Finding blood in an infant’s diaper is an alarming experience. Teething is often blamed for various symptoms, including changes in stool consistency and the presence of blood. Understanding the true relationship between teething and bloody stool is the first step toward determining the appropriate course of action. This information will help you distinguish between common issues and those that require immediate medical attention.
The Direct Answer: Teething Is Not the Cause
Teething is a normal physiological process involving the gums, not the gastrointestinal tract, and it does not cause bleeding in the stool. This misconception arises because the peak age for teething often coincides with other developmental milestones that affect the digestive system. Around six months, infants begin losing maternal antibodies, are introduced to solid foods, and place more objects in their mouths, all of which can change their stool.
Increased drooling during teething leads to swallowing more saliva. This excess saliva can slightly irritate the digestive system, sometimes resulting in looser, slimier stools, but it does not cause intestinal bleeding. If blood is present, it signals an underlying issue within the gastrointestinal tract. Attributing serious symptoms to teething can delay necessary medical care.
Minor and Non-Urgent Causes of Blood in Stool
The most frequent reason for bright red blood in an infant’s stool is a small tear in the lining of the anus, known as an anal fissure. These tears occur when a baby passes a hard or large stool, or a very frequent, watery stool that irritates the tissue. The blood from an anal fissure typically appears as a thin, bright red streak on the outside of the stool or on the diaper, indicating the bleeding is low in the digestive tract.
Another common cause is sensitivity or allergy to cow’s milk protein found in formula or passed through breast milk. This inflammation in the colon can cause microscopic tears, leading to small flecks or streaks of blood, often accompanied by mucus. Iron supplements or certain solid foods, like beets, can also change the stool color to a dark red or black, which may be mistaken for blood.
Occasionally, a breastfed baby may ingest blood from a mother’s cracked nipples. This swallowed maternal blood is harmless but can appear as dark flecks or a black, tarry consistency in the stool as it is digested. Any presence of blood warrants contact with a healthcare provider to confirm the source and rule out other conditions.
Serious Causes Requiring Medical Evaluation
Some causes of blood in the stool indicate a serious underlying condition requiring prompt medical attention. Infectious diarrhea caused by bacteria like Salmonella or E. coli can inflame the intestinal lining, resulting in bloody stool, often accompanied by fever and frequent, watery bowel movements. This type of infection can quickly lead to dehydration.
A medical emergency known as intussusception involves one segment of the intestine telescoping into another, causing an obstruction. This condition presents with sudden, severe, intermittent abdominal pain and is associated with a dark red, gelatinous stool described as “currant jelly” due to the mixture of blood and mucus.
Another serious, though rare, condition, particularly in premature infants, is necrotizing enterocolitis (NEC), which involves injury and inflammation to the intestinal tissue. Bleeding that appears dark red, maroon, or black and is mixed throughout the stool suggests the blood originated higher up in the digestive tract and has been partially digested. Conditions causing upper gastrointestinal bleeding, such as a peptic ulcer, are uncommon but present with dark or black stools. These colors and textures are significant warning signs that should trigger an immediate medical evaluation.
Action Plan: When to Call the Doctor
It is prudent to contact your pediatrician anytime you observe blood in your baby’s stool, even if the amount is small. The color and consistency of the stool, as well as your baby’s overall behavior, are the most important factors in determining the urgency. Collecting a sample of the bloody stool to show the doctor can be helpful for diagnosis.
Seek immediate medical care or go to an emergency room if the bloody stool is accompanied by serious symptoms:
- A high fever
- Persistent vomiting
- A swollen or tender abdomen
- Signs of dehydration, such as reduced wet diapers and lethargy
The presence of “currant jelly” stool or an excessive amount of blood also necessitates an immediate emergency visit. If your baby is otherwise happy, feeding normally, and showing only small, bright red streaks, calling your pediatrician for an urgent appointment is appropriate.