Blood in Baby's Stool: When to Seek Medical Attention

Blood in an infant's stool?

Hello, Dr.
Hsiao.
My daughter is exclusively breastfed, and I have been avoiding dairy and eggs in my diet.
She is currently 4 months and 21 days old.
Previously, she occasionally had a drop of blood or 2mm of blood in her stool, but since last month, after receiving the 13-valent conjugate pneumococcal vaccine and the pentavalent vaccine, the occurrence of blood in her stool has increased, almost daily or every other day.
Her activity level is good, and she has been gaining weight and height.
Recently, we have started introducing solid foods, and her daytime milk intake has decreased by 70ml every four hours, but in the afternoon, she can still drink 220ml every four hours.
Before she shows signs of rejecting milk, she drinks between 180-200ml approximately every four hours.
Should I take her to a major hospital for a stool examination?

Azhou, 40~49 year old female. Ask Date: 2021/02/21

Dr. Xiao Kaiwen reply Pediatrics

The presence of blood streaks in an infant's stool can range from mild to severe.
If this condition was observed before the introduction of solid foods, it is likely not caused by food intolerance.
It is advisable to consult a pediatrician at a major hospital for further evaluation.

Reply Date: 2021/02/21

More Info

When it comes to the presence of blood in a baby's stool, it is essential to approach the situation with caution and awareness. Given that your daughter is exclusively breastfed and has recently started trying solid foods, the appearance of blood in her stool can be concerning. While it is good to hear that she is active and gaining weight appropriately, the frequency of blood in her stool, especially after vaccinations, warrants further investigation.

There are several potential causes for blood in a baby's stool. Some of the most common reasons include:
1. Allergic Reactions: Since you mentioned that you are avoiding dairy and eggs in your diet, it is possible that your baby may have a sensitivity or allergy to something in your diet or in the formula if she has been exposed to any. Cow's milk protein allergy is a common cause of gastrointestinal bleeding in infants.

2. Anal Fissures: Sometimes, if a baby is constipated or has hard stools, small tears can occur in the anal area, leading to blood in the stool. This is often accompanied by signs of discomfort during bowel movements.

3. Infections: Gastrointestinal infections can also cause blood in the stool. These infections may be viral or bacterial and can sometimes present with other symptoms such as diarrhea, fever, or irritability.

4. Intestinal Conditions: Conditions such as intussusception (where part of the intestine telescopes into itself) or other structural abnormalities can lead to bleeding. These are less common but are serious and require immediate medical attention.

5. Vaccine Reactions: While vaccines can cause a variety of side effects, blood in the stool is not a typical reaction. However, if the timing of the blood coincides with vaccinations, it is worth discussing with your pediatrician.

Given that your daughter has been experiencing blood in her stool more frequently, it is advisable to seek medical attention. A pediatrician may recommend a stool test to check for blood and other potential issues. They may also inquire about any changes in her diet, bowel habits, or any other symptoms that may have developed.

In terms of when to seek immediate medical attention, consider the following signs:
- If the blood in the stool is bright red or appears to be mixed in with the stool.

- If your baby shows signs of distress, such as excessive crying, irritability, or difficulty feeding.

- If there are any changes in her overall health, such as lethargy, fever, or a significant decrease in activity level.

- If you notice any other concerning symptoms, such as vomiting or diarrhea.

In conclusion, while it is reassuring that your daughter is active and growing, the presence of blood in her stool is a symptom that should not be overlooked. It is best to consult with a pediatrician who can perform a thorough evaluation and determine if further testing or intervention is necessary. Early identification and management of any underlying issues can help ensure your baby's health and well-being.

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