1 Has your child passed red, jelly-like matter, and is he or she unwell?

2 Is your child under 1 year old, and are his or her faeces green?

3 Is there blood on the faeces?

4 Is the blood in small streaks on the faeces?

5 Is your child taking any medicines?

6 Are your child's faeces very pale?

7 Has he or she just recovered from an episode of diarrhoea and vomiting?

8 Emergency! Call an ambulance

Possible cause Intussusception, a rare disorder affecting young children in which the intestine telescopes into itself, is possible. This is particularly likely if your child is under 2 years old and he or she is having bouts of inconsolable crying.

Action While waiting for the ambulance, do not give your child anything to eat or drink. In hospital, your child will need tests and an enema, which may correct the problem; if it does not, an operation will be needed.

9

Possible causes and action Green faeces are normal in breast-fed babies and are not a cause for concern (see Babies' faeces). However, in bottle-fed babies, green faeces may indicate gastroenteritis, especially if they are watery. Call your doctor.

10

Possible cause A small amount of blood on the surface of the faeces may be due to an anal fissure (a split or tear in the lining of the anus), which is often associated with constipation. Consult your doctor.

Action Your doctor will probably advise you to give your child plenty of fluids and fibre-rich food (see Avoiding constipation in children). He or she may also prescribe stool-softeners, which will make passing faeces easier and allow the fissure to heal.

11 Call your doctor now

Possible causes Blood in the faeces may be a sign of a serious infection of the digestive tract or inflammation of the lining of the intestines. Both of these disorders need urgent treatment.

Action Your doctor will probably examine your child and send a sample of faeces for tests. He or she may also arrange for your child to have colonoscopy to confirm the diagnosis. If the cause of the bleeding is an infection, treatment may include antibiotics. Corticosteroid drugs may be prescribed if your child has an inflammatory disease.

12

Possible cause Certain drugs can cause changes in the appearance of faeces.

Action Stop giving your child over-the-counter drugs and consult your doctor. Meanwhile, do not stop giving your child his or her prescribed drugs.

13

Possible cause After an episode of diarrhoea and vomiting, faeces may be abnormally pale for a few days.

Action If your child seems well, there is no cause for concern. Consult your doctor if the faeces have not returned to normal within a week, or sooner if your child is unwell.

14 See your doctor within 24 hours

Possible cause Your child's pale faeces might be due to a failure to absorb fats as a result of an underlying disorder.

Action Your doctor will examine your child. Analysis of a sample of faeces may be needed to confirm the diagnosis. Other tests will be needed to determine the cause and appropriate treatment.

15

Consult your doctor if you are unable to make a diagnosis from this chart.