Constipation in babies
Nurturing the Nurturer postpartum doula insights
What is normal?
The consistency (hardness or softness) of your baby’s poo depends on what he or she is being fed. It also varies over time as solids are introduced to the diet, and as your baby’s digestive system becomes more mature.
Some parents worry that their baby is constipated if they don’t do a poo every day. In some babies, there may be several days between each bowel movement, and that is often not a problem.
Babies fed with breast milk only tend to have quite loose and runny stools to begin with. Their stools begin to get a bit firmer and less frequent over time. There can also be a big variation in how much breastfed babies poo. Some breastfed babies poo several times a day and some may poo only once or twice a week. This range is normal.
Babies fed with formula tend to have slightly firmer stools than breastfed babies, and they have fewer bowel movements.
Once solids are introduced (at about 6 months of age), poo will become slightly firmer again.
These variations are all part of your baby’s normal development — healthy poo can range from being loose and runny, to being soft but firm.
- Breastfed babies may have a poo following each feed, or only one poo each week.
- Bottle-fed formula babies and older children will usually have a poo at least every one to three days.
Constipation is a common problem in children, particularly around the time of toilet training or starting solids. It can also become a problem after a child has had a painful or frightening bowel movement.
What are the signs of constipation?
The most important sign of constipation is that the poo is hard and dry or crumbly and it looks like marbles. Other signs of constipation in babies are:
- Your baby is crying and looks uncomfortable before doing a poo. (Some straining is normal when babies do a poo; this usually does not mean constipation.)
- The poo or wind smells bad.
- Your baby isn’t eating as much.
- Your baby has a hard belly.
If the poo is very hard, it can sometimes cause small tears to form around your baby’s anus (back passage). These little tears can bleed and can cause your baby more pain and discomfort.
What you can do
Don’t give your baby medicines for constipation unless they are advised or prescribed by a doctor.
If your baby is fed with breast milk:
- You may need to feed your baby more often. See your doctor or child health nurse for advice.
If your baby is fed with formula:
- It may be that his or her formula has not been made up correctly, so it does not contain enough water.
- Double check that you are following the instructions on the tin of formula correctly.
- Make sure you are using the scoop that is provided with the tin of formula you are using — different brands can have different sized scoops.
- Make sure you are not packing the powdered formula too tightly in the scoop — it should be loosely filled, and levelled off using the flat side of a knife or the leveler provided.
- Make sure you are adding water to the bottle first, then the powdered formula. If you add formula first you will be adding too little water to the bottle.
If your baby is eating solids (from age 6 months):
- Offer extra water between their normal meals or diluted fruit juice (especially prune juice), 1 part juice to 3 parts water.
- Try to encourage them to eat extra servings of fruit and vegetables that have been pureed or chopped (depending on their ability to chew). These can include stewed prunes, stewed apricots, and steamed vegetables.
- Add more water to your baby’s solids.
Other things to try:
- Gently move your baby’s legs in a cycling motion — this may help stimulate their bowels.
- Gently massage your baby’s tummy.
- A warm bath can help the muscles relax (your baby may do the poo in the bath, so be prepared).
When to seek help
Very rarely, constipation can be a sign of an underlying health problem. If a baby under 6 weeks is constipated, you will need an assessment by a doctor to exclude an underlying condition.
Take your baby to a doctor, or seek help from a midwife or child health nurse if:
- your baby’s poo is dry and crumbly or like pellets, or they seem to have pain and discomfort when doing a poo
- your baby is constipated and they are gaining weight slowly
- they have blood in their poo
Sources:
Eat for Health (Infant feeding guidelines), Reflux Infants Support Association (Constipation, Motility Disorders and GORD in Children), The Royal Children’s Hospital Melbourne (Constipation), The Sydney Children’s Hospitals Network (Constipation)