Constipation is very common in babies. In fact, it’s one of the most frequent complaints that pediatricians hear from parents of infants. While uncomfortable, occasional constipation usually isn’t cause for concern. However, chronic or severe constipation can be serious and should be evaluated.
What is Constipation in Babies?
Constipation refers to infrequent, difficult, or painful bowel movements. Constipation in babies is defined as:
- Less than one bowel movement per day for breastfed infants over 1 month old
- Less than one bowel movement every 2-3 days for formula-fed infants over 1 month old
- Hard, dry stools that the baby has trouble passing
- Straining, pain, or crying during bowel movements
Normal stool frequency and consistency varies widely in babies. As long as the stool is soft and they are having regular bowel movements without difficulty or discomfort, there usually isn’t cause for concern.
What Causes Constipation in Babies?
There are several possible causes of constipation in babies:
- Formula: Formula-fed babies are more prone to constipation than breastfed infants. Cow’s milk formula can be harder to digest.
- Starting solids: Introducing solid foods, especially rice cereal and bananas, can cause firmer stools.
- Dehydration: Not getting enough fluids can lead to constipation.
- Illness: Some illnesses may disrupt normal bowel movements.
- Medications: Certain medications like iron supplements can cause constipation.
- Withholding stools: Some babies will purposefully hold in stool, which dries it out and makes it harder to pass. This often happens after a painful bowel movement.
- Anatomical issues: Rarely, babies may be born with abnormalities of the digestive tract that cause constipation.
In many cases, the cause is simply the baby’s immature digestive system. Constipation often improves on its own as the baby gets older and the gastrointestinal tract matures.
When to Worry About Constipation in Babies
Occasional constipation is common and usually not a medical concern. However, call your pediatrician if your baby has:
- No bowel movement for more than 3 days
- Hard, dry, pellet-like stools
- Straining, crying, or drawing legs up with bowel movements
- Blood in the stool
- Abdominal pain or vomiting
- Fever
- Significant change in stool frequency or consistency
Severe or chronic constipation should always be evaluated to rule out potential medical conditions like:
- Allergies: Allergies or intolerance to formula or foods can cause constipation.
- Hypothyroidism: Low thyroid hormone levels may impact bowel function.
- Cystic fibrosis: Thick mucus can obstruct the intestines.
- Hirschsprung disease: Problems with nerve function in the colon.
- Botulism: Rare bacterial infection that paralyzes muscles.
- Bowel obstruction: A blockage in the intestines.
While alarming, these serious causes are extremely rare. Mild to moderate constipation is usually due to diet or developmental issues.
Signs of Constipation in Babies
Signs that your baby may be constipated include:
- Passing fewer stools than normal
- Hard, dry stools
- Straining or grunting when passing stool
- Stools have visible blood
- Irregular stool consistency
- Increased fussiness during bowel movements
- Drawing knees up or arching back when passing stool
- Crying when pooping
- Passing small, pellet-like stool
- Inability to have a bowel movement after 5-10 minutes of trying
- Abdominal bloating or distension
Pay attention to what’s normal for your baby. Signs of constipation warrant a call to the doctor right away.
How to Help a Constipated Baby
For occasional constipation, there are several remedies you can try at home:
- Increase fluids: Breastfeed frequently and make sure formula-fed babies get enough formula. Offer an ounce of water between feeding.
- Massage abdomen: Use a warm, wet cloth and gentle circular motions. Bicycle legs and flex knees into tummy.
- Baby probiotics: Probiotics support healthy gut bacteria and soften stool. Ask your pediatrician for one suitable for infants.
- Fruit juice: A small amount of diluted prune, pear, or apple juice can help soften stool.
- Warm bath: A warm bath can help relax abdominal muscles and make passing stool easier.
- Baby laxative: Ask your pediatrician about using a gentle over-the-counter laxative temporarily.
Do not give your baby any medication, laxative, or enema without consulting your pediatrician first. Some home remedies like petroleum jelly or glycerin suppositories are not safe for infants.
If home treatments don’t work within 24 hours, take your baby to see the doctor. Never force your baby to pass stool as this can harm the intestines.
