As with adults, constipation is a common issue in babies and children. Constipation is typically defined as a condition in which you have fewer than three bowel movements in a week. But this definition doesn’t quite apply to babies, because their “normal” bowel habits vary greatly depending on their age and what they eat. If your baby isn’t having regular bowel movements, this doesn’t necessarily mean that he or she is constipated.
Normal Bowel Habits for Babies
In their first week of life, newborn babies have multiple bowel movements — about four — each day, with infants feeding on breast milk typically having them more than those drinking formula. Their stool is soft or liquid. Breastfed babies between one week and three months old have an average of three soft bowel movements each day, although this number can vary greatly. For instance, some infants may pass stool only once a week, while others may do so after each feeding. Infants of the same age who are drinking formula also tend to have about three bowel movements each day, but the type of formula they drink affects the consistency of their stool. Compared with formulas containing hydrolyzed milk proteins, formulas containing soy or cow’s milk often produce firmer stools. Babies typically shift to having only one to two “formed,” or more solid, bowel movements a day by the time they’re 2 years old. Importantly, straining to have a bowel movement — even to the point of getting red in the face — is normal for infants because they have weak abdominal muscles. This straining is no cause for concern if your baby is able to pass soft stool within a few minutes.
Causes of Baby Constipation
Constipation is rare in babies who are breastfed. It most commonly occurs in infants who are feeding on formula, or who are transitioning to solid (cereal or puréed) food. In rare cases, constipation may develop from medications or certain health issues, such as:
Hirschsprung disease, an abnormal development of nerve cells that affects the function of muscles in the large intestineSpinal cord issuesAbnormal development of the anusInability to properly absorb nutrients
Signs of Constipation in Babies
Your baby may be constipated if he or she is unable to pass soft stool within a few minutes of straining. Other signs of constipation include:
Having stool that is hard or pellet-likeCrying while having a bowel movementPassing stool less frequently than what’s considered normal for your infantMaking unusual movements while passing stool, such as arching the back or tightening the buttocksHaving a belly swollen with gas
In serious cases, constipation may also cause severe pain and rectal bleeding.
Constipation Treatment for Babies
If your baby is 4 months old or younger and is constipated, seek medical treatment from your pediatrician. If your baby is at least 4 months old, you can feed him or her fruit juice such as prune, apple, or pear juice, which contains a natural laxative called sorbitol. You can also mix the juice with cereal or purées. Check with your pediatrician to find out how much fruit juice is safe to give your baby. Dark corn syrup was once an effective home remedy for infant constipation because it also contained sorbitol. The corn syrup sold in stores today, however, doesn’t have same the chemical makeup and is not considered an effective solution for constipation. High-fiber (barley-based) cereals and high-fiber fruits and vegetables — such as puréed apricots, sweet potatoes, peaches, and spinach — may also help relieve constipation.
Constipation in Children
Children get constipated for the same reasons that adults do: They’re either not getting enough fiber and fluid to keep them regular, or they’re ignoring the need to have a bowel movement. “A child may have a hard bowel movement and will then start to withhold the stool,” says Marsha H. Kay, MD, a pediatric gastroenterologist and head of pediatric endoscopy at the Cleveland Clinic Children’s Hospital in Ohio. “Then, they develop a bad pattern with it so they’re not going normally. The stools get large and hard and painful, and they won’t have a bowel movement.” Children may also avoid having a bowel movement because they:
Are embarrassedDon’t want to stop playing to use the bathroomDon’t want to use a bathroom outside of their homeHave anxiety about toilet trainingDon’t feel the need to go any more because they’ve previously resisted the urge
The first step toward relieving your child’s constipation pain is by making sure that diet isn’t the source of the problem. Kids need plenty of fiber and fluids to prevent and treat constipation and encourage bowel movements. “Fiber and dietary modifications would be the first treatments, and there’s a variety of medicine used to help soften the stools,” says Kay. “Sometimes, there is also behavior modification that needs to be done, particularly with kids who are withholding.” To encourage your child’s bathroom habits and manage constipation:
Encourage your child to go to the bathroom as soon as he feels the urge, rather than waiting until it’s an emergency.Make sure your child feels relaxed on the toilet — don’t rush him.Create a routine and schedule for time to sit on the toilet and try to have a bowel movement.
