Constipated baby 3 weeks old
Symptoms, Treatment and When to Call a Doctor
Nationwide Children’s Hospital
Constipation (con-sta-PA-shun) in infants can worry parents. Most of the time, your baby is not really constipated. They may not have developed a routine for pooping yet. Some babies do not develop a bowel movement (BM) pattern for a while.
An infant’s BM pattern can change if their diet changes, like switching from breastmilk to formula, starting solid foods, or drinking less formula than usual. If your baby’s stool (poop) is not soft or easily passed, then they may be constipated.
In rare cases, constipation may be caused by a lack of nerves going to the intestines or by a problem with the way the intestine formed at birth. Your baby can be tested for these conditions if your health care provider feels it is needed.
Signs of Constipation
- less stools than their usual pattern
- straining more than normal to have a bowel movement
- a change in how the stool looks from soft and mushy to:
- small, hard pebbles, or like a large, round golf ball
- loose and watery
- abdomen (belly) bloated or swollen with gas
- painful cramps
Treatment
- If your baby is not eating baby food yet, you may give 1 to 2 ounces of 100% fruit juice (pear, prune, cherry, or apple) once a day. Stop the juice if their stools become too loose.
- If they are old enough to eat baby foods, feed them pureed pears, peaches, or prunes instead of giving them juice.
- If your baby eats cereal, it may help to give oatmeal, wheat, or barley cereal. Rice cereal can cause constipation in some children.
- Sometimes giving your baby a warm bath to relax them or exercising their legs, like riding a bicycle, will help stimulate the bowels to move (Picture 1).
- If it has been a few days since your baby has pooped and the juice or pureed food has not worked, then you can try a glycerin suppository. Place your baby on their back. Gently push the suppository into their anus (bottom). Suppositories are meant for occasional use.
- Contact your baby’s health care provider before giving them laxatives, baby mineral oil, or enemas to treat constipation.
Medical Therapy
Your child’s health care provider may order the following treatments:
- Give your child medication.
- Check your child’s temperature using a digital, rectal thermometer. Put a small amount of petroleum jelly (Vaseline®) on its tip before inserting into the rectum. Taking a rectal temperature may stimulate the baby to pass stool.
When to Call the Health Care Provider
Call the health care provider if any of the following occurs:
- Your baby is irritable and seems to be having stomach pain. Infants will pull their legs up to their stomach and cry when they are in pain.
- Your baby has constipation and develops vomiting, and their belly looks like it is bloated or filled with gas.
- You see blood in their stool.
- Their constipation does not get better with treatment.
If you have any questions or concerns, call your baby’s health care provider.
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Constipation in babies - causes, signs and treatments
Constipation in babies - causes, signs and treatments | Pregnancy Birth and Baby beginning of content5-minute read
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What is constipation?
Constipation is when your baby’s poo is hard and dry, making it difficult for them to poo. Sometimes, doing a hard poo can be painful. It’s common for babies to have constipation when they are changing from formula or breast milk to solid foods.
What is normal?
All babies are unique, and this includes how often they poo. There is a very wide range of ‘normal’. Some babies poo after every feed. Others will only poo once every few days. When it comes to how often they poo, once in 7 days, or 7 times in one day are both fine, so long as your baby is happy and well. But while the number of poos is not critical, if your baby seems to have pain when trying to poo or has a very hard, dry poo, you can speak with their doctor or child health nurse for advice.
Why is my baby constipated?
One of the main causes of constipation in babies is a change in diet. A change in diet may include:
- changing from being formula-fed
- changing from being breastfed
- exposure to new foods and flavours
- not drinking enough liquids (breastmilk, formula or water)
It is more common for bottle (infant formula) fed babies to have constipation than breast-fed babies.
If your baby has started eating solid food, a lack of fibre in their diet may also potentially cause of constipation. Some babies simply have a natural tendency towards constipation, even when they have a good diet and drink enough fluids. This doesn’t mean they are unhealthy or unwell.
Baby poo guide
Learn more about your baby's poo.
In extreme cases, rare illnesses can cause constipation such as:
- problems with nerve endings in the bowel
- problems relating to the spinal cord
- thyroid deficiency
- other metabolic disorders
All babies are checked for these conditions, so this is usually not something you need to be concerned about. But if you are worried about your baby or are notice that pooing is painful for them, seek medical advice.
How to recognise the signs of constipation
The main signs of constipation are hard, dry poos. The following are other signs of constipation:
- Your baby may show signs of straining when trying to pass a poo.
- Your baby may be unsettled, may seem fussy or irritated.
- Your baby may be eating less or feeding less well than usual.
