When To Call The Health Care Provider
- Your baby is irritable and seems to be having stomach pain. Infants will pull their legs up to their stomach and cry when they are in pain.
- Your baby has constipation and develops vomiting, and their belly looks like it is bloated or filled with gas.
- You see blood in their stool.
- Their constipation does not get better with treatment.
If you have any questions or concerns, call your babys health care provider.
HH-I-14 ©Copyright 1984, Revised 2022, Nationwide Childrens Hospital
Why Is My Infant Constipated
The standing pediatric advice to accept irregular bowel movements as normal is a principle cause of constipation in infants and toddlers. After irregularity turns into constipation, the ensuing treatment with fiber, fluids, and juices often causes diarrhea, and is, in part, behind the epidemic of autism in the United States.
Transcript
There are two type of constipation functional and organic. So, first, ask your pediatrician to rule out obstruction, impaction, infection, or any other condition behind organic constipation.
Most other causes are functional, and are relatively easily remedied. The problem is, that doctors are likely to give you some terrible advice regarding functional constipation. This advice usually boils down to the three following dogmas:
From the Textbook of Pediatrics: There is no medical harm in stool staying in the body for a long time :
Wrong! A healthy infant is supposed to move the bowels at least four times daily. Missing a single day enlarges and hardens up stools, and makes constipation much worse.
: My statement above that, ideally, breastfed infants are supposed to have at least 4 bowel movements daily drives some people nuts because, according to the dominant pediatric advice, frequency of bowel movements is considered normal in the range from 15 times a day to once a week or even longer, and for as long as the resulting stools remain soft and passable.
Good luck!
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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How Often Should My Breastfed Baby Poop
Just like their formula-fed counterparts, breastfed babies produce a lot of poopy diapers during their first few weeks, often moving their bowels after every feeding. Beyond that, bowel movement frequency in breastfed babies can run the gamut! Your little one may dirty their diaper five times a dayor only poop once every few days.
Does Switching Formulas Help Or Make Things Worse
After choosing a formula, you might decide that youd like to change to another one. Is this a good idea?
Switching your babys formula may make a difference in their poop, since their sensitivity to some of the ingredients in the original formula may have led to their constipation.
However, changing formula styles or brands can also make things worse, especially if you do it too often.
In other words, its not a good plan to give your baby one formula for 1 or 2 days, then changing to another formula right away when you see that theyre constipated. Instead, try giving baby a few weeks to adjust to any newly introduced formula.
In some cases, though, changing formulas might be wise. Even so, its best to speak with your childs pediatrician first.
Reasons to consider changing formulas can include:
- extreme fussiness
- a need for more iron in a babys diet, as determined by a doctor
- weakness or fatigue
Especially if your child is showing signs of allergies or wheat or dairy aversions, changing to a brand with different ingredients may make digestion easier.
Its never a good idea to create your own homemade formula, however. Your childs doctor can help you find an approved formula if your little one needs something special.
For many babies, a simple home remedy or two is all youll need to relieve constipation.
For an older baby, you can consider a dietary change.
For younger babies, you can try the following:
Reach out to your babys doctor if you notice:
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How To Help When Your Newborn Baby Is Constipated
One of the hurdles any new parent might face is baby constipation, but what should you do if you suspect your newborn is constipated?
Dr. Jane Sneed, a pediatrician at The Childrens Clinic in Jonesboro, Arkansas, who has been practicing since 1993, told TODAY Parents that constipation is extremely common in babies.
I would estimate 50 to 75 percent of infants have issues during their first year of life with some form of constipation arising from dietary issues following a stomach bug with diarrhea or from stress, like going out of town and having a significant schedule change, Sneed said. She added that some experts expand the diagnosis to include infrequent stooling only two to three per week or excessive straining for more than ten minutes. Regardless of the definition, the result is the same an unhappy baby.
Symptoms Of Constipation In Children
Your child may be constipated if:
- they have not done a poo at least 3 times in the last week
- their poo is large and hard
- their poo looks like “rabbit droppings” or little pellets
- they are straining or in pain when they poo
- they have some bleeding during or after having a poo, because their poo is large and hard
- they have a poor appetite or stomach pain that improves after they poo
If your child is over 1 year old, soiled pants can be another sign of constipation, as runny poo may leak out around the hard, constipated poo. This is called overflow soiling.
