How to Identify and Relieve Baby Constipation
Ever since baby arrived, you’ve probably talked about poop more than you ever imagined you would. While it might feel overwhelming to change diaper after diaper, it’s even more stressful when baby has trouble pooping or stops going altogether. Baby constipation is rough—and, sometimes, it’s hard to tell if they’re experiencing tummy troubles (how little is too little?). Suffice it to say, you’ve got poop questions, and we’ve got answers. So is your little one plugged up, and what does constipated baby poop look like anyway? Here, we’ll give you the lowdown on baby constipation, symptoms to look for, remedies to try and more. You’ll learn what you need to know to get to the bottom of newborn and infant constipation and get baby’s belly back on track.
In this article.
Baby constipation: What’s normal and what’s not?
Signs of constipation in babies
What causes constipation in babies
How to help a constipated baby
Baby constipation: When to worry
How to prevent baby constipation
To figure out if your child has a bout of baby constipation, it’s helpful to know how often infants typically go. For the first three months, a breastfed baby might have anywhere from five to 40 bowel movements a week. Since breastfed babies absorb so much of the milk they take in, some can go up to three or four days—or maybe even a week—without pooping. Their formula-fed counterparts can have anywhere from five to 28 bowel movements a week (or about two a day). So how do you know if you’re dealing with a newborn constipation? As long as when they finally do go it’s soft, pain-free and blood-free, it’s all good, says Lisa Santo Domingo, a pediatric nurse practitioner and medical director of Johns Hopkins Hospital’s Pediatric Chronic Constipation Clinic.
As infants age, breastfed and formula-fed babies start to have about the same number of poops—so from 6 to 12 months, they’ll both experience an average of two poops a day. But keep in mind that these numbers can vary greatly, as there’s a pretty wide range of what’s normal when it comes to how often baby poops. You might consider counting dirty diapers to help identify baby constipation. But Trina Blythe, MD, a pediatrician at Progress West Hospital in O’Fallon, Missouri, cautions that a lack of stool in diapers for exclusively breastfed babies may actually be a sign they’re not eating enough rather than experiencing constipation. Luckily, there are some other telltale signs of constipation in infants you can more readily rely on.
How can you tell if you have a constipated newborn or infant on your hands? According to Santo Domingo, children up to 4 years of age have to fulfill two or more of the following criteria for at least one month to be clinically diagnosed as constipated:
- Two or less bowel movements per week
- A pattern of painful or hard bowel movements
- History of excessive stool retention
- A large fecal mass felt in the rectum during a physical exam by baby’s doctor
In addition to the symptoms mentioned above, you’ll probably notice a few other signs of baby constipation. Irritability, fussiness, refusing food or pushing away the bottle are often telltale signs of baby constipation. Plus, toddlers who can walk may start going to a corner and squatting or hiding. “The most prevalent cue is when a child starts tip-toeing,” Santo Domingo says. It’s like an instinct they have, feeling that the straighter their body is, the better they’ll be able to withhold poop, which may be painful or scary for constipated children. Even babies who are able to pull themselves to stand will try to straighten out as much as possible when they’re dealing with constipation. Rest assured that these behaviors will likely disappear shortly after baby passes a large stool.
Is straining a sign of infant constipation?
Worried about all that moaning and groaning? Take a deep breath; it’s perfectly normal and isn’t a sign of constipation in babies. “Grunting and straining to push out a stool is normal in young babies,” Blythe says. “It’s difficult for them to pass a bowel movement while lying flat on their backs and not getting any benefit from gravity.”
Babies’ bodies often need time to figure out the whole pooping process, like learning how to relax their pelvic floor to have a bowel movement. “A lot of parents come in and think their child is constipated, when what they’re really dealing with is infant dyschezia—a condition in which an otherwise normal, healthy infant will have at least 10 minutes (though often more) of straining, crying, irritability and maybe turning red or purple in the face while trying to have a bowel movement,” Santo Domingo explains. These symptoms continue until baby finally goes—but the resulting stool is actually soft. And, while they may sound alarming, rest assured these symptoms are a normal part of baby learning how to poop, the American Academy of Pediatrics notes.
What does constipated baby poop look like?
