Red, White and Hard-What is Abnormal Poop?

26 Mar

When you were sitting around before kids you never thought about how much you would think and stress about poop but now you do.  If you’re not worried about the color, you’re worried about the frequency and once you get a handle on those you wonder when it will be sitting at the bottom of the toilet and not in a diaper.

I get tons of questions and statements about poop every week.  Here are some of the most common:

1) Is green (or black or purple) poop normal?

2) My baby is constipated because…the haven’t pooped all day or they strain and turn red when the poop.

So what kind of poop is abnormal.  I always try to keep it simple and this might be my most simple explanation yet…Red, White and Hard.


Red poop can be normal.  Especially if your child just drank a bunch of red gatorade or juice.  So if you first see red poop, think about your child’s diet.  If your child’s poop is red because it has blood in it, that is abnormal.

Bloody stool can be a really simple problem.  One of the most common causes is small tears near the opening of the rectum right before the stool comes out.  With this, you will see small streaks of blood around the stool or on the toilet paper.  The child has usually struggled with some constipation just prior to the blood showing up and this problem resolves by softening the stool for a few days so that the small tears can heal.

If there is more than just small streaks of blood in the stool there are some other problems that need to be considered.  These need to be addressed with your doctor by at least a phone call.  Some of the possibilities are infections (salmonella, shigella, c dificile), bowel diseases (such as Cronhn’s or ulcerative colitis) and other anatomic/surgical problems.


White stool should always be with your doctor.  In babies, this is a sign that there is a lack of bilirubin in the stool which can be a sign of a very serious condition called biliary atresia.  In this condition, the bile ducts that get rid of bilirubin are not connected to the intestines properly and result in a buildup of bile and liver problems if the problem is not corrected.


I define constipation as hard stools.  I don’t really worry about the frequency of the stool.  There are babies that go with every meal and there are babies that go once a week and everywhere in between is normal.  As long as the stool is soft, I’m not concerned.  Also, every baby turns red and strains when they are trying to poop.  I think of it like they are trying to figure out what muscles they need to push with.  Usually, after all that pushing and straining, the stool comes out runny or at least soft.  So, what can we do about that?  Make it runnier or softer?  No, I would say, leave it alone.

If you are seeing hard stools, let us know, so we can talk you through how to treat them.



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