Newborns and constipation
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
- 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.
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.
- 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.
- 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;
- 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.
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. 9+7 (423) 267-61-30; +7 (423) 274-32-22; +7 914-704-32-22.
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Newborn constipation: what to do | Causes of constipation in a newborn baby | Drinking regimen
Author, editor and medical expert - Klimovich Elina Valerievna.
Pediatrician and medical expert - Arutyunyan Mariam Arutyunovna
Views: 564 363
Last update: 09/22/2022.
Average reading time: 6 minutes 6 minutes 3
How to understand that the baby is constipated
When constipation is a temporary problem
Constipation in newborns with diseases
Functional constipation in babies of the first year of life
What to do if a newborn has constipation
Constipation is a pathology that people of all ages face, including newborns and toddlers during the first months of life. And although it is believed that the "debut" of the problem in children occurs at about the age of 2 years, the first "bells" usually appear already in the first year of life 1 . Why constipation occurs in newborns and infants and what to do when they appear?
How to understand that the baby has constipation
Constipation, or constipation, is commonly understood as a violation of the function of the gastrointestinal tract, manifested by rare stools, thickening and fragmentation of feces, and difficulty in defecation 1.
2 . However, for young children there are no strict criteria for the normal frequency of bowel movements 1 . It depends not only on age, but also on the type of feeding of the baby. The consistency of feces is also evaluated depending on the nature of the diet.
According to the accepted norms, in children of the first four months of life (before the introduction of complementary foods), who are breastfed , the rectum should be emptied after each feeding, and the feces should have a homogeneous mushy consistency. If the stool is less than 4 times a day, and the feces are thickened, this is a reason to talk about constipation in a newborn or baby 1.2 .
Approximately 4-6 months with the expansion of the diet, the child's stool becomes rarer - 2 times a day. Feces are compacted and formed into a cylinder 1 .
Formula-fed babies normally empty their intestines at least once a day at a certain time 1.
2 . Feces are soft and cylindrical 1.2 . In this case, there should not be any difficulties in defecation.
Be aware that stool frequency is not the only guide to diagnosing constipation in infants. Even if the frequency of defecation is within the age norms, but the baby's stool is dense, fragmented and scanty, and the emptying of the rectum itself causes him suffering, this is a reason to talk about constipation in the baby or "artificial" 1.2 .
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When Constipation is a Temporary Problem
The main cause of obstructed defecation in infants today is considered functional immaturity of the body 2 , leading to inconsistent work of the muscles of the anterior abdominal wall and rectal sphincters. Normally, the urge to defecate causes contraction of the abdominal muscles (pulling) and simultaneous relaxation of the muscles that close the anus. If this process is disturbed, and the sphincters of the rectum relax late, defecation is disturbed.
Doctors call this condition infantile dyschezia, not constipation
Diagnostic criteria for dyschezia:
- the baby is less than 9 years oldmonths;
- the baby strains hard (more than 10 minutes) before emptying the intestines;
- stools remain soft, as expected when breastfeeding or bottle-feeding.
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Constipation in newborns due to illness
The main causes of constipation vary with age. It is believed that a violation of the excretion of feces in the first month of a child's life (the neonatal period) is most often associated with organic pathology, that is, diseases or conditions that affect not only the functions of the intestines.
Constipation in infants and infants can be a manifestation of various pathologies:
- Neuromuscular diseases that disrupt intestinal motility - congenital megacolon, spinal cord lesions, dysplasia of the nervous tissue of the intestine.
- Anatomical defects, such as narrowing and obstruction of the intestine.
- Systemic diseases - rickets, hypothyroidism and thyrotoxicosis, Down's syndrome, connective tissue diseases, etc.
- Congenital intolerance to cow's milk protein and gluten (cereal protein).
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Functional constipation in babies of the first year of life
In the overwhelming majority of cases, constipation in young children is associated with temporary disturbances in intestinal motility as a result of nutritional defects of the nursing mother or the baby himself 1.2 .
| Nutritional causes of constipation in neonates and infants 1 | ||||||
| Underfeeding resulting in decreased volume and hardening of feces | Malnutrition of a nursing mother, in particular the abuse of "fixing" products containing little coarse fibers | Refusal of breastfeeding and transition to artificial feeding | Insufficient fluid intake in the child's body, especially if he is on artificial nutrition or receiving complementary foods | Fast, less than 3 days, change from one mixture to another | Feeding of non-adapted products, e. | Introduction of low-fiber foods such as semolina as complementary foods |
g. cow's or goat's milk The situation is exacerbated by the baby’s low physical activity, the mother’s excessive insistence and haste in potty training, and, in particular, the frequent irrational use of the gas tube, enemas and irritating laxatives to empty the rectum 1.2 .
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What to do if a newborn has constipation
48 hours after baby is born,
All of the above symptoms are a reason for an immediate visit to the doctor and examination of the baby.
With functional constipation, the problem is usually solved by normalizing the nutrition of a nursing mother and baby, laying out after eating on the stomach, tummy massage and special therapeutic exercises.