How to Prevent Constipation in Babies
You can help prevent constipation by:
- Breastfeeding whenever possible
- Giving plenty of fluids if formula feeding
- Introducing solids slowly starting at 4-6 months
- Avoiding foods that cause constipation like rice cereal and bananas
- Exercising legs with bicycling motions
- Establishing a potty routine after feedings
- Massaging abdomen regularly
- Dressing baby appropriately so they don’t get too cold
Keep in mind that some constipation is inevitable as you introduce new foods and your baby’s digestive system develops. Don’t hesitate to consult your pediatrician if remedies at home are not working.
When to See a Doctor for Baby’s Constipation
See the doctor right away if your baby has:
- No bowel movement in 3 or more days
- Hard, dry, bloody stool
- Fever over 100.4°F (38°C)
- Vomiting
- Abdominal distension or swelling
- Signs of dehydration like fewer wet diapers, dry mouth, and no tears when crying
You should also make an appointment if:
- Home remedies don’t relieve constipation after 2-3 days
- Your baby seems in distress when passing stool
- Constipation is interfering with feedings or sleep
- Constipation keeps recurring frequently
The doctor can:
- Rule out serious conditions like intestinal blockages
- Recommend appropriate laxatives or prescription formulas
- Help identify potential formula intolerances or allergies
- Advise dietary changes to alleviate constipation long-term
- Reassure you that it’s likely a normal stage of development
Seeking medical advice provides peace of mind and relief for your baby.
FAQs About Baby Constipation
Here are answers to some frequently asked questions about constipation in babies:
What’s the difference between constipation and normal variation in baby poop?
Normal baby stool varies widely in frequency and consistency based on many factors like diet and age. Constipation specifically refers to infrequent stools, difficulty passing them, and unusual hardness or dryness. Stools that seem abnormally hard and cause a baby distress signal a problem.
At what age can babies start taking medicine for constipation?
Do not give babies any medication without consulting a doctor. There are some laxatives and stool softeners deemed safe for babies over 2-3 months old. Correct dosage is important, so always follow the pediatrician’s recommendations.
When should I switch formula if I think it’s causing constipation?
It’s normal to try a new formula if you suspect the current one is causing chronic constipation. But make switches gradually and speak with your pediatrician first. Sudden formula changes can upset baby’s stomach. Consider asking about lower lactose or partially hydrolyzed proteins.
Can switching to solid food help chronic infant constipation?
Starting solids between 4-6 months may help some babies have more regular stools. But chronically constipated infants may continue having issues. Only introduce one new food at a time and go slowly. Talk to your pediatrician before making any major dietary changes.
Is it normal for breastfed babies to go several days without pooping?
Breastfed babies can go several days without pooping and have soft stool. However, if stools become hard and dry or your baby strains, that indicates constipation needing attention. Breastfeeding on demand and ensuring proper latch can help prevent problems.
Can constipation cause problems later on?
Occasional constipation is common and not cause for long-term concern. But chronic constipation left untreated can potentially cause painful fissures, stool withholding behaviors, bowel obstruction down the road, and other complications. That’s why it’s important to address frequent or severe constipation now.
How much juice or water can I give a constipated 4-month-old baby?
Small amounts of water or diluted juice can provide relief. Give no more than 2-3 ounces of juice per day. Excess juice strips nutrition and prolonged use can cause diarrhea. For water, offer 1-2 ounces between breastfeedings or mixed into formula. Get pediatrician guidance tailored to your baby.
What exercises help constipated babies pass stool?
Try bicycling baby’s legs, gently flexing knees into the abdomen, or moving legs in a swimming motion. Gently rub or apply warm compresses to the belly. Position baby on its back and carefully push legs into a squat. Never force movements or apply pressure on the belly.
When should I take my constipated newborn to the ER?
Seek emergency care if your baby has symptoms like high fever, vomiting, seizures, signs of dehydration, or an abnormal bulging abdomen. Also go to the ER if baby is crying inconsolably but unable to pass stool after 10 minutes of trying, or if you notice blood in the diaper.
Constipation causes distress but is usually temporary. Don’t hesitate to seek pediatrician advice. With some simple remedies and patience, your baby can get relief. Trust your instincts if you think something is wrong.