Any parent who has ever witnessed blood in their baby’s stool can attest to the fear that instantly occurs. The causes range from simple to severe, from allergic reaction to infection, and sometimes it’s because of the mother’s milk. This article will clarify what you must know as a parent.

Causes of Blood in Baby Stool

1. Constipation

This condition is relatively common in babies and causes much parental angst. Babies can have multiple bowel movements every day or go several days with none. Constipation results in hard stools that are difficult to pass. The stool then stretches the rectum and causes abrasions or tears in the skin resulting in bright red blood in the stool.

2. Infection

A variety of infections can occur and result in blood in the baby’s stool. Infants are susceptible to infections from minor amounts of contaminants. Certain bacteria can cause blood to appear in the stool. Bloody diarrhea is always a cause of great concern and requires a doctor visit to determine what infection is responsible. Never delay taking your baby to doctor when bloody diarrhea or an infectious cause is suspected.

3. Allergic Reaction

Milk and formula both contain a variety of proteins and other substances that can trigger an allergic reaction in the baby’s intestinal tract. The resulting inflammation can cause blood to appear in the stool. Mucus may also pass along with the stool.

4. Rectum Abrasion

Hard stool or an inadequately lubricated rectal thermometer can result in abrasions to the rectum. The blood will be a small amount and bright red. It may pass along with the stool or show up by itself in the diaper. Gently applying traction to the buttocks will often reveal a small abrasion or tear in the skin. The medical definition is fissure and these generally heal within a day or two.

5. Cracked nipple in mother

Breast-feeding can irritate the mother’s nipples and causes cracking and bleeding. The baby then swallows this mother’s blood and passes it through into the stool. A doctor can perform a simple bedside test to determine if the blood is from the mother or from the infant.

6. Too much breast milk

An excess of maternal breast milk can irritate the infant’s intestines and cause bleeding. Lactose intolerance is the usual culprit.

7. Other causes

Colitis is a generic term for inflammation of the colon. It can occur due to infection (viral or bacterial), inborn errors of metabolism and digestion, severe dehydration and results in blood in the stool.

Intussusception is a serious cause where one portion of the intestine telescopes inside another section of bowel. The intestine then swells and looses blood supply. This is an emergency. Dark or current jelly appearing stools along with intermittent bouts of crying are commonly observed in this condition. Occasionally the blood in a diaper is actually from the urine or a substance in the urine. Simple laboratory testing will sort out the source.

Treatment for Blood in Baby Stool

1. Treatment

Treatment is completely directed at the underlying cause.

• Constipation can be treated by adding 1 teaspoon of karo syrup to the bottle and using glycerin suppositories or mineral oil around the rectum to lubricate passage of stool.
• Trying soy or other specialty infant formulas treats excessive milk and lactose or formula intolerance.
• Infections, bloody diarrhea or current jelly stool all require medical evaluation and treatment based on the results of testing.
• Intussusception requires a specialized procedure or surgery to restore the normal position of the bowel. Delay can result in serious consequences and even death.

2. Warning

• Dark red blood resembling current jelly is a sign of intussusception. Diarrhea that is grossly bloody indicates a serious infection. If the baby is listless, lethargic or seems dehydrated a serious underlying problem is likely present. Any of the above conditions mandate emergent evaluation by a physician.
• If the child is happy, eating well doesn’t have a fever or seem in pain, the cause may be benign and self-limited. Fever, abdominal pain, distress or bloody diarrhea requires a trip to the doctor or emergency room immediately. The best suggestion is not to delay medical evaluation if any concerns or signs of distress are present in the baby.