- A tear or crack might appear in the skin around the anus, which may at times bleed.
In some cases, if your child is constipated, they may look bloated or their stomach may appear larger than usual. It can be possible to feel their poo (hard, solid lumps) while pressing softly on their stomach.
How to treat constipation at home
Try these tips to help babies who have difficulty passing poos:
- If your baby has infant formula, always measure the water first before adding the formula powder — this helps ensure that the ratio of water-to-formula is correct.
- If your baby is old enough to drink water, offer extra drinks (boiled and cooled first).
- Gently rub their stomach to help stimulate the bowel — your baby might also feel better with gentle massage to help manage the pain of constipation.
- A warm bath can help calm and settle your baby and relieve discomfort.
If your baby is older than 6 months, add some extra fruit and vegetables to their diet to boost their fibre intake.
If your child is older than 9 months, adding stewed prunes or apricots to their meal may help. They can have up to 3 tablespoons, 3 times a week. Cereal that has bran may also help mild constipation. Older babies can try prune juice diluted with water (half prune juice and half water). Start slowly, with 10 millilitres. Increase as needed until they can do a soft poo.
Does my child need to see a doctor?
Constipation is common. Often it will pass without intervention, or with the help of the strategies listed above. If you are worried that your baby has constipation, is uncomfortable or is in pain, their doctor can assess them and recommend baby-safe strategies. There are medical treatments for constipation that your doctor may consider, based on your baby’s circumstances.
If your baby was previously treated for constipation but still struggles to poo, it is important to go back to your doctor for a review. There are several treatments they can try.
Speak to a maternal child health nurse
Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
Sources:
The Royal Children’s Hospital Melbourne (Kids Health Information 2020 - Constipation), Queensland Health (Constipation in children), Perth Children’s Hospital (Constipation in children)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: September 2021
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What to do with constipation in a newborn?
Constipation in a newborn or infant is an extremely unpleasant problem for parents. And it is not always possible to quickly determine what is the cause of constipation in an infant. Most often, problems with bowel movements in babies are functional in nature and are directly related to the nutrition of the child.
Signs of constipation in a child of the first year of life
- Infrequent dry and hard stools
- Sleep disorder
- Troubled state nine0007 Pungent odor of feces and flatus
Causes of constipation in a newborn child
Causes of constipation in newborns and infants, as a rule, are not associated with a serious pathology of the internal organs or the central nervous system. The main cause of constipation in a baby is malnutrition, early transfer of a child to supplementary feeding with infant formula, frequent changes in products during artificial feeding.
When breastfeeding, the formation of constipation in children of the first year of life is affected by poor nutrition of the mother, for example, the use of large amounts of animal fats and a lack of fiber in the diet. One possible cause of constipation in newborns is dehydration. nine0003
What to do if a child has problems with stool
- If a child under one year old has acute constipation and there is anxiety, straining and arching, we actively massage the abdomen in a clockwise direction so that hand marks remain on the skin (but not bruises!) . We spread it on the stomach, do the exercise - legs to the head, children under one year old can massage the anus, if all this does not help - a children's candle with glycerin from the refrigerator.
- If such situations are repeated often - a mandatory consultation with a pediatrician. nine0008
- When introducing complementary foods to a baby with a tendency to constipation, introduce fruits and vegetables into the diet first.
- If the child is older than a year and the process is chronic - evaluate nutrition - whether there are the necessary 5 servings of vegetables and fruits per day (portion - from the palm or fist of the baby). Estimate - how much water does the child drink per day? Is there enough physical activity during the day? What is the psychological climate in the family and the attitude - not to demand a chair from the child, not to swear and not to shout, not to discuss problems with other people in his presence, not to force him to sit on the potty, not to scold him for dirty panties when anointing. nine0008
- It is better to choose laxatives based on macrogol or lactulose with the help of a doctor.
- In parallel with laxatives, we conduct psychological work with the child at home and with a specialist - books about defecation, toilet games, etc.
In what case should you be very worried about constipation in a child? Namely:
- if there is no meconium discharge in the first days of life; nine0008
- retardation and constipation;
- vomiting and tense abdomen;
- blood in stool;
- changes in hair growth and pigmentation of the sacrum and coccyx,
- violation of the development of the sacrum;
- changes in the anus - fistulas with discharge, hematomas, inflammation;
- change in the muscular skeleton of the anterior abdominal wall - lack of muscles or insufficient development.
