Starting solid food is going to dramatically change the consistency, frequency, and texture of baby’s poop. For more information on the impact on poop that each food has, use our free First Foods® database and see our guides for the best and worst foods for babies.
While poop comes in different shapes, sizes, textures, colors, and smells, most of the time these variations are completely normal. But here are 5 scenarios that do warrant medical attention:
1. White poop: Among younger infants, this may be a sign of a lack of bile from the liver, which is needed to properly digest food. Be sure to take a picture and contact your child’s pediatrician right away.
2. Bright red poop: Large quantities of bright red blood in the diaper warrants immediate evaluation regardless of whether or not it is associated with pain. Conditions associated with significant blood in the diaper include intussusception, Meckel’s diverticulum, arteriovenous malformation, colonic inflammation, and polyps.
More common, however are streaks of blood seen in the stool. This is often seen in infants and young toddlers with cow’s milk protein allergy. This can also be seen in children with anal fissures or hemorrhoids. Although streaks of blood in the stool do not require urgent medical attention, the child’s primary healthcare provider should definitely be made aware of them, as oftentimes they indicate that lifestyle changes are warranted.
Certain medications and foods can also cause red poop that can be confused for blood. These include medications like Amoxicillin and Omnicef, red food coloring, beets, cranberries, tomatoes, and watermelon.
3. Black or tarry poop: Black poop also warrants immediate evaluation from a healthcare professional. An entirely black stool is most concerning for an upper gastrointestinal bleed, most often located in the stomach or first portion of the small intestine. However, babies who receive iron supplementation (especially in formula) can also have very dark, black-ish stools. Certain foods can also cause a black coloration in stool such as blueberries, black licorice, and grape juice.
4. Any concern about constipation: Among infants older than 6 weeks of age who have not yet started solids, no poop in a few days for a formula-fed baby or no poop in about 10 days for a baby receiving human milk is unusual. If your child has other symptoms like hard stools, ribbon-like stools, a big belly, decreased appetite, extreme fussiness, or difficulty/discomfort passing stool, please make a visit with your child’s primary healthcare provider for further evaluation. Have an older child who is constipated? View our guide on Strategies to Relieve Constipation in Picky Eaters.
5. Several watery stools per day: Most often, loose, watery stools occur in conjunction with a viral illness (i.e. a “stomach bug”) and will resolve with time. If an infant or toddler is having watery stools, it is extremely important to focus on hydration, ensuring the child is making at least 3-4 good wet diapers per day. For infants, maintaining hydration with oral rehydration solutions (such as Pedialyte and Drip Drop) and human milk or formula are essential, but offering plain water can be dangerous. Sports drinks such as Gatorade or Powerade are inappropriate as they are high in sugar, which can make the diarrhea even worse. It is never recommended to give any medication to stop diarrhea (such as Imodium). If stools becomes bloody or if child is showing signs of dehydration (inability to make tears, dry chapped lips, or few wet diapers), please see a healthcare provider right away.
Written and reviewed by:
Dr. R. Ruiz, MD, FAAP. Board-Certified General Pediatrician & Pediatric Gastroenterologist