Blood in Urine (Hematuria) in Babies & Toddlers
Content reviewed against published AAP, NIH, Mayo Clinic guidelines
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Blood in the urine (hematuria) can appear as pink, red, brown, or tea-colored urine. In babies, it is important to first rule out false positives: urate crystals (orange/pink in newborns), food coloring (beets), and vaginal bleeding in newborn girls (pseudomenses — normal). True hematuria always requires medical evaluation to determine the cause, which ranges from urinary tract infections to kidney problems.
Key takeaways
- Blood in the urine (hematuria) can appear as pink, red, brown, or tea-colored urine.
- Most common cause: Urate crystals mistaken for blood (normal in newborns)
- Emergency: Blood in urine with signs of shock (pale, cold, rapid heart rate)
- Home care: Blood in urine always needs medical evaluation — there are no appropriate home-only treatments
Possible Causes
When to Seek Help
Emergency — Call 911 or go to ER:
- Blood in urine with signs of shock (pale, cold, rapid heart rate)
- Blood in urine with severe abdominal pain and vomiting
- Blood in urine with anuria (no urine output for 6+ hours)
- Blood in urine following significant abdominal or back trauma
- Tea-colored urine with seizures or severe hypertension
Urgent — See doctor today:
- Blood in urine with fever in infant (UTI needs prompt treatment)
- Cola/tea-colored urine with facial swelling or reduced output (nephritis)
- Blood in urine following bloody diarrhea episode (HUS)
- Frank blood in urine with flank pain
- Blood in urine with palpable abdominal mass
Same-day appointment:
- Confirmed blood in urine without other acute symptoms
- Pink/red urine persisting more than one void without food explanation
- Blood in urine with dysuria or frequency
- Recurrent episodes of visible blood in urine
Monitor at home:
- Urate crystals in newborn first week (orange/pink, not blood)
- Pseudomenses in newborn girl (small amount vaginal blood, first few days)
- Pink urine clearly after eating beets/red food — resolves in 24-48 hours
- Known microscopic hematuria under physician monitoring
By Age
0-2 months
Normal: Urate crystals (orange/pink staining) are very common in first week and NOT blood. Newborn girls may have small amount of vaginal bleeding from maternal hormone withdrawal (pseudomenses — normal, lasts a few days). These are benign.
Worry if: True bright red blood in urine. Blood in urine with fever (UTI in young infant is serious). Blood from urethra rather than vagina. Blood with abdominal mass felt. Blood with no urination (obstruction).
2-6 months
Normal: Normal urine should be clear to pale yellow without blood. Mild perineal skin breakdown can sometimes produce spots of blood in diaper from skin (not urine).
Worry if: Pink, red, or brown urine confirmed as blood. Blood in urine with fever (UTI). Blood in urine with swelling. Blood with crying during urination. Bloody urine with vomiting and pallor.
6-12 months
Normal: No blood should be present in urine. Pink staining from beets or food dyes after starting solids can mimic blood.
Worry if: True blood in urine (not food-related). Blood with fever or pain. Tea/cola-colored urine (glomerulonephritis). Blood in urine after abdominal trauma. Blood with reduced urine output.
1-3 years
Normal: Urine should be blood-free. Beets and some foods can cause pink/red coloration (beeturia — harmless).
Worry if: Cola/tea-colored urine 1-3 weeks after sore throat (post-streptococcal glomerulonephritis). Frank red blood in urine. Blood with abdominal pain or flank pain. Blood with facial puffiness or limb swelling. Blood following bloody diarrhea (HUS concern). Painless hematuria with abdominal mass (Wilms tumor).
Home Care
- Blood in urine always needs medical evaluation — there are no appropriate home-only treatments
- Distinguish from common mimics: urate crystals (orange, only in first week), beet juice (after eating beets), vaginal bleeding in newborn girls
- Save the diaper or collect a urine sample to bring to the doctor
- Note the timing: is it every void or intermittent? Start, middle, or end of stream?
- Record any recent illness (sore throat 1-2 weeks ago? Bloody diarrhea? Trauma?)
- Monitor fluid intake and urine output — note if output is reduced
- Do not give ibuprofen/aspirin if blood in urine is suspected (may worsen bleeding)
- Check for other bleeding: gums, nose, bruising (bleeding disorder)
- Keep child well hydrated while awaiting medical assessment
Frequently asked questions
What causes blood in urine (hematuria)?
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 urine (hematuria) in babies are not emergencies. However, seek immediate care if blood in urine with signs of shock (pale, cold, rapid heart rate).
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.