Q: Hello Doctor, my Baby Is 3 months and since yesterday he has been pooping blood mucus close to 7 times a day. What is the cause and how can I treat it? He also has some white discharge on his penis

A: Hey! Thanks for writing in and congratulations on your brand new baby!

As you may have noticed, your baby’s poop has gone through some colour changes since birth. Here’s a guide on what to expect:

• Black or dark green. Newborn poop is called meconium and it is typically black, sticky and hard to remove. Quick tip: after each diaper change, just slather some petroleum jelly on baby’s bottom. This keeps baby’s buttocks nice and clean from meconium. The next time baby poops, the poop will slide right off!
• Yellow-green. As the baby starts breastfeeding and digesting breast milk, the black meconium gives way to yellow-green coloured poop
• Yellow. Breast-fed babies typically have yellow-coloured loose stools
• Yellow or brown. Formula-fed babies have yellow or brown stools with hints of green. Consistency is more firm than that of breast-fed babies

However, blood in stool is never a good idea and should always be checked out in the hospital. Sometimes mums can mistake red-coloured stools due to foods like tomatoes and medicines like amoxicillin for blood in stool. But where in doubt, always err on the side of caution and see your baby’s paediatrician. Possible causes of blood in stool include:

• Cow’s Milk Colitis. Symptoms include loose, slimy stools which can have blood streaks and starts within the first 2 months of life. To prevent this, please do not give babies cow milk formula until one full year of age
• Anal Fissure. It is possible that the baby’s stool is hard enough to cause a tear of the skin lining the anus leading to the blood seen with the stool. Exclusively breast-fed babies usually do not have this problem
• Strep Skin Infection. A Streptococcal skin infection around the anus can also cause blood-streaked stools.
• Bacterial Diarrhea. Stomach infection with E.Coli or salmonella etc can lead to blood streaks in stool

Regarding the penile discharge, possible causes include smegma and balanitis

Both of these conditions could be due to poor hygiene.

Smegma, a natural penile lubricant, is a cheesy looking discharge that builds up on the head of the penis and under the foreskin, if the penis is not washed daily. It can become a rich culture medium for bacteria, prevent foreskin movement and eventually start to smell. This situation can lead to balanitis.

Treatment depends on cause. Antibiotic or antifungal medicine will be prescribed for infections. Steroids may be used for inflammation. Urinary catheters may be inserted for children with difficulty in urinating. Circumcision helps prevent recurrence of this problem etc. Symptoms typically disappear after about 3 to 5 days of treatment.

In the meantime,

• Clean the area daily gently retracting the foreskin. If you’re not sure how to do this, please be guided by the medical personnel providing care for your baby.
• To prevent spread of infection, be sure to wash your hands thoroughly after caring for your baby’s penis and as he grows up, teach your baby to do the same

Balanitis is skin irritation of the head of the penis which presents with itching. Causes include:

Bacteria, fungus or yeast (candidiasis)

Irritation under the foreskin caused by urine

Use of shower gels, soaps and other skin irritants

Skin conditions like eczema

Cleaning the penis too much or too little (poor hygiene)

Diaper rash

All the best!