The sight of a baby straining and discovering blood in their diaper is alarming, often leading parents to suspect hemorrhoids. While infants can develop hemorrhoids, they are extremely rare in this age group. The common symptoms—straining, discomfort, and bright red blood—are usually caused by a much more common and less serious condition.
Why Hemorrhoids Are Rare in Infants
Hemorrhoids are swollen, inflamed veins in the rectum and anus resulting from prolonged pressure on blood vessels. In adults, causes include chronic straining, obesity, pregnancy, or long periods of sitting. Infants rarely engage in the activities or have the underlying conditions that lead to hemorrhoid formation.
For a baby to develop hemorrhoids, chronic, excessive pressure sustained over a significant period is required. This formation is generally a slow process that often does not manifest until teenage years or adulthood. Although constipation and straining are common in babies, the duration and intensity are usually insufficient to create the necessary structural changes. In rare cases, infant hemorrhoids may be linked to underlying issues like chronic liver failure, which increases pressure in the veins carrying blood to the liver.
Anal Fissures: The Common Explanation for Infant Straining and Bleeding
The most frequent cause of bright red blood in an infant’s diaper or on their stool is an anal fissure. An anal fissure is a small, linear tear or split in the delicate skin lining the anus.
Fissures are caused by the passage of a hard, dry, or unusually large stool, which stretches the anal canal beyond its capacity. This painful event can lead to a cycle where the baby instinctively withholds stool to avoid pain, resulting in further hardening of the feces and a more painful bowel movement later. The primary symptom is a small amount of bright red blood, appearing as a streak on the stool, a fleck in the diaper, or on a wipe. This bright red blood indicates the source of the bleeding is low in the gastrointestinal tract, specifically at the anal opening.
Home Management for Hard Stools and Discomfort
Since hard stools cause most anal fissures, the main goal of home management is to soften the feces and soothe the area. For infants who have started solids, adding high-fiber foods can increase the stool’s water content. These foods include:
- Pureed prunes
- Pears
- Peaches
- Apricots
For babies over six months, a small amount of 100% prune or pear juice may be helpful, as these contain sorbitol, a natural laxative.
Adequate hydration is important, as this helps prevent the colon from absorbing too much water from the stool. For formula-fed babies, extra water can be offered between feedings. Parents can also try gently massaging the baby’s abdomen or moving their legs in a bicycle motion to stimulate the bowels. To help the fissure heal and reduce discomfort, a thin layer of a topical protectant like petroleum jelly can be applied to the anal area before a bowel movement to act as a barrier.
Warning Signs That Require a Pediatrician Visit
Most anal fissures heal quickly with home care, but parents should consult a doctor if symptoms persist for more than a few days. A pediatrician visit is necessary if the baby exhibits significant pain, seems to be withholding stool, or if the fissure does not heal within two weeks despite efforts to soften the stool.
Immediate medical attention is required if the baby’s symptoms suggest a more serious underlying issue. Red flags include fever, excessive vomiting, a swollen or distended abdomen, or a refusal to feed. If the blood in the stool is dark, maroon, or has a tarry-black consistency, this signals bleeding from higher up in the digestive tract and should be evaluated right away.