How To Deal With Infant Constipation
Constipation is unpleasant for little ones. Sometimes it can be eased at home but visit a doctor if youre concerned.
During a babys first year some problems with feeding may arise. Most of these are minor and can be managed at home but they can be distressing for both babies and parents.
If you are concerned, it is better to visit the doctor or public health nurse than to sit at home worrying. Early intervention and treatment are central to your babys health and wellbeing.
Sometimes a GP may have little experience dealing with babies. If you are not happy with the outcome of your visit it may be worth looking for a second opinion. Remember, nobody knows your baby as well as you do.
Here we advise on how to cope with common feeding problems that are not too serious.
Constipation is one of the most common problems seen in paediatric out-patient departments but reassuringly, it is usually only a temporary problem, not associated with any underlying disease.
Constipation is very rare in breastfed infants as breast milk tends to have a mild laxative effect. It is more common in bottle-fed infants. Remember that babies bowel habits vary considerably and it is easy to have an unrealistic idea of whats normal. It is important to be able to recognise a normal bowel habit as it is not uncommon for people to have very different ideas about what is normal!
Causes of constipation in infants
Dietary treatment for constipation
How Can You Treat Constipation
You can usually treat constipation at home with high-fiber foods and lots of fluids. Do not use any suppositories, laxatives or enemas without first consulting your childs doctor or nurse practitioner.
Youll also need to base your treatment on your childs age.
If your child is younger than 4 months old, try:
- 1 ounce of prune juice in 1 ounce of water, one or two times a day
If your child is 4 months to 1 year, try:
- High-fiber baby foods, such as cereals, fruits , vegetables, spinach and peas
- Prune juice
If your child is 1 year or older, try:
- Feeding him raw, unpeeled vegetables and fruits at least three times a day
- Increasing the bran in her diet by offering her graham crackers, bran cereal, oatmeal and whole-wheat bread
- Increasing the amount of water and juices she drinks
- Having your child sit on the toilet for 10 minutes after meals, especially after breakfast, to encourage a regular bowel pattern
When should you call the doctor?
Most of the time, home treatment will help. If not, contact your pediatrician to develop a plan for your child.
Call your childs doctor or nurse practitioner immediately if your child is in severe pain or has blood in his stool. You should also talk to your childs doctor or nurse practitioner if:
- Your child doesnt have a bowel movement after five days.
- He develops any tears in the rectal area that dont heal.
- She is soiling herself despite being toilet trained.
Contributed by: Patrick S. Pasquariello, MD
Imitators Of Constipation: Normal Patterns And Stools
- Breastfed and Over 1 Month Old. Stools every 4-7 days that are soft, large and pain-free can be normal. Caution: before 1 month old, not stooling enough can mean not getting enough breast milk.
- Straining in Babies. Grunting or straining while pushing out a stool is normal in young babies. They are learning to relax their anus after 9 months of keeping it closed. It’s also hard to pass stool lying on their back with no help from gravity. Babies also become red in the face and draw up their legs during straining. This is normal.
- Brief straining under 10 minutes can occur at times at any age.
- Large Stools. Size relates to the amount of food eaten. Large eaters have larger stools.
- Hard or Dry Stools. Also can be normal if passed easily without too much straining. Often, this relates to poor fiber intake. Some children even have small, dry rabbit-pellet-like stools.
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Symptoms Of Constipation In Children
A normal poo should be easy to push out and look like a sausage.
But if your child is constipated, poo becomes hard to push out. Your child might feel pain and discomfort when doing a poo or trying to do one. This might make your child avoid pooing, which can make the problem worse.
Hard poo might overstretch your childs anus and cause small tears on the surface, which might lead to pain and bleeding.
Your child might also have tummy pains that come and go. Some children might show holding on behaviour like rocking or fidgeting, crossing legs or refusing to sit on the toilet. They might also seem generally cranky.
If your child has been constipated for a long time, they might poo in their pants without meaning to. It might be a small or large amount of poo, and it might happen at any time of the day. This is called soiling or faecal incontinence.
Some children poo 2-3 times a day, and other children poo twice a week. This range is normal.
What Are Some Home Remedies For Baby Constipation
If your baby becomes constipated once heâs started on solid foods, check in with your healthcare provider, who may recommend any of the following changes or additions to his diet to help relieve constipation:
Water. If your baby is over 6 months old , offer him a little water in a sippy cup with his meals. This shouldnât replace breast milk or formula, however.
Fruit juice. A few ounces of 100 percent fruit juice such as apple, pear, or prune juice can also help your baby. These juices contain sorbitol, which works like a natural laxative.
Certain fruits and vegetables. Once your baby is eating solid foods, give him pureed foods such as prunes, pears, peaches, and peas. These can help with constipation since they contain more fiber than other fruits and vegetables.