If a baby up to a year old is breastfed for several days (3-5 days, but not weeks!) Does not poop and does not worry - if he is cheerful and cheerful, eats well, does not spit up and does not stain the diaper, and farts well, in this no parental intervention required! The stool should be soft and not cause trouble during bowel movements. nine0003
In the treatment of constipation, toilet training is important - every day at the same time, preferably after eating and drinking - calmly and kindly go to the potty (if the toilet is, then there should be a support under the feet so that the knees are above the level of the priests) and try to poop. If there was no stool for several days, you can pre-put a glycerin suppository.
In the presence of painful defecation, fissures and blood, urgently show the child to a doctor (gastroenterologist or proctologist) and start treatment - local baths, suppositories and laxatives are applied. This is absolutely necessary in order to soften the stool and prevent the formation of persistent fear of defecation, which is then very difficult to remove. Before defecation with a dense stool, you can additionally lubricate the anus with baby oil. nine+7 (423) 267-61-30; +7 (423) 274-32-22; +7 914-704-32-22.
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Constipation in children under one year old
Usually, parents of babies are worried about the exact opposite problem - too frequent stools. Therefore, not everyone immediately understands what to do if a baby under one year old has constipation. nine0003
Gastroenterologist, hepatologist at GMS Clinic Sergey Vyalov gave an interview to the Internet portal parents.ru and spoke about constipation in children under one year old.
Introduction
Constipation, also known as diarrhea, stool retention, discolia, caprostasis, difficulty in emptying the bowel is not a universal condition with unambiguous characteristics. Each person, including a child, has his own indicators of the norm and deviations from it, associated with age, intestinal microflora, diet, state of mind and hormonal background, concomitant diseases. Yet there are a few common points of reference. nine0003
What is constipation?
Specialists diagnose constipation if the baby does "big" things:
- regularly and without problems, but passing dry and hard stools;
- with difficulty - the child has to push, the feces do not come out on the first try;
- less than 5 times per day.
In the first six months of life, constipation is a rather rare occurrence, rather, on the contrary, in the period from 0 to 6 months, 6-10 bowel movements per day are considered the norm. Breastfed babies have more frequent bowel movements, while artificial babies have less. nine0003
Up to 6 months constipation is rare
Usually, parents of babies in the first months of life are alarmed by the condition opposite to constipation - too frequent bowel movements. But in a baby, regardless of whether he eats breast milk or formula, the intestines should work exactly like this - in a mode that is considered diarrhea for older children and adults.
There should be no other option, at least until the introduction of complementary foods at 4-6 months. After all, the baby receives mostly liquid food, the waste products of which have the same consistency and leave the intestines without encountering any obstacles on the way - the baby has not yet learned to control the sphincter that restrains the release of feces. nine0003
The baby's intestines have just begun to "get acquainted" with microorganisms that come from mother's milk, from her skin (the baby licks the nipple), from the environment. Far from all new "partners" are accepted: there are rejected ones, those who have not taken root, and so on. Checking and rejection are accompanied by loose, unstable stools.
Too frequent bowel cleansing does not need correction and treatment if the child is gaining weight and developing properly. Normal appetite and sleep, gas, absence of fever and other signs of illness indicate that parents have nothing to worry about. If the mother of a baby, tired of changing diapers 10 times in one day, wants to change the situation and asks the doctor to prescribe fixing medicines for the baby, then, unwittingly, she will doom her baby to chronic constipation. nine0003
Not according to the rules
And yet, in the first 6 months, constipation in infants is not excluded. It can be called:
- microflora transmitted from the mother;
- insufficient fluid volume;
- stress.
Let's say a woman has too many methane-producing bacteria in her stomach and intestines that cause constipation. They grow rather slowly, ferment, releasing carbon dioxide, which contributes to flatulence and bloating. With this deviation, the woman lives, adapted and learned to solve the problem with the intestines in one way or another. Noticing the same thing in a child, she decides that the baby has inherited her features and "saves" him with the same means, making a mistake. Babies should not be given laxatives, especially those containing senna. The baby's body gets used to such drugs too quickly and without them it can no longer cleanse the intestines. nine0003
Constipation in a baby up to 6 months is also provoked by a lack of fluid and hormonal fluctuations. At 6 months, the baby should receive a lot of moisture - about 140 ml per kilogram of weight per day. A breastfed child gains this rate from mother's milk and does not need additional sources of liquid (but only if there is no predisposition to constipation). Little artificers are soldered from the moment they switch to a mixture.
If a woman is tense or nervous, then her level of the stress hormone cortisol rises. Through breast milk, saliva or sweat, the substance enters the baby's body and also provokes constipation. nine0003
Even if the mother does not breastfeed the baby, the constipating microorganisms sooner or later get to the gastrointestinal system of the crumbs and make negative changes in it.
