Blood in an infant or child's stool

Blood in an infant or child's stool

When it's harmless and when you need to contact a doctor

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Dr. Stan (Stan Cohen MD)

Is a pediatric gastroenterologist at the Children’s Center for Digestive Health Care / GI Care for Kids, whose books on nutrition for parents led him to start Nutrition4Kids with his co-founders.

Small amounts of blood in your child's bowel movements is unusual, but it's usually not a reason to panic.

Constipation

Sometimes, hard, large stools can cause a tiny tear in a baby or child's tender bottom. It will hurt, but it will heal and often needs no treatment. To prevent hard stools, take a closer look at your child's diet. A few changes in their diet may be all that is needed.

In our blogs on constipation and what to feed your baby we point out that your infant or child's diet directly affects their stools. A high fiber diet , with plenty of fluid, is the best way to help them make soft, easily passed stools. A diet low in fruits, vegetables and fiber, with lots of high fat foods, starches and dairy, usually slows stool passage. It often creates firm stools, that are hard to pass and may also include a small amount of blood.

Blood Without Constipation 

If your infant or baby does not have constipation and there is blood in the stool, there is likely another cause of the bleeding. If you have a healthy and active baby, passing just a few specks or small streaks of blood (a little mucus may be there too) with a normal stool, the baby most likely has a mild condition. 

Food-related illnesses are often the cause. Among the mildest is lymphoid hyperplasia, where the lymph tissue in the intestine is slightly enlarged and affected by stool passing it. This can be caused by an allergic reaction to one or more foods or for unknown reasons.

Food-protein-induced enterocolitis syndrome (FPIES) is the most severe version, where a food triggers a terrible bout of vomiting, diarrhea- often with blood, and sudden dehydration. This condition requires immediate attention, usually with intravenous fluids. This condition improves dramatically when the offending food is eliminated from the diet. Dairy is often the cause, but certainly not the only one.

Both of these conditions require caution when introducing new foods into a baby's diet.

blood in stool when to be concerned

Intestinal Infections

Blood in the stool can come from an intestinal infection. Serious infections will also cause diarrhea.

Clotting problems and a number of intestinal conditions that occur early in infancy can also cause bleeding.

Necrotizing enterocolitis is one seen in very premature infants, especially as they begin feedings. This condition is almost always isolated to premies who are still in intensive care units.

Evaluating blood in the stool depends on how much blood is present, looseness and frequency of the stools, and if there are any health problems. The baby who is passing a large amount of blood or is having severe diarrhea, fever, vomiting, or any other symptoms needs to see the doctor.

The Older Child With Intestinal Bleeding

Just like infants, bleeding in an older child can come from clotting problems (also called bleeding disorders). Intestinal infections can cause blood in the stool – these are usually accompanied by diarrhea, abdominal cramps, and sometimes, fever, diarrhea or both.

Polyps, that are growths in the intestinal wall, can cause bleeding without any other symptoms.

Food allergies or reactions rarely cause bleeding in a toddler or older child.

In summary, it is important to contact your doctor if your child is bleeding without being constipated, doesn't quickly clear when you treat the constipation or has significant abdominal pain or other complaints.

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