Dealing With Constipation in Babies Under 1 Month Old

Constipation is a common issue that many new parents face in the first months of their baby’s life. For exclusively breastfed babies, it’s normal for them to go several days without a bowel movement. However, some babies do struggle with painful, hard stools. Constipation in young infants can be caused by a variety of factors. The good news is that there are many effective ways to safely relieve constipation in babies less than 1 month old.

What is Constipation in Babies Under 1 Month?

Pediatricians define constipation in babies under 1 month old as having less than one bowel movement per day or difficulty passing hard, dry stools. Some common signs of constipation in young infants include:

Infrequent bowel movements (less than one per day)
Hard, dry, pebble-like stools
Difficulty or signs of distress when passing stools
Straining, crying, or drawing legs up when having a bowel movement
Blood-streaked stools
Increased gassiness, fussiness, and discomfort

Causes of Constipation in Newborns

There are several possible causes for constipation in babies under 1 month old:

Formula-fed baby – Formula-fed babies tend to become constipated more often than breastfed babies. Formula is harder for babies to digest compared to breastmilk.
Dehydration – Not getting enough fluids can lead to hard, dry stools. Dehydration is a particular concern for exclusively formula-fed newborns.
Dietary changes – If you recently switched from breastfeeding to formula or started solids, this transition can be hard on your baby’s immature digestive system.
Low fiber intake – Breastfed babies depend on the fibers from breastmilk to keep their stools soft. Lack of fiber from inadequate breastfeeding can cause constipation.
Difficulty coordinating bowel movements – Some babies under 1 month old have trouble coordinating the muscles needed to pass stools, which can lead to painful constipation.
Immature digestive system – Babies’ digestive systems are still developing in the first few months. Constipation can occur as the intestines learn to move stools effectively.
Medical condition – In rare cases, an underlying medical issue like cystic fibrosis, hypothyroidism, or Hirschsprung disease may cause chronic constipation in infants.

When to Call the Doctor About Constipation

While constipation is common in babies, it’s still important to contact your pediatrician if your baby under 1 month old has persistent or severe symptoms. Call the doctor if your infant has:

No bowel movement for more than 3-4 days
Dry, hard stools more than 50% of the time
Hard, pellet-like stools that cause them distress
Straining, crying, or pain when passing stools
Blood in their stools
Significant vomiting or diarrhea along with constipation
Fever over 100.4°F (38°C)
Signs of dehydration – dry mouth, lack of tears, and few wet diapers

If your baby shows any of these signs, call your pediatrician’s office to determine if further evaluation is needed. Prompt medical treatment is crucial for relieving constipation in young infants.

Home Remedies and Lifestyle Changes

For occasional constipation in an otherwise healthy baby under 1 month old, there are several remedies and lifestyle changes you can try at home:

Increase fluids – Offer more frequent breastfeeding sessions and limit time between feeds. Dehydration worsens constipation so ensure baby gets enough fluids.
Feed in different positions – Try breastfeeding in positions that put light pressure on your baby’s abdomen like the football hold. Let gravity help move stool through the intestines.
Give tummy massage – Use warm olive oil and gently massage your baby’s tummy clockwise several times a day to stimulate bowel movements. Apply light pressure but avoid harsh force.
Move baby’s legs – Gently bending and moving your baby’s legs in a bicycling motion can help relieve constipation.
Warm bath – A warm bath can both hydrate and relax your baby’s stomach muscles to allow stool to pass more easily. Keep water at a safe temp to avoid burns.
Burp frequently – Stopping to burp your baby multiple times during each feeding can aid digestion and allow more air to pass through.
Switch formula – If using formula, try switching to a different brand formulated for sensitive tummies and easier digestion. Consult your pediatrician first.
Check your diet – If breastfeeding, avoid gassy foods like dairy, cruciferous veggies, beans, garlic, and onions which can upset baby’s tummy.
Use probiotics – Adding infant probiotic drops to breastmilk or formula can support healthy gut flora and relieve constipation. Check with pediatrician before using.
Exercise patience – Stooling patterns vary greatly in babies under 1 month. Don’t worry if it takes up to a week for stools to soften after trying home remedies.

When to Avoid Laxatives in Young Infants
Unless recommended by your pediatrician, laxatives and suppositories should be avoided in babies under 1 month old. Babies’ digestive systems are still too immature to handle these constipation aids safely.

Natural constipation relief methods are recommended as the first course of action for babies under 1 month old. Always consult your doctor before giving your newborn any medications, herbal remedies, or probiotics.

When Can Babies Start Solid Foods?

