If you are a parent, you have probably had the awkward experience of showing your medical provider a picture of your child’s poop. I can assure you from my many years of experience, you are not alone. This is one of the things that parents ask me about the most! I have examined many photographs of stools and in-person samples from almost every color of the rainbow. I'm not afraid to get down and dirty. So here we go!
What is a normal poop color?
Depending on your child’s diet (or time of day, growth patterns, star alignment), almost any color can be normal. Yellow, brown, green...nothing to see here, folks. It’s all ok!
What colors are you worried about?
Red, white and black might be cause for concern. Why?
Red: Red stool might be fresh blood. This isn’t always a problem - this could be something called an anal fissure (crack/opening in the skin of the anus) which is very common and often presents like streaks in or on the outside of a bowel movement. But it also could mean inflammation or a tear in the gut and is definitely worth bringing to the attention of your PCP (Primary Care Provider), especially if it's a large amount or lasts for more than a few stools.
Black: Black stool could be old, digested blood from higher up in the GI tract. The same rules apply as for red stool. The exception is meconium stool - a newborn's black and tarry first stools which are very normal.
White (very rare): This could indicate a liver problem. This is like a white clay color (see below). Most parents who think their child has white stool just have a lighter version of their normal stool. Still, this is worth bringing up with your PCP.
What can make my child’s poop turn different colors?
A few examples:
Orange: A medicine called cefdinir (Omnicef). This color change is harmless and is often mistaken for blood if it’s more of a red-orange. Also eating lots of carrots, pumpkin or other squash may color the stool orange (or even make your child’s skin have an orange hue!)
Black: Pepto bismol, Iron, Oreos, upper GI tract bleeding, nosebleeds with swallowed blood
Red: See above, but also lots of red dye can cause red stool (think Kool-Aid, Jello, etc)
Green: Mucous from a cold, stool passing quickly through the GI tract (sometimes from an infection or viral illness), food coloring, lots of green veggies (if the latter, your kid is very unusual and good for you!)
Blue/Purple: Food colorings, lots of blueberries/blackberries
Yellow: Newborns - breastmilk, if frothy and foul smelling - excess fat in the stool (this could mean your child is not absorbing all nutrients like they should)
Overall, it’s ok to ask about poop. And always take the poop color and evaluate it in the context of how your child seems to be doing. Do they LOOK sick? Are they tired? Are they growing? Eating well? This (plus the information above) will help you to decide how urgently you should take your child in to be seen.
Resources/References
PoopMD by Johns Hopkins: https://www.aappublications.org/content/35/9/44.2
https://health.ucsd.edu/news/features/Pages/2018-05-11-listicle-what-color-is-your-poop.aspx
https://www.nationwidechildrens.org/family-resources-education/700childrens/2017/04/the-poop-palette-what-do-all-of-those-colors-mean
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