Blood! Don’t be alarmed if you see an occasional bit of blood in your baby’s diaper or poop. There are many possible causes, most of which aren’t worrisome. It may be that your baby swallowed some blood or has a tiny anal tear. Or maybe it isn’t blood at all, and your baby’s poop is red because of something they ate (if they’re eating solids).
Still, there are potentially serious causes, too, so you’ll want to be aware of symptoms and get in touch with your baby’s doctor about them.
Reasons for blood in your baby’s diaper
If your baby’s diaper has a little blood in it, it’s usually from something temporary, such as:
- Vaginal discharge. Newborn female babies may have a little bloody vaginal discharge in their diaper due to the withdrawal of maternal hormones after delivery. This usually stops as the hormones return to normal levels.
- A circumcision wound. A male infant may be bleeding a little from a healing circumcision.
- Diaper rash. If a diaper rash is severe, it may cause bleeding.
- Anal fissure (see below). These small tears can cause small amounts of blood in your baby’s diaper or in their poop.
In these cases, the amount of blood would be small. If your baby has large amounts of blood or persistently has blood in their diaper, or if they have other symptoms, call their doctor right away.
Reasons for blood in your baby’s poop
Most red poop is caused by foods, not blood. Red foods (such as beets, cranberries, red candy or frosting, and tomatoes) may show up as red streaks or even chunks in your baby’s poop. Ditto red-colored beverages, such as cranberry juice or fruit punch.
Certain medications – such as amoxicillin and cefdinir – can turn poop dark or red, too.
If the red color is caused by blood, you may notice bright red or dark flecks or streaks of blood in your baby’s poop. Or maybe the poop will appear dark red throughout.
If you see black poop, it means the blood has turned from red to black over time in the intestinal tract. In that case, you’ll want to call the doctor right away if your baby is more than a few days old. Black poop can indicate intestinal bleeding. (Note: In the first few days after birth, black poop – called meconium – is normal and no cause for concern.)
The most common reasons for blood in your baby’s poop are:
Delivery
Your newborn may have swallowed some blood during delivery, and this may show up in their poop (or spit up). This would be gone in a few days, at most.
Anal fissures
Blood may come from a scratch or crack in the skin of your baby’s rectum, particularly if they’re having dry, hard, or large bowel movements. There may be bright red streaks or flakes on the stool’s surface. This is rarely a problem for newborns, but once a baby starts eating solid foods, constipation and fissures are fairly common.
Most fissures get better with simple treatment, but schedule an appointment so your baby’s doctor can take a look, because it’s possible to develop an infection in the fissure. You can help an anal fissure heal by applying antibacterial ointment to the irritation. And, of course, you’ll want to address the constipation.
Cracked nipples
Your baby may have swallowed blood from a cracked nipple during breastfeeding. (The crack may not be obvious and it may take some searching to find it.) The blood may look like little flecks in their poop.
Swallowing the blood won’t hurt your baby, so continue to breastfeed as your nipple heals. You’ll want to treat the nipple damage, though, to avoid infection and other breastfeeding problems. A lactation consultant can help you get to the bottom of the issue. Sometimes a simple adjustment in your baby’s latch is all that’s needed.
Nosebleed
If a baby has a nosebleed and swallows some of the blood, it can show up in their poop.
Food allergies and sensitivities
A food allergy or sensitivity – usually to cow’s milk, but possibly another food allergen, such as soy protein – may cause streaks or flecks of blood to show up in your baby’s poop. This is caused by inflammation of the colon (colitis). Your baby may have no other symptoms, or they may also have a rash, abdominal cramps, constipation, or diarrhea.
If your baby has an allergy or sensitivity, their doctor may recommend a change in formula. If you’re breastfeeding, you’ll need to avoid the offending food.
Blood in a baby’s stool isn’t often serious, but occasionally it’s caused by a condition that needs prompt attention, such as:
Upper gastrointestinal bleeding
This may be happening in the stomach, esophagus, or small intestine. It usually produces dark red or black stools.
An intestinal blockage
If your baby has an intestinal blockage, they may suddenly become ill with a fever and abdominal pain. Their tummy may be swollen. They may also vomit a red or black substance that looks like coffee grounds.
The most common type of obstruction is a condition called intussusception, in which the intestines telescope. This usually results in blood and mucus in the stool (“currant jelly stool”). A blockage is a medical emergency, and your baby may need surgery.
A bacterial or parasitic infection
An infection (such as gastroenteritis, salmonella, E coli, shigella, staphylococcus, Clostridoides difficile, or campylobacter) may cause your baby to have diarrhea, a fever, and trouble feeding. They’ll probably need antibiotics. They may also need IV fluids if dehydration becomes a concern.
Because blood turns darker over time, bright red blood may mean that there’s an infection near the end of the gastrointestinal tract, while black stools may mean a problem earlier on.
Necrotizing enterocolitis
This is a serious intestinal infection that sometimes shows up in babies who were born preterm or have other health conditions. In addition to blood in their stools, their stomach may look swollen, and they may not eat. They may have diarrhea and/or vomiting. A baby with this condition will be given antibiotics and may need to be fed intravenously until their intestines heal.
Inflammatory bowel disease (IBD)
IBD can cause blood in the stool because it inflames the lining of the digestive tract. IBD includes ulcerative colitis and Crohn’s disease. It may also cause diarrhea, abdominal pain, lack of appetite, and weight loss. If your baby has IBD, they’ll probably be given medication to help reduce inflammation and antibiotics to help treat any infections that develop in the digestive tract.
Meckel diverticulum
Some babies are born with a small pouch on the lining of the lower small intestine. This condition rarely causes symptoms but can result in blood in the stool. It may require surgery if the symptoms are severe (there’s a large amount of bleeding).
Polyps
These growths on the lining of the large intestine (colon) are noncancerous but can cause blood in a baby’s bowel movements. The polyps can be removed if necessary, though they usually cause no other symptoms.
When to call the doctor about blood in your baby’s poop or diaper
If your baby was born prematurely or is younger than 3 months old and you notice blood in their diaper or poop, call their doctor to be on the safe side.
Otherwise, if you notice blood in your baby’s poop and you know the cause, there’s no need to inform your baby’s doctor. But if you don’t know what the culprit is, or if it continues to happen, talk with your baby’s doctor.
Call right away (or take your baby to the emergency department) if your baby also has a swollen tummy or any signs of illness (such as fever, diarrhea, or refusal to eat) or if they seem lethargic or extremely fussy.
The doctor can test your baby’s stool to confirm that it contains blood (so bring along a sample, if possible).
If they’re concerned, they may run further tests, such as blood tests (to check for underlying disease or anemia if the blood loss is great), a colonoscopy to examine the lining of the colon, an upper endoscopy to examine the lining of the upper intestine, and imaging tests (such as an x-ray, ultrasound, or CT scan).
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