The American Academy of Pediatrics recommends waiting until babies are around 6 months old before introducing solid foods. Babies’ digestive systems aren’t developed enough to handle solids until the half-year mark.

Starting solids too early can actually make constipation worse in babies under 1 month old. Their immature gastrointestinal tracts have trouble digesting thicker, heavier solid foods. Breastmilk or formula should be baby’s sole source of nutrition for the first 6 months.

Can I Give My Baby Under 1 Month Old Water?

Giving water to newborns is generally not recommended. Breastfed babies should only receive breastmilk for the first 6 months. Formula-fed infants may be given small amounts of water during very hot weather once they are 1 month old, but water does not need to be given routinely.

Exclusively breastfed babies do not require any supplemental water. Breastmilk consists of 88% water and contains all the hydration and nutrition your baby needs in their first weeks. Giving additional water can interfere with breastfeeding and lead to insufficient milk supply.

If your baby is formula-fed, additional water may help relieve temporary constipation. But always check with your pediatrician before offering water. Only give small amounts of water and avoid replacing formula feedings.

When to Worry About Infrequent Bowel Movements

While every baby is different, most newborns stool multiple times per day in the beginning weeks. Very infrequent bowel movements in babies under 1 month old can signal potential problems.

Call your pediatrician if your newborn goes:

Over 24 hours without a bowel movement in the first week
Over 3 days without a bowel movement after the first week
Over a week without pooping after one month old

Prolonged periods without stooling could indicate dehydration, formula intolerance, or a more serious medical issue. Let your doctor assess causes of infrequent stools.

Managing Bowel Movement Difficulties

Prune juice and other constipation remedies are not approved for babies. But if your infant is crying, straining, or distressed when trying to have a bowel movement there are a few soothing techniques you can try:

Bicycle legs – Gently pump baby’s legs in a bicycle motion to relax their tummy.
Tummy massage – Use warm olive oil and massage their abdomen gently in clockwise circles.
Warm bath – Give a warm bath to relax muscles and help stool pass more easily.
Burping – Stop feeding frequently to burp and release excess gas that could be causing discomfort.
Comforting hold – Hold baby firmly against your chest in a comforting skin-to-skin embrace.
Distract them – For bottle-fed babies, offer a pacifier dipped in sucrose solution to provide pain relief during difficult bowel movements.

Check with your pediatrician if stooling problems persist for more than a few days or your baby shows signs of distress. Passing hard stools can be painful for young infants. Proper treatment can prevent complications like stool withholding.

When to Start Probiotic Supplements

There is some evidence that probiotic supplements containing live microorganisms can alleviate constipation in babies. However, probiotics are not recommended for preterm infants or newborns under 1 month old.

The gut microbiome remains underdeveloped in babies this young. Introducing probiotic bacteria too early may overstimulate their immature immune systems. Breastmilk already contains beneficial bacteria that promotes healthy gut flora.

Talk to your pediatrician before starting any probiotic supplement. Most doctors recommend waiting until after the first month to begin probiotics for constipation relief. Research the safety of specific strains like Bifidobacterium infantis for babies.

Probiotics typically require up to 2 weeks to take effect. Once started, they need to be given consistently for results. Work closely with your pediatrician to find the most appropriate probiotic supplement and dosage for your baby if constipation persists.

When to See a Gastroenterologist

For moderate or severe cases of infant constipation that don’t resolve with lifestyle remedies, your pediatrician may recommend seeing a pediatric gastroenterologist. These specialists treat gastrointestinal conditions in babies and children.

Signs that warrant a referral to a gastroenterologist include:

No bowel movement for over 7 days
Blood in stool
Persistent vomiting, diarrhea, or dehydration
Failure to gain weight
Failure to respond to constipation treatments
Suspected food allergies or lactose intolerance
Abdominal swelling or masses
Family history of inflammatory bowel disease

A pediatric GI specialist has specialized training to get to the root cause of chronic constipation in babies and rule out underlying conditions. They can provide prescription laxatives and enemas if medically needed for a complete bowel cleanout.

Specialists have access to diagnostic tests like:

Abdominal X-ray to check stool placement and impaction
Anorectal manometry to assess rectal muscle coordination
Barium enema to evaluate the lower GI tract
Endoscopy procedures to examine the digestive system internally

Severe cases unresponsive to treatment may require hospitalization, IV fluids, and careful monitoring. Pediatric gastroenterologists provide the most advanced medical management for constipation in babies under 1 month old when needed.

