What is the cause of melena (black stools) in a one-year-old child?

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Last updated: February 21, 2025View editorial policy

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Differential Diagnosis for Black Stool in a 1-Year-Old

Single Most Likely Diagnosis

  • Gastrointestinal bleeding from a swallowed maternal blood (e.g., during breastfeeding): This is a common cause of black stools in infants, especially if the mother has a bleeding nipple or if the infant has swallowed blood during delivery.

Other Likely Diagnoses

  • Ingestion of substances that color the stool black (e.g., iron supplements, black licorice, or certain medications): Infants may accidentally ingest substances that can cause black stools.
  • Gastrointestinal infection or inflammation (e.g., gastritis or duodenitis): Certain infections or inflammatory conditions can cause bleeding in the gastrointestinal tract, leading to black stools.
  • Allergic colitis or cow's milk protein allergy: These conditions can cause gastrointestinal bleeding, which may result in black stools.

Do Not Miss Diagnoses

  • Intussusception: A life-threatening condition where a part of the intestine telescopes into another, causing bowel obstruction and potentially severe bleeding.
  • Volvolus or intestinal malrotation: Conditions that can cause bowel obstruction and ischemia, leading to bleeding and potentially black stools.
  • Meckel's diverticulum: A congenital anomaly that can cause gastrointestinal bleeding, especially in infants.

Rare Diagnoses

  • Hemorrhagic disease of the newborn: A rare condition caused by vitamin K deficiency, leading to bleeding in the gastrointestinal tract.
  • Congenital or acquired gastrointestinal vascular malformations: Rare conditions that can cause gastrointestinal bleeding and black stools.
  • Ingestion of a foreign body that causes gastrointestinal bleeding: Although rare, infants may ingest objects that can cause bleeding in the gastrointestinal tract.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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