Infant cereals. Try feeding him whole-wheat, barley, or multigrain infant cereal once he is eating solid foods. These three types contain more fiber than rice cereal and may help get things moving.
If the above dietary changes havenât given your baby relief, contact his healthcare provider again for guidance.
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When To Visit A Doctor
Constipation is rarely caused by a serious condition, but if your tamariki hasnt improved after a few days, or youre worried, call PlunketLine or visit your doctor.
If the constipation lasts a long time or keeps coming back, talk to your doctor – they may prescribe a medicine to help soften the poos.
Q How Do I Know If My Baby Is Constipated
If your baby is very uncomfortable or clearly in real pain, and his poos are small and hard, then he has some degree of constipation. This is very rare in babies who are solely breastfed, but not uncommon in babies who have formula, or who have solid foods.
Ask your health visitor or the chemist for advice on treatment. Make sure you are making up the formula powder with the correct amount of water. Some formulas are specially targeted at babies who have minor constipation your health visitor can discuss your options.
Persistent constipation needs to be checked out by the doctor.
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How To Recognise The Signs Of Constipation
The main signs of constipation are hard, dry poos. The following are other signs of constipation:
- Your baby may show signs of straining when trying to pass a poo.
- Your baby may be unsettled, may seem fussy or irritated.
- Your baby may be eating less or feeding less well than usual.
- A tear or crack might appear in the skin around the anus, which may at times bleed.
In some cases, if your child is constipated, they may look bloated or their stomach may appear larger than usual. It can be possible to feel their poo while pressing softly on their stomach.
Baby Constipation Remedies And Relief:
- Change Baby’s formula. Starting a new formula may resolve constipation. Some infants have softer stools when they drink formula from concentrate versus powder-based . Ask your babys doctor for guidance.
- Slightly dilute the mix. Your babys poops may improve when you add a tablespoon of organic adult prune juice or one ounce of water into the formula, once or twice a day .
- Give a bottle of water. If the weather is very hot and your baby is showing signs of dehydration, depending on your baby’s age, you can give a few extra ounces of waterjust be sure to check in with your doctor beforehand.
- Open the door. Babies trying to poop often have a hard time squeezing the stomach muscles and relaxing the rectum at the same time. They accidentally tighten the anuswhen they should be easing itand consequently, they strain to push the poop out the door! To relax your babys anus, bicycle their legs and gently press their knees down to their stomach a few times. If this fails, you can insert a Vaseline-greased thermometer or cotton swabjust one-half to one inchinto the anus. Babies usually respond by bearing down to push the object outoften pushing poop out at the same time.
- Change up solid foods. White foods can bind a baby up. But, certain fruits and veggies like broccoli, plums, prunes, prune juice, or fresh aloe juice can help get pooping back on a regular schedule.
Note: Never give honey or corn syrup as a laxative, before the first birthday.
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What You Can Do
- Try not to give your child too much fiber, as it can cause tummy pain.
- If your child’s diet is low in fiber, give them more fresh fruit and vegetables, cereals, rice, dried fruits, breads and dried fruit.
- Encourage your child to drink lots of fluids .
- Encourage your child to get enough exercise.
- Encourage your child to recognize their need to poo, even if they are busy playing.
- Encourage your child to let all their poo come outeach time they go to the toilet.
Reduce Amount Of Rice Cereal
Rice cereal can also trigger constipation because its low in fiber. Reduce the amount of rice cereal you feed your baby to relieve constipation.
Another option is to insert an infant glycerin suppository into your babys anus. These are safe for infants and available over the counter for fast relief.
Babies under the age of 6 months only need formula and breast milk, no other fluids. If youve been giving a baby under 6 months solid foods or rice cereal, stop giving these foods. See if their symptoms improve. If symptoms dont improve, see their pediatrician.
For older kids, here are a few basic tips to stimulate bowel movements.
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Signs And Symptoms Of Constipation In Babies
Look out for two or three of these symptoms1:
- Poos that are small, hard and pellet- like or large, hard and difficult to push out.
- Less than three poos a week.
- Foul-smelling wind and poo.
- Excessive gas.
- Straining and crying when pooing .
- A tummy that is firm to the touch .
- A poor appetite .
- Your baby is irritable and tearful.
- You baby seems low on energy.
Still unsure? Head over to our Baby Symptom Checker. If you have any concerns about your babys symptoms, speak to your health visitor.
How Long Can A Baby Go Without Pooping
In some cases, longer than you might think. While many little ones poop every day, its possible and not necessarily something to panic about if a baby goes 24 hours without pooping and even up to a full week without a bowel movement.
Since exclusively breastfed babies sometimes use up every bit of breast milk towards energy production, its not unusual for them to sometimes go up to seven days without pooping.
