Streaks of blood in stool...very concerned

[@llli*bjm.mama]

My son is 6 weeks old and ebf for the past 2 weeks (supplemented with formula for the first month) and 2 days ago had very small amount of blood in his stool in one diaper change. His stools are sometimes green and have mucus as well but not always. They can be the typical mustard color. He does have frequent stools, almost immediately after each feeding that are explosive. I called the pediatrician the following morning and she said it was probably a milk protein allergy/intolerance. She advised to eliminate dairy from my diet. She didn't have me bring him in for a physical exam or his stool for testing. I stopped dairy intake yesterday and his stools were perfect but tonight he had two more stools with small streaks of blood. Both stools were explosive. He is not fussy and he has no other symptoms. No fever, pain, vomiting, gagging, etc. in fact he has been sleeping better than ever overnight for the past 2 nights. i dont seem to have symptoms of oversupply. He is happy and is still gaining weight. I have posted pics of his stool and was wondering what others think it may be from their experiences. You can see the small amount of blood in the second pic. Could it possibly be for an anal tear or fissure since his stools are so explosive? If it continues i am going go bring him in to be examined. I am concerned that i am harming my baby and it makes me feel discouraged about bf. how long can he go with blood in his stool before its hrmful? I am a FTP so any advice is helpful.

[@llli*mommal]

Whoa, flashback! Your LO's diapers look just like my DD2's did. Hers were like that for months, but she was otherwise completely healthy, and remains a very healthy kid to this day (she's almost 3 now).

First of all, please do not let this get you too worried. As long as your baby is growing and developing normally, and his only troublesome symptom is streaks/specks of blood in his poop, then this is not a major health concern. My personal feeling is that you might want to consider doing a bit of proactive vitamin supplementation in a few months- with my kid, I figured that if she was losing blood from her intestines, it made sense to be sure she was getting some iron back in a supplement. You don't need to worry about your baby's health unless he stops growing and developing normally, or starts having large jelly-like blobs of blood in his stool.

The 2 most common causes of bloody streaks/specks in poop are food intolerance/allergy and oversupply (not necessarily in that order). Since you don't think you have oversupply, it probably makes sense to work on dietary elimination. Your doc's advice suggestion to eliminate dairy is a good one, since dairy proteins are the most likely offender. You want to give this a couple of weeks before deciding whether or not the elimination is making a difference, because it can take that long to completely purge the proteins from your body and for the intestinal irritation to heal. If after a couple of weeks you see no difference, then you might want to consider adding dairy back in and eliminating the runner-up suspects like wheat and soy.

Since the blood in your baby's diaper seems to be mixed with the poop rather than streaking the surface, I don't think this is an anal tear. Those are rare in EBF babies, since those explosive stools are actually really easy to pass. It's firm, constipation-style poop that's more likely to cause tears or fissures, because baby has to really strain to get those out.

[@llli*maddieb]

I am concerned that i am harming my baby and it makes me feel discouraged about bf. How long can he go with blood in his stool before its hrmful? I am a FTP so any advice is helpful.

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I am so sorry you feel this way. You are doing what is best for your baby after some early struggles, this must be so hard! I know it is scary to see blood in your babies stool, but please don't blame your breastmilk or let anyone else do so. First of all, You don't even know if the issue has anything to do with your milk.

Even if it is a dairy intolerance, the medical recommendation by the Academy of Breastfeeding Medicine is to keep breastfeeding. Breastfeeding is so much better (or rather, formula is so harmful, comparatively) on so many levels, that I am not sure when, if ever, formula would be preferred (there are two very rare conditions when a baby cannot tolerate the lactose in breastmilk, nor can such babies tolerate most formulas. But it has nothing to do with dairy intake by the mother and your baby would be exceedingly sick from day one. So it's certainly not that.)

I generally agree with mommal, but what I don't get is why, if the issue is dairy, it would show up after you stopped the (presumably dairy based) formula supplements? Your baby was getting WAY more dairy proteins in his diet then. Right? No? Someone help me out here.

Anyway, PLEASE read this kellymom article and this protocol by the academy of breastfeeding medicine. You can also show that to your baby's doctor. She could possibly contact the ABM, if she has questions (I think.) Don't let anyone tell you your delicious and designed specifically for your baby breast milk is not good for your baby! It just is not true.

http://kellymom.com/health/baby-health/bloodystool/

http://www.bfmed.org/Media/Files/Pro...ish_120211.pdf

[@llli*mommal]

I generally agree with mommal, but what I don't get is why, if the issue is dairy, it would show up after you stopped the (presumably dairy based) formula supplements? Your baby was getting WAY more dairy proteins in his diet then. Right? No? Someone help me out here.

Sorry, Meg, I missed the bit about the formula supplements! I agree that if the problem is dairy, and the supplemental formula was dairy-based, then it's kind of funny that the blood would show up now. However, my pediatrician told me that dairy protein sensitivities tend to peak in the 4-6 month window (not sure if I recall the timing correctly or not)- so they're not necessarily present immediately after birth, regardless of how or what the baby is being fed.

[@llli*still.here]

dairy protein sensitivities tend to peak in the 4-6 month window (not sure if I recall the timing correctly or not)- so they're not necessarily present immediately after birth, regardless of how or what the baby is being fed.

Symptoms tend start up sometime around 6-8 weeks.

That said, I wouldn't jump right to a dairy elimination because of one (or even a couple) of diapers with small amts of blood in them. If it gets worse or continues for weeks or other symptoms start appearing, then I would probably get concerned.

If you've already started the dairy elimination (sorry I just read that part), then you might as well keep it up just to see if it helps. Make sure you are eliminating all dairy, reading ingredients lists carefully. Try not to replace dairy with large quantities of something new, like soy or nuts, as those are common allergens as well.

[@llli*bjm.mama]

Symptoms tend start up sometime around 6-8 weeks.

That said, I wouldn't jump right to a dairy elimination because of one (or even a couple) of diapers with small amts of blood in them. If it gets worse or continues for weeks or other symptoms start appearing, then I would probably get concerned.

If you've already started the dairy elimination (sorry I just read that part), then you might as well keep it up just to see if it helps. Make sure you are eliminating all dairy, reading ingredients lists carefully. Try not to replace dairy with large quantities of something new, like soy or nuts, as those are common allergens as well.

Thank you all for your advice. His stools are now persistent with small amounts of visible blood. They are still green with mucus. Today jan 29 will be my third day on a complete dairy and soy free diet. However I am getting concerned that I am seeing visible blood with each diaper change. He still has no other symptoms and is doing well. Should I take him to see the doctor or should I wait for his 2 month check in 3 weeks. I would hate to take him to the office if it is not necessary since it is flu season. Any thoughts appreciated!

[@llli*still.here]

I don't think it's necessary to take him in right now. They can't really do anything about it at this point. You are already doing what needs to be done to try and fix it.

[@llli*mommal]

You're doing all you need to do, so IMO there's no need to take him in to the pediatrician.

Bear in mind that it takes time for the intestinal lining to heal, so once you're at the point where the baby's intestines are irritated enough that he's having bloody poops, you shouldn't expect things to change overnight. It took a while to get into this situation, and it's going to take a while to get back out. And again, with an otherwise healthy, happy baby, some bloody poops aren't a big deal. Freaky, yes, but not an urgent health concern.