Regular periods of eating, sleeping and pooping are highly praised characteristics in infants. Parents who notice decreases in the frequency of their child’s bowel movements are right to be concerned. However, there is flexibility in what is considered a normal pattern: some infants have a bowel movement after every feed and others, every couple of days. If stools are large and soft and the infant is comfortable before and after passing them, frequency is less important. Rarely, constipation is a sign of a metabolic or structural problem. If symptoms worsen after a few days of home care, or other symptoms such as fever, vomiting or bloody stools are present, call your pediatrician.
Symptoms of constipation include:
- passing very hard or dry stools
- painful stools
- changes in frequency (decreases in normal pattern)
Tips for handling your infant’s constipation at home:
- Breastfeed your baby, it is your best line of defense. Breast milk is easier to digest than infant formula because it is specific to the needs of human infants. It helps promote bowel regularity, mature the digestive tract and protect it from infection. Contact a La Leche League leader or lactation consultant if you need assistance.
- Small, frequent feeds: infants have small tummies. In order to give them a chance to better digest their food, offer smaller feeds, more often in the day. If you normally offer 6 ozs. every 4 hours, try offering 3 ozs. every 2 hours. This method may reduce gas and fussiness as well.
- For babies who are formula fed, ensure that the formula is being properly prepared. Formula that is over concentrated can lead to difficulties with digestion as well as other medical problems. An extra ounce of water can be offered a couple of times a day to ensure adequate hydration.
- For some formula-fed babies, the answer is switching formulas. The iron in formula is often blamed for constipation, but there is no evidence that there is a link between the two. And babies need the iron to reduce the risk of anemia. Some babies, however, are intolerant of cow’s milk and do better on different iron-fortified formulas. Note: you should switch infant formulas only under your doctor’s guidance.
- Soft tummy massages, especially while in a warm bath, can help produce a bowel movement. Also, try moving your baby’s legs in a cycling motion while they are lying on their backs to help loosen stools. For older babies, if you are offering foods, try to limit more constipating options such as rice cereal, bananas and applesauce. Instead, try barley cereal, strained pears, plums, and prunes. A couple of ounces of diluted fruit juice, particularly those containing sorbitol, such as prune, pear, and apple juices can be helpful. Do not eliminate iron fortified cereal in breast fed babies as this is essential for their growth and development.
- Check with your doctor to see whether it’s okay or necessary to use an over-the-counter stool softener or glycerin suppository. Always check with your doctor before resorting to this type of treatment. For tips for older babies and toddlers, please see Constipation & Your Toddler.