When infant constipation is to blame, baby’s 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.”
Another common sign of constipation in babies is a small amount of blood on the outside of the stool—this can happen when a constipated baby passes stool large enough to create a tiny fissure around the anus. If you’re seeing a significant amount of blood, call your child’s doctor right away.
So what causes constipation in babies? Really, it could be due to a number of factors, from foods they’re eating to passing illnesses to family history. Here, we break down the most common reasons behind baby constipation:
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Change in diet. More often than not, a change in diet is the culprit causing baby constipation—like shifting from breast milk to formula or transitioning baby to cow’s milk. “The introduction of cow’s milk protein—and an allergy or intolerance to it—is probably the largest contributor to baby constipation,” Santo Domingo says. When baby has a cow’s milk protein intolerance (CMPI), their immune system sees the milk protein as something bad it needs to fight off (like it would with harmful bacteria or viruses). 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 it by the time they’re a year old, says Swati Kolpuru, MD, a pediatric gastroenterologist with Banner Health.
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Introducing solid foods: When baby is about 4 to 6 months of age, you can start experimenting with different solid foods. This is when many little ones begin to experience baby constipation for the first time. “For infants who have already started baby foods, giving foods that are high in fiber will help treat and prevent baby constipation,” Blythe says. She recommends feeding them at least two servings of fresh fruits and vegetables daily, and making sure they’re well hydrated.
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Potty training: Kolpuru cites this as a common trigger for constipation in babies. The toilet can be scary for little ones, as they don’t quite understand where their poop goes once it’s flushed. This fear of the potty can cause them to withhold stool and result in constipation.
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Illness: When baby gets sick, they’re probably not eating or drinking as much as usual. This change in diet and lack of water can cause waste to move through the colon at a much slower pace, Kolpuru says. Once baby’s system is thrown out of whack, infant constipation can follow close behind.
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Certain medications: High-dose iron supplements, antacids and certain pain medications can lead to baby constipation, Kolpuru says. If you’re worried baby’s medicine could be to blame, check in with your doctor.
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Family history and genetics: Certain conditions like celiac disease can also be a contributing factor to constipation in infants. If baby’s been introduced to gluten in late infancy and is having trouble pooping, speak with your pediatrician.
Rarely, more serious conditions like cystic fibrosis and Hirschsprung’s disease may be to blame for newborn constipation. Hirschsprung’s disease is a rare congenital condition that affects the gut and causes a “functional obstruction,” Kolpuru says. It occurs in about one out of 5,000 births and is more common in boys. (FYI: This is among the reasons everyone at the hospital closely watches the timing of your newborn passing their first poop. “Having a stool right after birth confirms that there’s no blockage in the intestine,” Kolpuru explains.)
It’s important to realize that constipation in newborns may be caused by different issues than constipation in older babies. If baby is not even one month old yet and has other symptoms such as vomiting, abdominal distension, blood in stools or a fever, talk to your pediatrician right away. “[These] indicate other causes of constipation that could be life-threatening and need immediate attention,” Kolpuru says.
No parent likes to see their child in discomfort and distress, so knowing how to help a constipated baby can make a world of difference. Once you’ve spoken to your pediatrician and ruled out any other issues, there are some baby constipation home remedies and treatments you can turn to. Here are some things you should—and shouldn’t—try to help a constipated baby.
Baby constipation home remedies
For baby constipation relief, you can try giving infants under 6 months with hard bowel movements some water—about one single ounce. Heard of giving apple or prune juice for baby constipation? Constipated babies 6 to 12 months can have two to four ounces of apple, pear or prune juice a day until their stools soften. “The sugars in juice basically bring water into the bowel to help soften the bowel movement,” Santo Domingo says.
You may have been told that using a rectal thermometer can help offer some infant constipation relief, but expert advice for this baby constipation home remedy varies. Santo Domingo doesn’t recommend any kind of rectal stimulation. “You always run the risk of perforation, especially given that that area could be irritated,” she says.
She also discourages giving baby mineral oil or Karo syrup for baby constipation. “We’ve found that it doesn’t help. Karo syrup doesn’t soften the stool—it just coats it to make it easier to pass, but you’re still passing a large stool. And with mineral oil, there have been some reports of aspiration.” Check with your pediatrician and get their input before giving your little one any baby constipation home remedies.
