Anyone who finds blood in or on his baby's chair is understandably worried about his child's health. Although the cause of this is often harmless, you should contact your pediatrician; especially if large amounts of blood leak, repeated blood is found in the stool or even if the child shows other symptoms of a serious underlying disease such as fever, diarrhea and / or vomiting.
This can not only help you to find the cause of the bleeding, but if necessary, it can also initiate further examinations or treatment if you suspect a serious illness.
There are numerous reasons for blood in a baby's stool. A common cause are small tears in the intestinal or anal mucosa, called fissures . Because of their still sensitive mucous membranes, babies are particularly susceptible to such injuries, which can be caused, for example, by very stout bowel movement, but can also occur with diarrhea.
Another common cause of blood in the stool are infections of the gastrointestinal tract. These may be viral or bacterial, for example, by Salmonella, E. coli, Schigellen, and others. The inflammation of the young intestinal mucosa can cause bloody diarrhea.
In such a situation, a doctor should definitely be contacted; not only to treat the causative infection, but also to be able to recognize and treat a severe course and possible complications in good time. Because of their low body weight and their not yet fully developed immune system, babies are much more susceptible to complications such as dehydration (severe dehydration ) than adults.
Intolerance to food, such as cow's milk, is another potential trigger for bloody stools in babies. Up to 3% of infants suffer from cow's milk allergy, which can lead to inflammation of the intestinal mucosa and thus to bloody stools. Breastfed babies can also develop bloody stools as a result of cow's milk allergy, as nursing mothers who consume dairy products can pass the allergy-causing proteins on to their infant through their mother's milk.
Another important cause of bloody stools in infants and toddlers is a telescoping involution from one section of the intestine along the longitudinal axis to another referred to by the medical profession as invagination . The child suffers from sudden, colicky pain. In the further course it can then come to "raspberry-like", bloody chairs. At least now, a doctor should urgently be contacted to fix the problem quickly, before permanent damage to the entrapped intestinal sections arise.
As useful and life-saving as vaccinations are, it is unfortunately inevitable that a few children will experience side effects, including blood in the stool. In addition, reports of cases of intussusception have been reported in the introduction of rotavirus vaccine. These were especially common in children who were older than recommended for the vaccine at the time of vaccination. Therefore, experts recommend that the rotavirus vaccine be taken as early as possible, ideally from 6 weeks of age, in order to minimize the risk of complications.
Even a baby who is just teething can develop bloody stools. The cause may be swallowed blood, which escapes when the teeth break through.
In addition, many babies suffer from a sore butt during this time, which can bleed if it is severely affected and can stain the chair red.
Furthermore, the time of teething also represents the time in which the food of the baby is increasingly being changed, as a result of which food intolerances against the new food can also appear.
Even after the administration of suppositories, small bleeding may occur, which can then be found on the stool.
This may be due to small lesions of the delicate intestinal mucosa, which occur either during insertion of the suppository or when the child tries to squeeze out the suppository again.
An allergy to proteins contained in breast milk can also lead to bloody stools in babies. Frequently, the babies do not find that they are allergic to the proteins of the mother herself, but to the foods that she has ingested and then pass on to the baby through the milk.
To make a diagnosis, the pediatrician needs some information about you and your child. After a physical examination of the child, in which the cause of bleeding may already be identified, other diagnostic steps may be added as needed, such as stool examinations for causing germs, blood tests or an ultrasound, if there is a suspicion of an intussusception.
However, if an intolerance is ultimately suspected, diagnostically and therapeutically the renouncement of the suspected trigger occurs at the same time. If this improves the symptoms, the diagnosis can be considered certain. If not, further diagnostic tests must be undertaken.
The presence of other symptoms can give important clues to the cause of the bloody stools.
For example, if the child has fever, diarrhea, and / or vomiting, infection is at the forefront.
If bloody, raspberry jelly-like stools occur together with sudden onset of colic, an intussusception could be the cause and should therefore prompt parents to seek out a child's emergency.
If, on the other hand, the affected child (or even close relatives) has concomitant illnesses such as atopic dermatitis or allergies, this is more likely to be due to food intolerance.
The co-occurrence of mucus and blood in a baby's stool is an indication of inflammation of the intestinal mucosa, as it may occur as a result of intolerance, but also of infection. The inflammatory response not only promotes mucosal injury, it also ensures that the intestinal mucosa produces more mucus and secretes fluid.
Diarrhea can also be associated with blood in baby's stool. On the one hand, diarrhea caused by the aggressive secretions and high volumes that pass through the intestine can cause intestinal mucosal injury, which can lead to bloody stools.
On the other hand, diarrhea may also be an indication of infection or food intolerance. In any case, bloody diarrhea should be clarified by a doctor as it may indicate a serious condition and may require further diagnostic and treatment measures.
The treatment depends on the underlying cause.
In case of small fissures, ie cracks in the mucous membrane, a change in diet can help to regulate the baby's bowel movements to avoid hard stools.
For infections of the gastrointestinal tract the emphasis is on the symptomatic treatment, ie the adequate supply of liquid to compensate for losses caused by vomiting and diarrhea. Here, it is important to closely monitor the child in order to quickly recognize a deterioration of the state of health. In addition, regular weighing can help to assess whether the child is drinking enough. If the baby is unable to take in the required amount of fluid, in-patient treatment may be required, providing the child with fluid through the vein.
If intolerance is the problem causing it, the strict renunciation of the triggering food is the treatment of choice.
An intestinal invasion requires a quick medical therapy in the hospital. In this case, the intestine is usually everted again by a careful enema under ultrasound control. In severe cases, however, an operation may be necessary, especially if permanent damage to the intestinal tissue has already occurred.
The prognosis for bloody stools in babies is dependent on the underlying disease, but generally very good.
Anal fissures, for example, can be handled well with chair-regulating measures and are often self-adjusting when the child gets older and the mucous membrane becomes less sensitive.
An infectious cause is also a good prognosis, provided that the fluid losses are sufficiently replaced and no complications occur (see disease course). However, if the stool has not returned to normal after one week, the pediatrician should be contacted for safety.
Even with food intolerances, the baby's bowel movement should normalize rapidly after the trigger is removed from the diet. In many cases it is even the case that the intolerance disappears on its own during the further development and in childhood or adolescence there are no longer any problems with the consumption of the affected food.
Even if the bowel vagina is detected in good time, the prognosis looks good and the child can be quickly returned home after a short visit to the clinic. However, it should be noted that in about 20% of small patients in the further development to another intussusception, so that parents should be sensitized for early detection.
Although the prognosis of gastrointestinal infections is generally good, it can also be a complicated course of disease in babies and toddlers.
Thus, certain bacterial infections, such as those caused by specific E. coli strains, can not only lead to massive blood and fluid losses, but also damage to blood cells and the kidney, which is referred to as hemolytic uremic syndrome .
Also, an invagination not recognized or too late can take a complicated course, since the invaginated intestinal sections are no longer adequately supplied with blood and can consequently die off. This is an acute emergency and requires surgery as soon as possible to remove the affected part of the intestine.