Constipation in Babies & Treatment

Since time began, parents have worried about their baby’s pooing habits. The smallest change from their usual elimination routine can add to an already long list of things to be concerned about.

But fret not. There’s a lot to learn about constipation, what can be done, and importantly, when it is reasonable to become anxious. Bear in mind that constipation is very rarely a cause for medical concern. Most often, constipation only causes the baby temporary discomfort which is quickly forgotten once they have pooed. And importantly, provides immediate relief to anxious parents.

What is Constipation?

Constipation is about how firm poos are, not about the frequency they are passed. Every baby has their own individual bowel habits and many factors influence pooing. Diet, fluid intake, movement, sleeping habits and general behaviour all play a role when it comes to pooing.

Babies do not need to have a poo everyday to stay healthy. In fact, many babies don’t poo for several days, especially breastfed babies who may not poo for a week or more. Some days, babies poo more often. Some seem to ‘hold on’ for a few days and then have several poos within a few hours. There is no one ‘right’ pattern when it comes to pooing behaviour. 

It’s normal for poos to be firmer when they first come out, and then become more pasty and soft.  Sometimes babies strain when they first start pooing, but relax once they’ve passed the initial poo with a firmer consistency.  

Poos can also vary in colour from bright yellow to dark, khaki green. Knowing what to expect and what’s a little more unusual can help parents to understand what’s going on with their baby’s gut.  

Breastfed and formula fed babies have different bowel habits.  Breastfed poos tend to be softer, more yellow and runny.  Formula fed babies have firmer poos which have a stronger smell. Comparing the two is rarely useful, as is comparing individual babies. 

What Do I Need to Know About Baby Constipation?

Remember, constipation refers to the consistency of bowel motions, not the frequency. So even if your baby hasn’t pooed for a couple of days, this isn’t necessarily a sign that they are constipated.

• Pooing infrequently is not always a sign of constipation and may just reflect an individual baby’s bowel pattern.
• All babies are unique and their bowel habits are not exempt from differences. Some babies have looser poos and others more firm.
• Changes in feeding, routine and general behaviour can influence the frequency of bowel motions.
• Baby poos often bear a resemblance to what the baby has eaten. Food begins its digestion in the mouth and goes through a series of changes until most of the nutrients have been extracted. Whatever food isn’t used by the body becomes waste.
• Babies who eat a lot tend to poo a lot. That’s just the way it is.

How Would I Know If My Baby Is Constipated?

• If there is a change from the frequency of their normal bowel habits.
• If they are straining, going red in the face, becoming distressed and appear to want to poo but nothing is happening.
• If they pass dry, hard pebbles rather than soft poos.
• If their tummy is hard and distended (bloated).
• If there is a change in your baby’s feeding. Some babies don’t want to feed as much or as frequently if their tummy already feels full.

What’s Going On With You?

Many babies grunt, groan and make a lot of noise when they’re pooing. They strain, go red in the face and make noises which suggest they’re really struggling to fill their nappy. However, all that noise doesn’t necessarily mean they’re constipated.  Some babies just use a lot of energy trying to pass a bowel motion, and when they do the result is completely normal.

Some babies don’t make any outward signs when they need to poo. The first indication can be a rather distinctive smell coming from their nappy area.

Although difficult at times, it’s important for parents not to show any outward signs of displeasure when changing their baby’s dirty nappy. It’s healthy for children to learn that pooing is a normal process and early messages help build positivity. Nappy changing is one of the many parenting skills which build over time, and with repeated practice and exposure the process becomes easier. 

There was undoubtedly a time when you would never have entertained the idea of wanting to know so much about baby poo.

Treatment for Baby Constipation

Watching a constipated baby strain to try and force out a hard poo can be almost as distressing for parents as it is for the baby.

Fortunately, there are things you can do to help relieve your baby’s constipation. Generally, simple dietary changes have a flow-on effect towards creating changes in a baby’s bowel habits. 

For babies who are not yet having solid food:

• Extra milk feeds may help. If you are breastfeeding, offer your baby an extra breastfeed or two during the day or late evening.
• If you are formula feeding, offer your cooled, boiled water in-between their feeds. 
• Make sure you are preparing their formula exactly as instructed on the Tin.

For babies who are eating solid food:

• Extra fruit and vegetables in their diet will help to boost fibre intake.
• Pureed carrots, pumpkin, green vegetables and pureed apples all contain high quantities of fibre.
• Offer your baby a cup of cooled boiled water to sip on when they’re having their meals.

Important

Occasionally, constipation is a sign that the baby’s gut is not working as it needs to. It’s important to see a health professional if you are at all concerned about your baby’s bowel habits.  Before giving your baby any medication or treatments which you feel could help them to poo, first consult with a doctor.

How Can I Help My Constipated Baby?

• Give your baby some time with their nappy off each day. Being able to kick freely while not constrained can be helpful.
• Gently massage your baby’s tummy in a clockwise direction.
• Give them a deep, warm bath and let them move around freely whilst you hold them securely.
• Bicycle your baby’s legs. Lay your baby on their change mat and flex and extend their legs. Pushing their legs gently up onto their chest can help to relieve feelings of discomfort.
• Avoid becoming too obsessed about your baby’s bowel motions. As long as they are still feeding well, appear happy and aren’t bothered by their pooing habits, then try not to be either. Follow their lead and try to stay calm.

What Are the Best Foods for Constipated Babies?

If your baby is breastfed, offer them extra feeds. Top-up breastfeeds are a good option for increasing milk intake. If they are bottle fed, an extra feed or some cooled boiled water between feeds may help. If you are breastfeeding, increase your own intake of fibre rich foods. Sometimes there is a flow-on effect to the baby. You may also like to try increasing your baby's intake of fresh fruit and vegetables. If they are too young for solids, extra milk feeds will help. If they are not too young for solids, offer pureed carrots, pumpkin, sweet potato and broccoli. Avoid offering too many white or processed foods such as pasta, bread, rice and potatoes.

What Not To Do For Your Constipated Baby

• Give laxatives, suppositories or enemas unless you’ve been advised to do so by a health professional.
• Sit them on the toilet or a potty believing this will help. Toilet training is a developmental stage in the toddler years and requires a complex sequence of nervous system maturity.
• Compare their bowel habits with other babies. Every little person is an individual and there are too many factors which play a role in bowel habits and frequency.
• Make too many changes to their milk or solid food intake. Lots of changes at one time can have a negative effect and the baby may start having very loose poos.
• Massage their tummy very firmly. A baby’s gut is still immature and easily damaged through rough handling. Always be gentle.

If Dietary Changes Don’t Help

One of the functions of the large bowel is to reabsorb water from the poos so they aren’t too loose. If poo sits in the large bowel for a few days, too much water is reabsorbed. This means the poos become dry and hard to pass. Sometimes the poo becomes too big, dry and impacted for the baby to push out.

Always speak and check with a qualified nurse or healthcare professional about your baby to understand what your baby’s individual needs are, especially if you are ever concerned about your baby's well being.

When to See a Health Professional About Your Baby's Constipation?

• If your baby is aged less than two months of age and they haven’t pooed for a few days.
• If your baby passes blood in their poo.
• If your baby is not feeding well or seems distressed in any way.
• If your baby seems unwell.

Remember,

Speak with your Child Health Nurse or doctor if you are concerned about your baby’s bowel habits. Constipation can be a sign of insufficient milk intake or, more uncommonly, health concerns.