Baby constipation medicine
Wondering what medicine to give a constipated baby? The options are limited. For children who don’t respond to water or juice, Kolpuru suggests trying a small glycerin suppository to help relieve baby constipation. It’s important to note, however, that these are meant for occasional use in constipated infants and shouldn’t be a regular part of baby’s routine.
Some well-meaning friends may recommend gripe water or gas drops as ways to relieve baby constipation. Many parents say that the former alleviates colic and other tummy troubles, while the latter works miracles breaking up gas bubbles. That said, there’s little scientific evidence behind these claims. Plus, you want to ensure all the ingredients in the gripe water and gas drops are safe for baby. Kolpuru remains skeptical on the use of either option for constipation in infants. Instead, she recommends stool softeners (with your pediatrician’s approval), if juice and diet modifications don’t help.
Similarly, probiotics for baby constipation have been increasing in popularity lately. Many parents swear by infant-safe tummy and probiotic drops that can help balance bad and good bacteria in the digestive tract. While the evidence isn’t concrete, some research indicates that prophylactic use of probiotics can help alleviate some types of digestive troubles in infants. However, some experts remain dubious. “Probiotics haven’t yet been proven to relieve constipation in infants, so I generally don’t recommend them,” Blythe says. Whatever baby constipation medication or remedies you opt for, check in with your pediatrician first.
Baby foods that help with constipation
In some cases, your pediatrician may want to consider eliminating cow’s milk for a short period of time to see if that’s causing baby constipation. For babies eating solids, you can also offer certain fibrous foods that help with constipation, including:
- Barley or oatmeal cereals
- Prunes, peaches, plums, pears and apricots
- Other soft, fibrous and pureed fruits and vegetables
Wondering if there are solids to eliminate for constipated infants? “Bananas and rice are common binding agents, because they’re soluble fibers that soak up water as they pass through your system, and tend to bulk stools,” Santo Domingo says. While there’s no need to completely get rid of binding foods, it’s a good idea to cut back on them if you’re noticing baby constipation symptoms.
Baby massage for constipation
Want to know how to relieve constipation in babies quickly? One of the easiest things you can try is giving baby a massage. Blythe recommends trying a gentle tummy massage of the left side of the belly to help stimulate the colon. And you can do exercises with baby as well. “Bicycling the hips and holding the knees up in a squat position help simulate the movements needed to have a bowel movement,” Blythe says. You can also try a warm bath to help relax those muscles.
Baby constipation can be pesky, but it’s typically not cause for concern. Still, if baby’s constipation lasts for two or more weeks, or if it’s accompanied by other symptoms, including a fever, abdominal swelling and blood in your child’s stool, reach out to your pediatrician to make sure there are no other issues at play, the Mayo Clinic recommends.
As for preventing infant constipation, unfortunately, there’s not a lot you can proactively do. “Prevention really comes down to recognizing the warning signs, and trying to stay on top of them,” Santo Domingo says. Of course, monitoring baby’s diet for foods that cause constipation, giving them a diverse assortment of fibrous fruits and veggies and keeping them hydrated can always help.
It’s never fun watching your little one struggle with constipation, but rest assured, more often than not, constipation in babies is nothing to worry about. And if you do find yourself with questions or concerns, don’t hesitate to talk to your pediatrician.
About the experts:
Trina Blythe, MD, is a BJC Medical Group pediatrician at Progress West Hospital in O’Fallon, Missouri. She received her medical degree from Albany Medical Center in New York.
Lisa Santo Domingo, DNP, MSN, is a pediatric nurse practitioner and medical director of Johns Hopkins Hospital’s Pediatric Chronic Constipation Clinic. She received her doctor of nursing degree at Johns Hopkins University in Baltimore, Maryland.
Swati Kolpuru, MD, is a board-certified pediatric gastroenterologist with Banner Children’s Specialists Gastroenterology Clinic in Mesa, Arizona. She earned her medical degree from King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College in Mumbai, India, where she also completed her residency. She completed a second pediatrics residency and her training in pediatric gastroenterology at the University of Maryland Medical Center.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
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