Constipation in babies

How can I tell if my baby is constipated?

Constipation occurs when your baby has trouble having bowel movements. Signs of constipation include:

• Less frequent bowel movements than usual, especially if your baby hasn't had one for three or more days and is obviously uncomfortable when he does
• Hard, dry stools that are difficult for her to pass – no matter how frequently
• Straining for more than 10 minutes without pooping
• Being fussier or spitting up more than usual

Note: It's common for infants to strain during a bowel movement. If your baby strains and produces soft stool, he's not constipated.

What is normal for your baby?

If you're concerned that your baby may be constipated, first consider what her normal pattern is. How often she has a bowel movement depends on factors such as what she eats and drinks, how active she is, and how quickly she digests food. She may poop after every feeding, or she may wait a day or more in between.

Babies who breastfeed exclusively are rarely constipated. Breast milk naturally balances fat and protein, so it produces stools that are almost always soft – even if your baby hasn't pooped for several days. If your baby is breastfed, there's no "normal" number or schedule – only what's typical for your baby. It's not unheard of for breastfed babies to have one bowel movement a week.

If your baby drinks formula or eats solid food, she'll probably poop at least once a day.

Why is my baby getting constipated?

Possible causes of constipation include:

Solid food. Your baby may become mildly constipated as he eats more solid food, especially if it's low in fiber. (Skip low-fiber traditional first foods like rice cereal in favor of higher-fiber options such as oatmeal.)

Formula. The protein component in formula can cause constipation in some babies. If you're concerned, ask your baby's doctor about switching brands.

Iron drops. While the amount of iron in formula is too low to cause constipation, the higher amount in iron drops can.

Dehydration. If your baby becomes dehydrated, his system will respond by absorbing more fluid from whatever he eats or drinks – and also from the waste in his bowels. The result can be hard, dry stools that are difficult to pass.

Weaning. Decreasing breast milk in your baby's diet can sometimes lead to dehydration, contributing to constipation.

Illness or a medical condition. Although it's uncommon, constipation can be caused by an underlying medical condition such as hypothyroidism, cystic fibrosis, or botulism, and certain food allergies and metabolic disorders. If there doesn't seem to be a reason why your baby passes hard, painful stools, have his doctor rule out these conditions.

How can I treat my baby's constipation at home?

Here are some home remedies to try:

• Help her get some exercise. If your baby's a crawler, encourage her to do a few laps. If she's not crawling yet, try pumping her legs instead. While she's lying on her back, gently move her legs in a forward, circular motion as if she were pedaling a bicycle.
• Massage your baby's belly. For step-by-step instructions, watch this video about baby massage for helping digestion.
• If you feed your baby formula, ask her doctor about switching to a different brand or type.
• If your baby is old enough to eat a variety of solid foods, cut down on constipating foods like rice and bananas. Try higher-fiber foods such as pureed prunes, peas, apricots, or pears, or whole-grain cereals to help loosen her bowel movements.
• If your baby is passing such hard, dry stools that you see a little blood or even slight tears (fissures) in the delicate skin near the opening of her anus, you can apply an ointment such as petroleum or nonpetroleum jelly to the area to help it heal. Keep the area as clean and dry as possible, and mention the fissures to your baby's doctor.

What about juice or water?

While the American Academy of Pediatrics recommends not giving a baby younger than 12 months any juice, a little prune, apple, or pear juice in addition to usual feedings is okay to help relieve constipation. These fruits contain sorbitol, a sweetener that acts like a laxative. Make sure the juice is 100 percent fruit with no added sugars.

If your baby is 4 months or older, you can offer 2 to 4 ounces of juice per day, but for no longer than a week or two. If your baby is between 1 and 4 months old, talk to your doctor before offering juice.

You can give your baby water once he begins eating solids. For babies between the ages of 6 to 12 months, the Centers for Disease Control recommends offering 4 to 6 ounces of water a day.

What about laxatives?

Never give your baby an over-the-counter laxative without consulting her doctor first. The doctor may recommend one of these types of laxatives:

• Stool softeners draw water into the stool, making it more comfortable for your baby to poop.
• Glycerin suppositories relieve severe constipation by stimulating your baby's rectum. Using a suppository occasionally is fine, but don't do it on a regular basis because your baby could wind up relying on them to have a bowel movement.

When should I call the doctor?

Call the doctor if your baby is younger than 4 months old and:

• Has very hard stools
• Hasn't had a bowel movement within 24 hours of when he usually goes

Call the doctor if your baby of any age:

• Isn't eating
• Loses weight
• Is vomiting
• Has a swollen belly
• Has blood in his stool
• Fusses when he poops
• Isn't helped by basic treatments, such as an adjustment to his diet

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