North American Registry of Midwives (NARM) Practice Exam

What could the elimination of green urine and greenish loose stools indicate in a baby?

1. Normal digestion

2. Excretion of bilirubin

3. Risk of infection

4. Allergy to formula

The correct answer is: Excretion of bilirubin

The presence of green urine and greenish loose stools in a baby can indicate the excretion of bilirubin. Bilirubin is a byproduct of the breakdown of red blood cells and is processed by the liver. In infants, particularly newborns, it is common to see variations in stool and urine color as they adjust to feeding and their digestive systems mature. When bilirubin is excreted, it can cause changes in stool color, often resulting in greenish hues if the bilirubin levels are elevated or if they are processing it at a certain rate. While normal digestion might suggest a variety of stool colors, green stools specifically tied to bilirubin indicate a biological process rather than typical digestive function. Risk of infection and allergy to formula might present with different clinical signs and symptoms, such as fever, significant changes in behavior, or digestive distress, rather than just changes in urine and stool color. Thus, the elimination of green urine and greenish loose stools is best associated with bilirubin excretion as the body recognizes and processes substances during early life.