Constipation after introduction of complementary foods
The kid is growing, improving his skills, and it's time to introduce him to new foods. These circumstances, on the one hand, help to establish peristalsis, and on the other hand, increase the risk of constipation.
nine0002 By six months, the baby is already trying to control defecation, because he realized that after it there are unpleasant sensations - itching, burning and other discomfort in the areas where the feces get. In order not to experience discomfort, the child tries to restrain the urge. At first, he does not succeed, because the rectum has already learned how to work - reflexively contract and push out waste. And after a couple of months, everything works out, the baby wins and enters the path leading to chronic constipation. To get the baby out of this vicious circle, the mother must minimize the duration of the baby's skin contact with feces and expand the baby's diet by mastering complementary foods. nine0003Proteins, fats and carbohydrates that are part of the products are absorbed in the small intestine, and do not reach the large intestine, where feces are formed. What can not be said about fiber. While the baby is drinking breast milk or formula, this component of the dishes is not familiar to him. Even if a nursing woman herself consumes a lot of plant foods, the baby does not get anything. Fiber, as already noted, is not absorbed in the intestines, does not enter the bloodstream, which means that it is not in breast milk. For the first time, a baby gets fiber with complementary foods by trying its first 25 grams of mashed potatoes from zucchini, carrots and other vegetables. Plant fibers literally attract all waste to themselves, as a result, fecal masses are formed, which help the intestines to master the correct peristalsis. There are a lot of muscles in this section of the gastrointestinal tract, in the intestines, they must learn to consistently contract - tighten and relax in order to squeeze waste out. nine0003
The next new product should be introduced one month after the previous one. The novelty is likely to cause more frequent and loose stools at first. If it does not have a green color and does not foam, there is no need to run to the doctor and ask to prescribe fixatives. Be patient, after a while the innovation will be mastered and will bear fruit. Instead of liquid and shapeless yellow-white feces, you will see brown feces that have formed.
nine0107 Special constipationThere are other causes of constipation in babies. Unfortunately, they are much more difficult to deal with, since these are developmental pathologies, diseases, and injuries.
Acute constipation. It develops for anatomical reasons, for example, due to obstruction of the large intestine, or during intussusception - the introduction of one part of the intestine into another, which causes blockage of the lumen. Against the background of complete well-being, the baby suddenly becomes restless, cries, refuses to eat. The attack ends as unexpectedly as it began, but after 3-5 minutes it repeats and intensifies: one or two times vomiting appears with an admixture of green bile. If the stool passes, then blood impurities are visible in it. After 5–6 hours, the stool stops, and bloody discharge comes out of the rectum. At the same time, the baby's stomach is soft. The temperature is usually normal. The child may even lose consciousness. With such symptoms, you need to call an ambulance. nine0003
Hirschsprung disease. It is based on a violation of the innervation of the large intestine - the central nervous system cannot control this section of the gastrointestinal tract. As a result, processed food accumulates in the intestines. The picture of the disease is quite diverse. If only the short part of the intestine is affected, then constipation forms gradually, and it is possible to do without surgical intervention for quite a long time. When a longer segment is affected, the absence of stool is fraught with a serious condition and immediate surgical intervention is required. nine0003
infectious attack. If in the first months of life the baby suffered an intestinal infection, the nerve cells in the large intestine may die, which will lead to a delay in the act of defecation, accumulation of feces and the development of constipation. With dysentery, the so-called toxic megacolon is possible (a sharp expansion of the colon). The child develops impaired consciousness and repeated vomiting. The abdomen increases sharply due to a greatly enlarged intestine. The complication requires emergency surgical care. nine0003
Problems with the CNS. Injuries during childbirth and the syndrome of infantile cerebral palsy also affect the functioning of the gastrointestinal tract, as they are associated with various complications, such as impaired swallowing, regurgitation, and vomiting.
Vasculitis. Vascular inflammation extends to the nerve plexuses and sensitive cells located in the intestinal wall.
Disorders in the work of the endocrine system. With hypothyroidism (lack of thyroid function), the movement of contents through the intestines slows down. With dysfunction of the parathyroid glands, constipation occurs due to a violation of mineral metabolism, with diabetes mellitus it becomes the result of damage to the nerve plexuses of the intestine or dehydration of the child's body. nine0003
Medical constipation. Before giving your child any drug prescribed by a doctor, carefully read the instructions. For example, anemia remedies containing iron can cause constipation. Observance of the rules of intake will help to avoid it - directly during meals, reducing doses of iron when introducing foods with a high iron content into the diet - buckwheat, apples, greens. Particular attention should be paid to constipation resulting from treatment with non-steroidal anti-inflammatory drugs, neuroleptics, sorbents and antibiotics, which cause intestinal dysbacteriosis.