My Baby Has an Anal Fissure (Blood When Pooping)
The short answer
A small streak of bright red blood on the surface of your baby's stool or on the diaper is most commonly caused by an anal fissure, which is a tiny tear in the skin around the anus from passing hard stool. Anal fissures are very common in babies and toddlers and usually heal on their own with simple measures like keeping stools soft. While this is rarely serious, any blood in your baby's stool should be mentioned to your pediatrician.
By Age
What to expect by age
In very young babies, small streaks of blood in the stool can be caused by anal fissures from straining, but can also result from swallowed maternal blood during delivery or from cracked nipples during breastfeeding. Cow's milk protein allergy is another possible cause of blood in the stool at this age, often accompanied by mucus and fussiness. Your pediatrician should evaluate any blood in a young infant's stool to rule out less common but important causes.
As babies transition to solid foods, their stools often become firmer, which can lead to anal fissures. This is the most common cause of bright red blood on the outside of the stool or on the diaper in this age group. Ensuring adequate fluid intake, offering high-fiber foods like pureed prunes and pears, and applying a small amount of petroleum jelly to the area can help the fissure heal.
Toddlers frequently develop anal fissures, especially if they are prone to constipation. The pain from the fissure can cause a cycle where the child withholds stool to avoid discomfort, which leads to harder stools and further tearing. Breaking this cycle with stool softeners as recommended by your pediatrician, warm baths, and a high-fiber diet is key to healing.
Constipation-related anal fissures remain common during the potty training period. Children may resist using the toilet due to pain from a fissure, making potty training more challenging. Focus on resolving the constipation and healing the fissure before pushing potty training. Most fissures heal within a few weeks with appropriate stool softening and topical care.
What Should You Do?
When to take action
- A small streak of bright red blood is visible on the surface of a hard stool or on the diaper, and your baby is otherwise healthy
- The bleeding is minimal and only occurs occasionally when your baby passes a hard stool
- A previously identified fissure is healing with at-home treatment and bleeding is decreasing
- You notice blood in your baby's stool for the first time, even if it seems minor
- The fissure does not seem to be healing after two to three weeks of at-home treatment
- Your baby is crying or showing significant pain with every bowel movement
- There is a large amount of blood in the stool, blood mixed into the stool rather than on the surface, or dark tarry black stools
- Your baby has bloody stool along with fever, vomiting, abdominal distension, or lethargy
Sources
Related Resources
Related Digestive Concerns
My Baby's Belly Looks Swollen
A rounded, slightly protruding belly is completely normal in babies and toddlers due to immature abdominal muscles and their proportionally larger organs. However, if the belly becomes suddenly swollen, feels hard and tight, or is accompanied by pain, vomiting, or changes in bowel movements, it needs medical evaluation as it could signal gas buildup, constipation, or rarely, something more serious.
My Baby Eats Non-Food Items (Pica)
It is completely normal for babies and young toddlers to explore by putting objects in their mouths. True pica, which is the persistent eating of non-food substances, is uncommon before age two and may be linked to iron deficiency or developmental factors. If your child repeatedly seeks out and eats non-food items past the typical mouthing stage, it is worth discussing with your pediatrician.
Baby Excessive Gas After Starting Solids
Increased gas after starting solid foods is completely normal and expected. Your baby's digestive system is encountering new proteins, fibers, and sugars for the first time and needs time to adapt. The gut bacteria are also diversifying, which naturally produces more gas. This typically improves within a few weeks as the digestive system adjusts to each new food.
My Baby Gulps Air While Feeding
Swallowing some air during feeding is normal for all babies, but excessive air gulping can lead to gas, hiccups, and spit-up. Common causes include fast milk flow, poor latch (if breastfeeding), bottle nipple flow that's too fast or slow, and crying before feeds. Simple adjustments to feeding position, pacing, and equipment can usually help reduce air intake significantly.
Baby Poop Color Changes with Solids
Dramatic changes in poop color after starting solids are completely normal and expected. What your baby eats directly affects stool color - carrots may turn poop orange, spinach makes it green, beets can make it reddish, and blueberries can turn it dark blue-black. As long as your baby is comfortable and the stool is not white, black (tarry), or bright red with blood, these color changes are harmless.
Baby Straining but Poop Is Soft
If your baby strains, grunts, turns red, and even cries while pooping but the stool comes out soft, this is likely infant dyschezia - a very common and harmless condition. Your baby is simply learning to coordinate the muscles needed for a bowel movement (relaxing the pelvic floor while pushing with the abdomen). This almost always resolves on its own by 3-4 months.