I talked with his Dr. He thought it was not a good idea on the soy milk and to switch him to whole milk. I kept him on soy milk for 2 weeks. Two days ago I reintroduced cow’s milk. He woke up this morning coughing and runny nose (like a cold), and he has been straining all day to try to have a BM. Finally when he got it out, his little tush just around the anus was extrememly swollen with the red ring. The poop was two shades of green and extrememly stinky. I feel like the doctor thinks I am a crazy woman when I ask him/tell him that I think it’s a milk allergy. But the proof is all there. Should I just take my son to an allergy specialist, back to the pediatrician and demand that he take notice to my son’s tushy and other issues with milk, or just continue with his dairy free diet?

    • I’ve learned that doctors don’t always know what is best. The constipation and asthma you are describing are both classic symptoms of a milk allergy–and not just to the lactose, either. I’d stick with soy milk, or even try other milks, such as almond, coconut, or hemp. Those three may be a bit more pricy, but they have more good fat (which is important at this stage–the hemp especially is high in omega 3 fatty acids) than soy does, and you’ll avoid any questionable issues with soy (we use soy, but only organic/non-GMO soy, and we make almond milk and use hemp milk too).

      You could take him to an allergist, but if he proves that he’s allergic to milk, you’ve just spent money to prove what you already know. I’d say ignore the doctor, leave the dairy alone, and trust your mommy instinct. Your boy will be just fine!

      (PS I’m not a doctor, but I’m a mother to a boy with a ton of allergies, so I think I’m qualified to give an opinion!)

  13. [...] Normal, Like Breathing | Red tushies and green poop http://dianaibclc.com/2011/02/21/red-tushies-and-green-poop/ [...]

  14. [...] http://dianaibclc.com/2011/02/21/red-tushies-and-green-poop/ [...]

  15. I am having the exact same problem. Thanks for the article. I keep talking about this and my family is probably so sick of hearing me say maybe its this or maybe its that. My LO is 2 months. Started being extremely fussy and restless around 3 weeks. On top of that she was congested and wheezy sounding on occasion. She was fussy when awake and towards the end of nursing start pulling off, arching her back and crying. Then I noticed the green frothy poops getting worse and this extremely red rash ring around her bum. She was thrashing in her sleep at night and cry. She hardly napped during the day because and would wake up suddenly crying. I looked online and figured it was a milk protein allergy and told her doctor.. He said she simply could have a little cold and gave me diaper rash cream. I stopped eating anything with milk protein….which seemed like everything! She was a new baby! Happy, content, sleeps 7 to 10 hrs a night, wakes up smiling, napped soundly, nice yellow seedy poop, no rash or boogy nose! He told me to try milk again and just like that all symptoms are back in the same day! so im eliminating dairy once again. Its not too bad, just takes some planning.. Some fast food restaurants have food allergen menus if theres no time to cook. I would eat baked potato, garden salad or chili from wendys. Fresco chicken burritos from taco bell and for the sweet tooth chocolate soy ice cream with a blob of peanut butter on top! Anything is better than seeing my little girl suffer. Cant wait to not eat dairy tomorrow so I can see her smile at me all day again!

  16. What about a red ring but still having classic mustard colored poop. His poop is very normal but he does have some irritation around his anus.

  17. I am not sure if you will get this post as this blog post is a bit old now. If I have tried the elimination diet and it is not helping in terms of the diarrhea, green acidic smelling poops, and occasional blood, but the baby is growing appropriately and has never been too fussy, gassy or had any rashes…would you continue to breast feed or switch to formula (he is now 6 months). If I do continue to breast feed, will that make the possibility of allergies greater because his intestine just wont heal?

    • I would always continue to breastfeed, because your milk has protective and healing factors that a substitute can’t duplicate. Also, make sure you’re talking with your pediatrician to rule out other issues with your baby’s digestion and immune system. Thanks for reading.

      • Thank you so much for your reply! I have been going to a pediatric GI who feels that I may not be cutting out everything completely. I feel I have done all that I possibly can do. At this point she seems to be leaning towards the formula, but I am torn. I don’t want to cause irreversible damage by continuing to breast feed with him regularly ingesting some sort of allergen from my breast milk. I cannot seem to find any studies indicating which path is better in this situation formula or breast milk (given he has relatively minor symptoms).

      • Would voice of experience help? I know exactly what you are facing. My husband reminded me constantly that my milk was bad for our baby when he was your baby’s age. We tried goat’s milk, but he was more allergic to that. I wish I had known about hemp milk then, or that fresh organic carrot juice can be used as formula (it will turn them orange, called “carrotinitis” or something like that, but it’s harmless and goes away when they add in other foods).

        I chose to wean at 12 months. I lived on a diet that was next to impossible for an adult who has to watch others eat normal foods, and I hated it. I was still eating reaction-causing foods, but I couldn’t identify which ones. Still, I chose to wait until 12 months, and then took 2 weeks to wean. I don’t regret waiting that long or weaning that early (depending on who you ask). I feel that waiting 12 months gave him the best of all the benefits of breastmilk, and weaning before my ideal of 2 years (which I have yet to reach with any of my 3 children) to give him the chance to figure out allergens easier, was the best choice all around.

        I would avoid formula. At 6 months, it is going to be next to impossible to get him to eat anything like those hypoallergenic formulas (they taste absolutely horrid). I would make sure you are avoiding gluten and dairy especially, along with the other highly-allergenic foods. We avoided citrus, because my brother was sensitive to it as a child, and later found out he can have it. That was such a blessing! But in any case, you will have to rethink your diet. Try some exotic roots (starting with sweet potatoes, which aren’t quite as exotic). Try GF grains like rice and quinoa and millet. If you have a high powered blender (and even if you don’t, but the result won’t be the same and it won’t heat up), you can blend millet with just enough milk so it blends freely, a little sweetener (we use maple syrup or agave), a splash of vanilla, and a dash of cinnamon, and blend on high in the Vitamix until it starts to steam. It has the consistency of pudding. We use hemp milk, but any non-dairy milk that your baby can tolerate would be good, and it is so smooth it would make an excellent baby food (maybe minus the cinnamon at first, and even without the sweetener if the milk has some).

        Also, something that might not be obvious, but try going organic. My son used to throw up whenever he had carrots or apples, but after avoiding them for about a year, he can now eat them regularly, as long as they are organic. He can have the occasional glass of non-organic apple juice, but I’d say 95% of his apples are organic. We use as much organic as we can–all produce except for citrus, which isn’t sprayed for pests, as well as some grains when we can afford them. I think it really makes a difference.

        Hope that helps! My son is 5 now, and just as normal, minus the bit of eczema that is left (at 6 months, it was over about 90% of his body) and his special diet, as any other kid out there.

  18. Thank you for your reply. This has all been very discouraging. I just hope to see some change so that I feel like I have done the right thing. I will try gluten. Fingers crossed this works!


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