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How Can I Relieve My Babys Gas
Most newborns, particularly between the ages of one to four months, suffer from gas. This is more common in bottle-fed infants as compared to the breastfed ones. Even babies on pacifiers have this issue. A few methods to relieve gas in the baby are
- Simple home remedies for baby gas:
- A warm bath and compress work as the best natural remedy for colicky babies and offers respite from gas. Warm water helps relieve pain. Soak a towel in warm water, squeeze it, and gently rub it on the babys abdomen.
- The gentle massaging of the abdomen can be calming and relaxing, but even more importantly, the pressure on the babys abdomen can help expel the gas. Also, try the colic hold to help relieve pressure in a gassy baby. To do this hold, lay the baby across the lap on their abdomen.
Why Is My Newborn Constipated
As a Mama , you’re constantly watching for clues about your baby’s health and wellbeing. Every laugh, cry and hiccup are all little signs to what your baby wants and needs at that moment in time. If you’ve noticed that your baby’s bowel movements have been more infrequent , this may be a sign that they’re constipated and struggling to poop.
Your baby’s bowel movements will change a lot as they grow and develop. Although it can be alarming, constipation in newborns and infants is very common and easily treated.
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But Why Is My Baby Constipated In The First Place
There arent that many functional causes that may affect a babys bowel movement, particularly among otherwise healthy and well-nourished babies, because the act of defecation in infants is entirely unconscious.
Before identifying the most likely causes, let me first make it absolutely clear: unlike what youve been incorrectly told by doctors, severe dehydration is more likely to produce diarrhea than constipation. Thats, incidentally, why the extra fluids did not relieve constipation in the study I mentioned above. I explain the reasons behind this seemingly paradoxical situation here and here.
And if that prune or pear juices have helped your baby once or twice, it wasnt because of fluids in them, but because of the hyperosmolar sugars and fibers in these juices, having an effect similar to polyethylene glycol.
With dehydration concerns now aside, the two most prominent functional causes of infant constipation are:
I do suspect that in most cases both of the above factors dysbacteriosis and inadequate quality of milk cause functional constipation in infants, particularly when there is a history of using antibiotics.
So, how do you determine the quality of your milk? Not easy Besides a simple assessment of fat, protein, carbohydrates, and water content, the complete vitamin and mineral assay requires specialized and expensive equipment. I dont know of any lab that does it.
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Symptoms Of Constipation In Newborns
As with anything concerning newborns, sometimes it can be tough to figure out what is going on. Keep in mind that every childs bowel routine is different. One baby might have a bowel movement after every feeding, but another might have only one per day, and sometimes might even skip a day for no apparent reason.
1. Appearance of the Stool
Newborn constipation often shows up as a very uncomfortable baby who is not passing stools, even when she tries to do so. When stool is passed, it is likely dry and hard, and might cause discomfort for the child. If your child hasnt had a bowel movement in three or four days and seems to be uncomfortable, constipation might be the culprit.
2. Child Behaviors That Show Discomfort
Beyond the dry and hard stools, your baby will have other ways to show you that shes uncomfortable. A child who fusses, cries or even screams when passing the stools is a sure sign of a child who is constipated. Very young infants might pull their legs up to their chest repeatedly, as though they were trying to rid themselves of something. They might fight against being swaddled, fuss and cry for no apparent reason and they might even refuse milk or food.
When to Call the Doctor
If you notice that your child is passing stools that contain mucus or blood, dont try out any home remedies instead, head for the doctors office right away.
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What About Juice Or Water
While the American Academy of Pediatrics recommends not giving a baby younger than 12 months any juice, a little prune, apple, or pear juice in addition to usual feedings is okay to help relieve constipation. These fruits contain sorbitol, a sweetener that acts like a laxative. Make sure the juice is 100 percent fruit with no added sugars.
If your baby is 4 months or older, you can offer 2 to 4 ounces of juice per day, but for no longer than a week or two. If your baby is between 1 and 4 months old, talk to your doctor before offering juice.
You can give your baby water once he begins eating solids. For babies between the ages of 6 to 12 months, the Centers for Disease Control recommends offering 4 to 6 ounces of water a day.
