Most babies who appear to have newborn constipation have functional constipation.1 This is temporary constipation caused by a diet change, growth spurt, or just being a newborn. Infants are born with weak abdominal muscles and immature sphincters, so straining to have a bowel movement can be normal, especially if they have a soft stool after a few minutes of straining.2 Organic constipation is caused by a medical problem such as a disease or deformity.3
Baby constipation is common, with 3%-5% of doctor visits for children related to constipation issues.1 As a parent, you must know your baby’s bowel movement (BM) patterns to notice changes. Then, monitor the changes to see if you need to contact your provider. Most parents worry about newborn constipation issues, but it is usually functional, and you can treat it at home.1
How do you know if your baby is constipated? There are several signs to watch for:2,3,4,5
- A smaller number of bowel movements than normal
- Stools that are hard or shaped like pellets
- Large, round stool or watery stool
- They’re straining more than usual
- Fussiness or crying when baby is making a bowel movement, followed by hard stool
- Swollen or bloated belly
- Decreased intake/refusal to eat
- Vomiting
- Blood in the stools (often from an anal fissure)
Each baby develops bowel movement patterns once they consistently eat the same food, formula, or breast milk. So, you will notice if there is a difference in your baby’s pattern. Of course, their pattern can naturally change with age and the types of food introduced into their diet. For example, it is normal for exclusively breast-fed babies to pass gas frequently but only have a bowel movement every four to seven days.5 However, some breastfed babies poop after every feed!
Most formula-fed infants have anywhere from one to four BMs per day. Some infants will have a BM with every feeding, while others may go every one to three days.3,6 Just be aware of your baby’s BM pattern and watch for changes.
Baby constipation is most common when there is a diet change for the baby. This includes changes from breast milk to formula, from one formula to another, and when solid foods are introduced. If you see a difference in your baby’s pooping pattern, or if the stool (poop) is hard and not easy to pass, your baby could be constipated.4
Some other causes of newborn constipation could be:3,4,8
- Not drinking enough fluid
- Low fiber in the diet
- Immature digestive system in newborns
- Weak abdominal muscles in newborns
- After an illness
- A medical disease or anatomical malformation, such as Hirschprung’s disease
Regardless of the cause of your baby’s constipation, if it doesn’t resolve after two weeks with home remedies, you should contact your provider.7
There are many ways to help your baby poop. One of the easiest ways to relieve baby constipation is a diet adjustment.2,4,5 Remember to experiment with the amounts of added food or liquid items. It is best to only change one thing at a time and no more than one thing per 24-hour period. You do not want to give your baby diarrhea. Also, always check with your doctor before adding water, juice, or cereal to your baby’s diet. Here are some simple ways to help your baby’s constipation:2,4,5
- Add water to their daily routine: Start with 1-2 oz daily, but not at regular feeding time. This is not recommended for young infants as people often misunderstand and add too much water, resulting in hyponatremia.
- Add 100% apple, pear, or prune juice for babies, which are good for constipation: You might start with 2 oz of juice, one to two times a day, but not at regular feeding time. Go slow and follow your doctor’s orders.
- Increase fiber in the diet: You can do this by adding wheat, oatmeal, or barley cereal. Avoid rice cereal, as it might cause constipation, and there are concerns it contains inorganic arsenic.9 Limiting this is also essential as these increase calories that are not particularly beneficial to growth.
There are also other ways to help with baby constipation that don’t include a diet change to help your baby pass their stool (poop). For example, you could try body positions to help the newborn poop, the belly press trick, and rectal/anal stimulation:4,5
- Give the baby a warm bath: It can relax them and make it easier to pass the stool.
- Exercise the baby’s legs like they are pedaling a bicycle: This can help stimulate the bowels.
- Position or push the baby’s knees up to the chest: This puts the body in a squatting position (even though they are lying down), which helps release stool from the anus.
- Gently massage or press on the belly: Start at the lower right corner of the abdomen. Move upward in a straight line, then across the belly at the belly button level toward the left side and down to the left corner.
- Use a rectal thermometer to stimulate the anus: Put the thermometer in the anus as if you were taking their temperature. You can also do this with a cotton swab by adding some Vaseline to the swab and inserting it into the anus — only insert the tip of the swab.
You must contact your provider if none of the above home remedies relieve your baby’s constipation. They may suggest using a baby glycerin suppository or an enema.
If you decide to use a home remedy to help with your baby’s constipation, you should always follow your provider’s advice. If the home remedies don’t produce results after two weeks, contact your provider for further instructions. But if you see any of the following signs or symptoms in your baby, call your doctor immediately:1,4
- Blood in the stool, which could indicate an infection in babies
- Black-colored stools which can mean there is blood in the digestive system
- Large bloated and distended belly, along with not wanting to feed and signs of constipation
- Vomiting develops after symptoms of constipation and belly bloating
Preventing baby constipation isn’t the best way to look at the situation. You never know when your baby may get constipated and need some help with passing stool. You should consistently monitor the stool for signs of constipation but can’t prevent it. And if you try too hard to prevent constipation, you may end up with the opposite problem — diarrhea.
The best way to prevent baby constipation is by following a proper diet, following your provider’s instructions about the baby’s diet, and remembering how to treat baby constipation. Here is a list of some general guidelines you can follow to try and help prevent baby constipation:7
- Ensure plenty of fluid intake: Ensure your baby is feeding the proper number of times per day for their age. Your provider can give you this information.
- Use proper amounts of fiber in the diet: Different baby foods contain different amounts of fiber. Pears, peaches, plums, and prunes (or any of their juices) contain high fiber.
- Frequent monitoring of stools: It’s easy to monitor your baby’s stool since you and your family are the most frequent diaper changers. If there are fewer dirty diapers than usual or the stool seems hard and pellet-like, that’s the time to help your baby with constipation.
- Regular exercise and tummy: Exercise for babies includes tummy time. This is where you lay them on their belly for a small amount of time a few times a day, moving their legs in a circular motion as if peddling a bike. Do this while playing with them or during a diaper change, and some of the swings and bouncy seats give your baby a chance to exercise.
As a pediatric registered nurse, over the years, I have heard many parents mention the fastest or most effective way that helped their baby to poop. Here are some of the “winners” of the “I got my baby to poop” category:2,4,5
- If your newborn is passing gas but not pooping, they will be pooping soon. The gas indicates the intestines are working and moving the stool along. Be patient.
- The general rule for fruit juice is to give a baby 1 oz for every month of life. So, a 2-month-old can have 2 oz of fruit juice per day.
- Rectal stimulation with a rectal thermometer or a cotton swab two to three times daily is one of the easiest and most effective home remedies for constipation.
- Make sure the baby gets regular exercise and tummy time.
- Never give a baby stool softener, laxatives, or an enema without contacting your provider.
All babies have their systems and respond to constipation home remedies differently. And since babies grow and change rapidly, you might find it frustrating to keep trying multiple remedies until you find the one that works for your baby. This is normal. Try to be patient. You will become aware of your baby’s BM pattern. Once familiar with their pattern, it will be easy to recognize signs of constipation. You can help them easily with all the tips and tricks when that happens. Then you, like many other parents and caretakers, can start your baby on the road to smooth and easy BMs. Happy diaper changing!