Blood in Stool in Babies & Toddlers
Content reviewed against published AAP, NASPGHAN, AAP guidelines
Last reviewed:
Blood in a baby's stool is alarming for parents but is often caused by minor issues like an anal fissure or swallowed maternal blood (in newborns). Blood can appear as red streaks on the outside of stool, mixed throughout, or as dark/black tarry stools (indicating upper GI bleeding). The cause, amount, and appearance all help determine urgency.
Key takeaways
- Blood in a baby's stool is alarming for parents but is often caused by minor issues like an anal fissure or swallowed maternal blood (in newborns).
- Most common cause: Anal fissure (small tear from hard stool)
- Emergency: Currant jelly stools with intermittent screaming and vomiting (possible intussusception)
- Home care: For anal fissure: soften stools with increased fiber and fluids (see constipation remedies)
Possible Causes
When to Seek Help
Emergency — Call 911 or go to ER:
- Currant jelly stools with intermittent screaming and vomiting (possible intussusception)
- Large volume rectal bleeding (more than a tablespoon)
- Black tarry stools (melena) suggesting upper GI bleeding
- Bloody stool with abdominal distension and bilious vomiting
- Blood in stool with signs of shock (pale, cold, rapid heart rate, lethargic)
- Blood in stool in premature infant with distended abdomen (NEC)
Urgent — See doctor today:
- Bloody diarrhea with high fever
- Blood in stool with significant abdominal pain
- Moderate amount of blood mixed throughout stool
- Painless significant rectal bleeding (red blood without stool)
- Blood in stool with signs of dehydration
Same-day appointment:
- Persistent blood-streaked mucoid stools in an otherwise well infant (possible milk protein allergy)
- Recurrent blood with constipation not resolving with home treatment
- Small amount of blood in stool that persists for more than a few days
Monitor at home:
- Single small streak of bright red blood on hard stool (likely anal fissure)
- Known anal fissure with occasional blood that resolves with stool softening
- Suspected swallowed maternal blood in a breastfed newborn with no other symptoms
By Age
0-3 months
Normal: Small blood streaks from swallowed maternal blood (from cracked nipples during breastfeeding) are common in the first weeks. A small amount of mucus in breastfed baby stool can be normal.
Worry if: Persistent blood-streaked mucoid stools (possible milk protein allergy). Significant blood volume. Dark tarry stools (upper GI bleeding). Blood with distended abdomen in premature infant (NEC risk).
3-12 months
Normal: Occasional blood streak on hard stool surface (anal fissure) is the most common cause and is usually benign. May recur with constipation episodes.
Worry if: Currant jelly stools (blood and mucus mixed) with intermittent severe pain and vomiting (intussusception — emergency). Large amounts of blood. Blood with high fever and appearing very ill.
1-3 years
Normal: Anal fissures from constipation remain the most common cause at this age. Small bright red streaks on stool surface after straining.
Worry if: Painless significant rectal bleeding (possible Meckel diverticulum or polyp). Blood mixed throughout stool with diarrhea and fever (bacterial infection). Chronic bloody diarrhea with weight loss.
Any age
Normal: Red foods (beets, red gelatin, tomatoes) and medications (iron, bismuth) can mimic blood in stool.
Worry if: Large volume of blood (tablespoon or more), blood with hemodynamic instability (pale, rapid heart rate, weak), black tarry stools (melena), or bloody stools with abdominal distension.
Home Care
- For anal fissure: soften stools with increased fiber and fluids (see constipation remedies)
- Apply small amount of petroleum jelly or coconut oil to the anus to ease passage of hard stool
- Warm sitz baths for toddlers with anal fissures (sit in warm water 10-15 minutes)
- If cow's milk protein allergy suspected in breastfed baby: mother may trial eliminating dairy for 2-4 weeks under doctor guidance
- Save the diaper with blood to show the doctor
- Note the color, amount, and pattern of blood (on surface vs. mixed in, with or without mucus)
- Do NOT insert anything into the rectum without medical guidance
- Do NOT give iron supplements that could mask dark stools without consulting doctor
Need help deciding what to do?
Use our interactive triage tool →Frequently asked questions
What causes blood in stool?
When is this an emergency?
What can I do at home?
When should I call the doctor?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Symptoms
Bottom line
Most cases of blood in stool in babies are not emergencies. However, seek immediate care if currant jelly stools with intermittent screaming and vomiting (possible intussusception).
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.