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Constipation in Infants -- Getting to the Bottom of It

Margie Mars
May 14, 2015

What causes constipation in infants, and what can you do about it?

Constipation in infants can be difficult to deal with. The crying, fussing and sleeplessness are enough to make any parent or caregiver pull their hair out! Far worse is seeing your precious angel in so much pain and feeling helpless. Whether this has been an ongoing problem for your baby or it's her first time, making sure it's real constipation is the first step in finding relief.

Healthy babies can go without pooping for surprisingly long periods, and what's normal varies from baby to baby. Your breastfed baby might only have three bowel movements a week, because the milk is almost completely absorbed. In bottle-fed babies, stools are more bulky, and they can go as long as three days without pooping. (On the flip side, some babies go ten times a day, and that's normal too.) No matter how long it takes, if it comes out soft, he's not constipated. You should talk to your pediatrician if you have any questions about how often your baby goes.

If your baby is around or under four months old, don't let her bowel movement (BM) behavior fool you! Young infants can make a huge production during a BM. They grunt, growl, cry and screw up their faces until they're beet red. But if it comes out soft, he's fine. If BMs come out very dry, like pebbles and after a long time with obvious discomfort, your baby is probably constipated.

Some Causes of Infant Constipation
 

  • Diet Change
    "Infants usually become constipated after a change in diet. If there is a change from breast feeding to formula feeding, or from the bottle to solids," says Dr. Carlo Reyes, a pediatrician and the assistant medical director of the emergency department at Los Robles Hospital in Thousand Oaks, Calif., "an infant's gastrointestinal tract needs time to adjust to the change, and constipation may result."
     
  • Dehydration
    Does she have six to eight wet diapers a day? If not, be on the lookout for dark urine and eyes, soft spots on her head that look sunken, extreme crankiness, dry mouth and lack of skin elasticity that could indicate dehydration. This is a medical emergency -- contact the pediatrician immediately.
     
  • Rare but Serious Conditions
    While very rare, constipation in infants can be a sign of things like diabetes or thyroid problems. "Concerning causes of constipation include obstruction or a condition called Hirschsprung's disease," says Dr. Reyes. This occurs when nerve connections where the colon attaches to the rectum don't develop adequately. When constipation is accompanied by more serious symptoms like vomiting and fever, you should seek an evaluation with your primary pediatrician.
     

Relief From Constipation in Infants
 

  • Water/Fluids
    Dr. Danelle Fisher, pediatrician and vice chair of pediatrics at Providence Saint John's Health Center in Santa Monica, Calif., suggests, "Water can help both breast-fed babies and formula-fed babies." For constipation, "a baby one to two months of age can have one ounce of water a day, spread throughout the day or all at once. For a baby who is older than four months, I recommend trying a mixture of one ounce prune juice and one ounce water daily." If you're breastfeeding, you can also try to add a daily feeding or two. Make sure you stay hydrated, too. Nursing moms should drink at least ten glasses of water every day.
     
  • Fruit
    If your baby is already eating solids, try giving her strained pears (warming them slightly seems to help), prunes, peaches, plums or apricots. Start with a 1/4 cup of fruit or so the first day -- you don't want to overdo it and then have the opposite problem! You can also try undiluted fruit juices. For babies four to eight months old, give two to four ounces of 100 percent fruit juice per day. For eight- to 12-month-olds, give up to six ounces.
     
  • Rectal Stimulation
    Coat a rectal thermometer with a liberal amount of petroleum jelly. Dr. Fisher instructs, "With the baby lying down with a diaper underneath, insert the tip of the rectal thermometer into the anus and twirl slowly in a circle. Remove the thermometer, and poop should come out within 24 hours."
     
  • Warm Bath and Massage Technique
    Famous pediatrician Dr. William Sears has a family trick that can work wonders. He says, "Although it's messy, it works. Immerse your baby in a warm bath so that the water is around chest-high. When your baby is relaxed in the bath, massage baby's abdomen and get ready for the [mess]."
     

Check in with your pediatrician about your baby's constipation for any of the following reasons:
 

  • If these techniques do not relieve the constipation
  • If you are more concerned or your baby is uncomfortable
  • If your baby does not poop for more than 5 days
  • If there is blood in the stool or diaper

 

Margie Mars is the mother of eight and Oma of three. She writes for several top parenting sites and specializes in attachment parenting and autism. Margie and her family live in Oregon.

For more on baby health, check out these signs of dehydration in infants.

* This article is for general informational purposes only. It is not intended nor implied to be providing medical advice and is not a substitute for such advice. The reader should always consult a health care provider concerning any medical condition or treatment plan. Neither Care.com nor the author assumes any responsibility or liability with respect to use of any information contained herein.

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