What Are The Signs That My Newborn Is Constipated
Babies who exclusively consume breast milk rarely become constipated as breast milk is easy to digest, and is also considered a natural laxative. However, this doesn’t mean that your baby will never become constipated.
Babies who are fed formula, on the other hand, may have 3-4 bowel movements per day, or have one every few days. Every baby is different, and what’s normal for your baby might not be the same for someone else’s. It all depends on the type of milk they’re consuming, if solids have been introduced into their diet and if so, what foods they’re eating.
Signs and symptoms that your baby may be constipated include:
- A firm tummy: A firm, tight tummy could be a sign that your baby is constipated. They may also be bloated, which can make their stomach feel full or stiff and taught.
- Infrequent bowel movements: The number of poops that your baby has changes from day to day. But, if your little one goes more than a few days without pooping, and their stool is hard this could be a sign of constipation. Constipation is not only determined by how many bowel movements your baby has, but also the consistency .
- Refusing to eat: If your baby is constipated, they may become full quickly and refuse to eat because their tummy is uncomfortable.
- Straining: Constipated babies often pass very hard, clay-like stools. These stools are a lot more difficult to pass, so your baby may try to push and strain more than usual and may be fussier/cry more than usual when trying to poop.
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What Does Constipated Baby Poop Look Like
When baby constipation is to blame, babys poop comes out in hard balls. We often use the Bristol Stool Scale, which shows the range of stool textures from one to seven: One is rabbit-like, pellet-shaped poop, and seven is pure liquid, Santo Domingo says. We define constipated stool as anything that falls into levels one through three, with three looking like a collection of grapes or corn on the cob.
Youre Using Negative Feeding Practices
Feeding should always be a positive experience, for any child, at any age. When its not positive, young children can make negative associations with eating.
For example, if your child is eating with a baby-led weaning approach and is gagging frequently, this could be negative for him. The same goes for spoon-feeding your baby.
If you force bites of food when your baby is full and doesnt want any more, you could trigger a negative association with coming to the highchair to eat.
While most babies will recover from minor incidents like gagging, some babies who are more sensitive to their environment, transitions and changes, or a have a sensitive temperament may imprint these negative experiences.
You can imagine, this can make a baby withdraw from food, or at least negatively influence her desire to eat.
To avoid this situation, brush up on your feeding style and feeding practices so they are positive, connected and responsive this will help you create a positive feeding experience for your baby.
You can learn that and more in my book, The Smart Moms Guide to Starting Solids.
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Can Few Poops Still Be Normal
Because breast milk is so nutritious, sometimes a babyâs body absorbs almost all of it, leaving little to move through the digestive tract. Your baby may poop only once in a while — itâs perfectly normal for breastfed infants to have a bowel movement once a week.
Some infants just have a slower gut, so they don’t go very often. Hard stools are common from time to time. But if your baby seems to be in pain or you have any concerns, call your doctor.
In rare cases, a medical problem causes lasting, serious constipation. For example, the muscles in the intestine arenât working the way they should or thereâs a blockage in the digestive tract.
Why Do Babies Get Constipated
So what causes infant constipation? Really, it could be due to a number of factors, from foods theyre eating to passing illnesses to family history. Here, we break down the possible reasons behind baby constipation.
Diet More often than not, a change in diet is the likely culprit causing baby constipationwhether its because youre shifting from breast milk to formula, transitioning baby to cows milk or introducing solid foods. The introduction of cows milk proteinand an allergy or intolerance to itis probably the largest contributor to baby constipation, says Santo Domingo. When baby has a cows milk protein intolerance , his or her immune system sees the milk protein as something bad it needs to fight off . This negative reaction to the protein is what leads to a constipated baby with an upset stomach and other intestinal problems. But the good news is that most babies will grow out of it50 percent of infants who have CMPI regain tolerance by age 1, and more than 75 percent will be back on track by age 3.
Illness When babys not feeling well, he or shes probably not eating or drinking as much as usual, which can throw his or her system out of whack and result in infant constipation.
Certain medications High-dose iron supplements or narcotic pain medication can lead to baby constipation. Your doctor can let you know if babys medicine could be to blame.
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