Hi, Our daughter is 2yrs 5months, 15.2kg, 93cm. Natural waterbirth, no complications. Still breastfeeding - 3 to 4 feeds daily. Usually eats well, plenty of fibre and drinks lots of water. She had a bloody stool at 20 months and another at 22 months. GP suspected anal fissure due to constipation (she was straining on the first occasion; hasn't strained since.). Re constipation, she has never had a day without a BM, they are regular and usually semi mushy. Only semi solid on four occasions; though she does frequently pass loads.

Referred to paediatrician at 2yrs 1 month. (The week prior to first consultation, she had a very bad bout of gastroenteritis, fever over 3 days, vomiting and diarrhoea, didn't eat anything solid for 5 days. Otherwise she has had no illnesses. History of atopic eczema - mild.) Blood tests showed her to be anaemic (Hgb 9.4, MCV 63, iron levels 2.6). Prescribed Sytron 2.5 mls 3x daily for 6 weeks and Movicol Paediatric Plain for the constipation. Referred to dietician who thought our daughter's diet was fine.

(One slightly bloody stool in the interim, although not absolutely certain it was blood, might have been bits of undigested strawberries). Review with paediatrician last week. Latest blood tests not back yet. BUT tonight our wee one had a BM with faint streaky blood running though it and "fleshy" bits! No straining and not hard. I am worried. (Re the blood, I'm not sure if there is a connection, but she has eaten peanut butter last 3 times there has been a bloody stool.) Not sure if this is significant or not, but last weekend she had a fever - lasted 2 days, would come down with Calpol and then up again, diarrhoea twice. Her appetite has gone down, she looks pale and her energy levels are not what they were. She is just not herself.

Please could you advise me on:
1. Our daughter's iron stores were very low at 2.6. Is 6 weeks of the iron supplement enough to get her iron levels back up to 10 (as our paediatrician claims)? I can hardly believe that it is. Also, if it does transpire that our wee one needs more of the iron supplement, there will have been a break of just over 3 months between the end of the first dose and the start of the next prescription. Will that break affect the virtue of the first dose in any way - i.e. do you need to be taking the iron supplement continuously to receive the full benefit of it?

2. What are those fleshy bits about?! Looked and felt like bits of tissue. Would this be coming from her intestine? Is it a sign of anything sinister?

Our daughter is growing well and her development is great - no issues there. But I'm very worried about the low iron levels, especially as she has an iron-rich diet with plenty of vitamin C at every meal. Yet, she is pale and her energy is never sustained for very long. If it's not dealt with asap, it will surely hold her back. What is going on? I'm at a loss. Any ideas?

Many thanks for your time and trouble - any insight would be greatly appreciated.

Maria