What should you do if there is blood in a baby's stool?

What does the evidence show for blood in a baby's stool?

• A few bright-red streaks on a hard stool can come from an anal fissure, but red foods and some medicines can also change stool color. Save the diaper or a clear photo and explain recent foods and medicines rather than deciding by color alone. 1
• Blood alongside constipation warrants assessment, especially with ongoing pain, swelling, vomiting or weight concerns. A possible small tear does not make repeated bleeding an issue to manage indefinitely with diet changes. 2
• Food-protein reactions are one possible cause of infant bowel symptoms, and milk-protein allergy differs from lactose intolerance. A feeding change should follow assessment and a clear nutritional plan rather than an expanding list of foods removed without guidance. 3
• Bloody diarrhea requires a prompt call, particularly when accompanied by fever, vomiting or dehydration. Do not give an infant an over-the-counter antidiarrheal medicine or a homemade remedy while waiting to see whether the blood disappears. 4
• The AAP symptom guide calls for urgent assessment when blood occurs in a baby under twelve weeks or with pain, diarrhea, illness or black tarry stool after the initial meconium stools. Large amounts of blood or vomiting blood warrant emergency evaluation. 1
• The first newborn stools, called meconium, are normally dark and tarry. Black stool after that early transition is different and should be discussed with the pediatrician. If you are uncertain whether a diaper fits the expected newborn pattern, ask rather than assuming it is blood or dismissing it. 5

When should I call my provider about blood in a baby's stool?

Seek urgent assessment for any suspected blood in stool in a baby under twelve weeks, or at any age with diarrhea, pain, black tarry stool after the initial meconium stools or a sick-looking baby. Go to emergency care for substantial bleeding or vomiting blood. Call 911 for collapse, severe weakness, breathing trouble or unresponsiveness.