But formula-fed babies, babies whove started solids, and toddlers tend to poop more often than that. For them, going more than two to four days or so could be a sign of constipation, provided theyre also straining to go and generally seem uncomfortable.
That said, every child is different, and some babies and toddlers simply go a little longer in between, well, going, than others. So pay attention to whats typical for your little one.
If she often goes two or three days in between poops, constipation might not pop up on your radar unless shes been BM-free for four days. But if your child normally goes like clockwork every single day, you might watch for signs of constipation after a day or two without poop.
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How To Help A Constipated Baby Or Toddler
Constipation doesnt just make your little one miserable. It can get worse when left untreated, making it even harder for your child to pass stool. So if you suspect constipation is the cause of her discomfort, take quick steps to get things moving again with these tips for baby and toddler constipation relief.
Pay attention to the calendar, too. You should call the doctor if your newborn formula-fed baby has passed less than one stool a day or if your older baby or toddler hasnt had a bowel movement for four or five days.
Constipation is rarely an issue for exclusively breastfed babies, but if your little one seems to be going longer than normal without a poop and youre concerned, theres no harm in checking in with the doc.
You should call the doctor, too, if your baby or toddlers constipation is accompanied by abdominal pain or vomiting, theres blood in her stool, or at-home measures to get things going arent working.
How To Treat Baby Constipation
A change in formula or in Mom’s diet could help combat constipation in formula-fed and breastfed babies, respectively. Solid foods, which are often the cause of constipation, can also be the cure, Dr. Shu says. Several kinds of fruits and veggies, such as pears and broccoli, can get things back on track, along with fruit juice and water.
When a change in diet isn’t doing the trick, talk to your pediatrician before employing other methods. The doctor might suggest rectal stimulation with the use of a cotton swab or rectal thermometer. This usually produces a bowel movement within several minutes of stimulation, Dr. Shu says.
Another possible is a glycerin suppository. If it works, it could take about an hour to produce a poop, Dr. Shu says. Other suggestions may include Miralax, a tasteless powder you can mix into a drink senna, a natural vegetable laxative and lactulose, a synthetic sugar used for treating constipation. Ask your pediatrician before trying any of these treatment options.
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Constipation In Breastfed Babies
Can breastfed babies get constipated? The simple answer is yes. Whilst constipation is rare in babies who are solely breastfed3, it can still happen.
Remember that exclusively breastfed babies don’t need anything other than breastmilk until they’ve started eating solid foods. Its recommended that this doesnt happen until your baby is around 6 months of age4.
Constipation In Formula Fed Babies
Constipation tends to be more common in formula fed babies. If youve recently started giving your baby formula milk and you notice a change in their bowel movements, its likely that their tummy is simply adapting to the change.
If you find yourself dealing with formula fed baby constipation, make sure that youre preparing feeds according to the manufacturer’s instructions. Its never advisable to reduce or increase the amount of powder you use, as too little wont provide the nourishment they need, and too much can cause constipation5 or make your baby ill. You could also try giving your baby cooled, boiled water in between their normal feeds6.
If symptoms persist and you need further advice, dont hesitate to speak to your health visitor, pharmacist or GP about other nutritional solutions available to help manage your babys constipation.
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Symptoms Of Constipation In Babies
Constipation isnât just about how often your baby poops. Itâs also about how tough it is for them to do it. If they have soft, easy-to-pass stools every 4-5 days, theyâre probably OK. On the other hand, you should talk to your doctor if they:
- Have a hard time going or seem uncomfortable
- Have hard stools
- Have a swollen belly
Does My Child Need To See A Doctor
Constipation is common. Often it will pass without intervention, or with the help of the strategies listed above. If you are worried that your baby has constipation, is uncomfortable or is in pain, their doctor can assess them and recommend baby-safe strategies. There are medical treatments for constipation that your doctor may consider, based on your babys circumstances.
If your baby was previously treated for constipation but still struggles to poo, it is important to go back to your doctor for a review. There are several treatments they can try.
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Treating Constipation In Babies
- If your baby is bottle-fed, check the formula tin to make sure the formula is being made correctly. Always measure the water first and then add formula powder.
- Offer extra drinks of water.
- Gentle tummy massage can help.
- A warm bath may help the babys muscles to relax .
- Give only medication prescribed by your doctor.
Symptoms Of Constipation In A Breasted Baby
How can you tell if your babys constipated? Its important to note that the frequency of bowel movements isnt always an accurate indication of constipation. Neither is seeing your baby grunt or strain while having a movement.
Many babies look like theyre pushing when theyre having a bowel movement. That may be because babies use their abdominal muscles to help them pass stool. They also spend a lot of time on their backs, and without gravity to help them, they may have to work a little more to move their bowels.
Better indications of constipation in a breastfed baby are:
- firm, tight, distended belly
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