Was it blood?

Urinary urate crystals can stain the nappy red, but this is not clinically significant. Medications such as rifampicin products that are excreted in the urine can make the stools appear red.1

Bleeding and blood

Ask if there is a family history of a bleeding disorder and/or whether the baby has bled from other sites, such as the nose, or has any bruising.

Ask about the colour of the blood, whether it was mixed with the stools, and if there was any associated pain. Bright red blood on a wipe or on a nappy (but not mixed with the stools) suggests bleeding from the anal region. Although constipation and an anal fissure usually coexist in cases of blood in the nappy, constipation is the commonest cause of a rectal bleed beyond the neonatal period, irrespective of whether an anal fissure is visible.2 A fissure associated with constipation usually results in a baby …