Common Medications for Infant Constipation

When conservative treatment fails, there are a few medications and supplements doctors may use judiciously to treat constipation in infants under 1 month old. These can help soften stools and restore regular bowel movements.

Glycerin suppositories – Inserted into the rectum to stimulate bowel movements by mimicking feces. Given sparingly to infants > 2 weeks old.
Polyethylene glycol powder (Miralax) – Osmotic laxative that hydrates stools. Dose must be carefully calculated by weight for babies.
Lactulose syrup – Draws water into the colon to soften stool. Not recommended for newborns.
Magnesium hydroxide (Phillips Milk of Magnesia) – Pulls water into intestines via osmosis. Low doses may be used for infants over 1 month.
Docusate sodium (Colace) – Stool softener that lubricates dry, hard stools. Only for short-term use in babies.
Probiotic supplements – Promote healthy gut flora and digestion. Use specific infant strains cautiously after 1 month old.

Check with your pediatrician before giving any medications or supplements to babies under 1 month. Laxatives, stool softeners, and suppositories can have harsh side effects if improperly dosed. Follow safety guidelines strictly.

When to Expect Bowel Movement Normalcy

It’s normal for a baby’s bowel movements to change in frequency during the first month of life. Here’s a general timeline of what to expect:

First 24 hours: Pass meconium stool as a newborn
1-3 days old: Stool 2+ times per day, greenish-brown or yellow seedy appearance
1 week old: Stooling 2-3 times daily, loose yellow or mustard-colored
2 weeks old: Stools less loose, transitional poops, 1-2 times per day
1 month old: Stools increase in solidity and decrease in frequency, may go 1-2 days without

Breastfed infant stools often change drastically around 6-8 weeks old. Poops become infrequent but softer compared to formula-fed babies. By one month, expect less frequent but larger, darker yellow stools.

Constipation Causes to Watch For

Some uncommon health conditions can also provoke constipation in young infants. Pediatricians monitor for signs of:

Cystic fibrosis – Impacts water absorption leading to thick mucus stools
Hirschprung’s disease – Birth defect affecting colon nerves and muscle movement
Posterior urethral valve – Blocks urine flow causing abdomen swelling
Neonatal abstinence syndrome – Withdrawal after exposure to opioids in utero
Spinal issues – Defects like spina bifida that affect bowel coordination
Small left colon syndrome – Rare condition causing narrowing of descending colon

While most infant constipation is situational, ask your doctor about checking for any underlying medical causes if stools don’t improve. Prompt treatment of serious conditions can prevent complications.

Parental Tips for Dealing With Constipation

Coping with a constipated, uncomfortable newborn can be frustrating for parents. Here are some tips for navigating this common issue:

Remain patient – Stool patterns vary greatly. Allow time for remedies to work before switching approaches.
Keep a log – Chart your baby’s bowel movements and any difficulty, staining, or discomfort.
Massage gently – Light tummy massage clockwise in 5-10 minute sessions can relax the intestines.
Offer comfort – Hold, rock, and soothe your baby when they struggle to pass stool.
Stay hydrated if breastfeeding – Drink plenty of fluids to provide breastmilk with adequate water content.
Avoid OTC laxatives – Stick to pediatrician-approved remedies only to prevent unsafe responses.
Introduce tummy time – Lay your baby on their stomach when awake and supervised. This strengthens abdominal muscles.
Stimulate rectum – Wipe baby’s rectum with a wet cotton ball or wet wipe to trigger a bowel movement after a long delay.
Dress baby loosely – Avoid any clothing or diapers that put pressure on your baby’s abdomen and rectum.
Check for allergies – If taking formula, switch dairy-based to soy-based formula to see if it improves stooling.
Upgrade diapers – Consider super-absorbent diaper brands that feel less bulky and allow stool to pass easier.
Seek support – Talk to other parents and your pediatrician if constipation is affecting your feeding routine or quality time with baby.

While dealing with an inconsolable, constipated infant can be taxing, have patience. Gentle home remedies coupled with your pediatrician’s advice will get your baby’s bowels moving more smoothly.

The Bottom Line
Constipation in babies under 1 month old is common but treatable with the right interventions. Try feasible home remedies first, like tummy massage, extra fluids, movement, and baths. Check with your pediatrician before giving any medications or probiotics to a newborn.

Call your doctor if signs of constipation persist for over 3 days, cause significant distress, or disrupt feeding. The first month is an adjustment period for babies’ developing digestive systems. With some softer stools and a bit more comfort, your baby’s tummy troubles should pass quickly. Be attentive to any worsening symptoms and stay in close contact with your pediatrician during the first months of constipation management.