If your little one is struggling to poo, they’re probably suffering from infant constipation. Here’s what to do.
Medically reviewed by Dr Roger Henderson and based on a text by Jane Tanghøj, health visitor
A baby who is just breastfeeding can often go days or even a week between bowel movements, which means it can be difficult to detect whether your baby is constipated.
While baby constipation is not usually serious, it can cause quite a bit of discomfort for your baby and be worrying for you.
So how can you help your constipated baby poo normally? We look at the causes, treatment and prevention for constipation in babies:
What is baby constipation?
Constipation is a condition where stools (faeces or poo) become firmer and harder so that they can no longer be easily passed out of the body. Your baby may be troubled or in pain when they need to empty their bowels, and the bowels will not be emptied as often as usual.
When a baby first becomes constipated, it can be the start of a vicious cycle. This is because your baby may find it painful to pass the large hard stools that have gathered in the intestine. Cracks around the anus may appear. These may start to bleed and cause more pain.
To avoid the pain, your baby may subconsciously start holding back stools, which makes the stool stay longer in the large intestine. As a result, your baby’s body will absorb more water from the stools making them even harder. This can cause your baby to remain constipated.
A baby who is constipated often has colic pains (rhythmic spasms of pain in the abdomen from the intestines), because the large amount of stool in the intestines makes the intestines dilate and more actively try to clear out their contents. In some cases, the child may not want to eat and may even retch a little.
Signs of baby constipation
The following symptoms may be signs that your baby is constipated:
Causes of baby constipation
There are a number of causes of baby constipation, which can be related to how you feed your baby:
Constipation in the breastfed baby
A breastfed baby will very rarely get constipation because breast milk is more easily digested. Breastfed babies have several helpful types of bacteria in their large intestine that are capable of breaking down some of the otherwise indigestible carbohydrates, proteins and fats in milk. As a result, their stools are softer, making bowel movements easier.
Breastmilk also contains a hormone called motilin that increases the movement of the baby’s bowels, helping them to empty. Further protection against constipation comes from the fact that a breastfed baby can draw as much milk as they need from the breasts.
A breastfed baby will very rarely get constipation because breast milk is more easily digested.
Dehydration can cause constipation. But if a breastfed baby is a little dehydrated or dry he or she can usually simply take more milk, unlike a bottle fed baby who can drink no more than what is in the bottle.The composition of breast milk also changes as your baby grows older, so it will supply the needs of your baby at all times.
Constipation in the bottle fed baby
Bottle fed babies frequently suffer from constipation because formula milk is harder for a baby to digest and the baby has a limited supply of fluid (ie what is given to them in the bottle).
A baby who receives only formula milk will typically have fewer bowel movements than a breastfed child. Their stools will be thicker and have a different, more greenish colour.
Other causes of constipation in babies
Food (ie type of milk and then the particular foods given after weaning) is usually the cause of baby constipation. However dehydration, especially in hot weather, can be an important contributory factor.
But in some cases, constipation can be a symptom of a more serious underlying disease.If your baby isn’t gaining weight or shows any other unusual symptoms, seek the advice of a doctor.
Bowel movement in newborns
Bowel movement in babies up to six months old
The number of bowel movements a young baby has varies considerably and what is ‘normal’ may range from a bowel movement several times a day to as little as once a week. In rare cases, there can be up to three weeks between bowel movements.
The number of bowel movements a young baby has varies considerably.
Breastfed babies usually have frequent bowel movements until they are two to three months old. Their stools are typically yellow. However they may go for days without opening their bowels.
A young baby should only be given a laxative if he or she is bothered by the long intervals between bowel movements or appears to have difficulty or pain passing stools. It’s best to check with your GP or health visitor before giving a baby a laxative.
Bowel movement in older babies
Bowel movement in babies over four months old
Once a baby starts on transition foods or solids (ie weaning), the frequency of bowel movements and the consistency and appearance of their stools will depend on the food they eat. Your baby’s stools will begin to look a bit more like ordinary stools in consistency and smell.
Once your baby starts eating solid food, the pattern in bowel movements will change. Your infant may have movements several times a day or as infrequently as once every two to three days.
Once your baby starts eating solid food, the pattern in bowel movements will change.
At this point, some babies may get slightly constipated. This is because the intestines have to get used to the new composition of the nutrients and may need a higher fluid intake to deal with some foods, such as fibrous root vegetables like carrots.
Once a baby’s food consists of more solid food, constipation may be caused by dehydration.
Tips to help a constipated baby
Try the following tips to ease your baby’s discomfort:
- Massage your baby’s tummy
Start at the belly button and then massage outwards in circles in a clockwise direction. Some oil or cream on your fingers can also help to lubricate the skin and keep movements smooth and gentle.
Only continue if your baby enjoys the massage and is comfortable and relaxed.
- Move your baby’s legs in a cycling motion
Place your baby so he or she is lying on their back. Hold their legs and turn them gently in a quick cycling motion.
This will make the stomach muscles move and, in turn, put gentle pressure on the intestines, which increases their muscular activity to help squeeze contents through.
- Give your baby a bath
A warm bath can make your baby relax so the stools are passed more easily. Once your baby has relaxed in the bath, you can also massage their stomach (see above).
When you wash your baby’s bottom, apply some cream or petroleum jelly (Vaseline) around the outside of the anus.
- Check you are making formula correctly
If your baby is on formula milk, you should follow the instructions on the package carefully. Making the mixture too thick by putting in more than the recommended amount of powder can lead to constipation and other medical problems.
There are different brands of formula milk on the market, and they are basically of equal quality. It’s often best to stick to the same brand, because different formulas may require different dilutions.
However, some babies get on better with different milks, so if you have problems it may be worth carefully switching to a different brand. Some formula milks even contain prebiotics – food substances which help to grow the number of friendly bacteria in the baby’s intestines – and these may help to reduce the risk of constipation.
- Give cooled, boiled water
You can give your baby extra fluids with bottles of cooled, boiled water. Make sure to test the temperature before you give it.
If the above suggestions don’t work for your baby, consult a doctor about special laxatives for chronic constipation.
Preventing baby constipation
Once your baby is between four to six months old, you can start introducing more porridge and fruit or vegetable purées into their diet.
These are rich in fibre and will help prevent constipation. Apple or prune purée are particularly good for this purpose. However, you may find your baby needs a little more water in order to digest the fibre properly