Constipation in Babies

Many parents become concerned if their baby has not pooed for a couple of days.  And it’s easy to become anxious, especially when usual bowel habits change. As basic as it seems, regular bowel motions are a sign that our babies are healthy and thriving. When they don’t poo as we expect them to, or their poos aren’t as regular as usual, this can start a cycle of parental concern.

What is Constipation in Babies?

Constipation is when the baby passes a dry, hard poo. It is about the consistency of the poo, not how often the baby does a poo. This difference is important to understand to avoid unnecessary concern.

Constipated poos look like small pellets rather than a ‘sausage’ or soft paste in the baby’s nappy.  Sometimes there is a small tear or fissure in the baby’s anus from trying to push hard poo out. Anal fissures cause the baby pain.  There may also be a speck of blood on the poo or on the baby’s nappy.

What Do I Need to Know About Baby Constipation?

Remember, constipation refers to the consistency of bowel motions, not the frequency. So even if your baby hasn’t pooed for a couple of days, this isn’t necessarily a sign that they are constipated.

  • Pooing infrequently is not always a sign of constipation and may just reflect an individual baby’s bowel pattern.
  • All babies are unique and their bowel habits are not exempt from differences. Some babies have looser poos and others more firm.
  • Changes in feeding, routine and general behaviour can influence the frequency of bowel motions.
  • Baby poos often bear a resemblance to what the baby has eaten. Food begins its digestion in the mouth and goes through a series of changes until most of the nutrients have been extracted. Whatever food isn’t used by the body becomes waste.
  • Babies who eat a lot tend to poo a lot. That’s just the way it is.

How Would I Know If My Baby is Constipated?

  • If there is a change from the frequency of their normal bowel habits.
  • If they are straining, going red in the face, becoming distressed and appear to want to poo but nothing is happening.
  • If they pass dry, hard pebbles rather than soft poos.
  • If their tummy is hard and distended (bloated).
  • If there is a change in your baby’s feeding. Some babies don’t want to feed as much or as frequently if their tummy already feels full.
  • Unsettledness and more irritable behaviour.

Breastfeeding and Constipation

Breastfed babies may poo every time they have a feed, or may not poo for a week or more. In the early couple of months most breastfed babies poo frequently, especially if they’re having plenty of breast milk.

It’s uncommon for breastfed babies to become constipated. Breast milk has a natural laxative which helps to keep their poos soft and more liquid than formula milk. The action of sucking at the breast starts a process called the gastrocolic reflex. This means that baby’s gastrointestinal tract starts moving and stimulates contractions in the large intestine. Many mothers prepare for a dirty nappy each time they sit down to breastfeed.

  • Newborn babies who are breastfed will often poo several times each day until they’re around six weeks old.
  • It’s quite common for breastfed babies who are a couple of months old to not poo for several days. They can pass very smelly wind in the meantime.
  • Infrequent poos in the first few weeks of life may be a sign that a breastfed baby isn’t getting enough milk.
  • Breastfed poos vary in colour. They can be bright yellow to mustard and even bright green.
  • Breastfed poos may contain mucous and small white curds of fat.
  • Breastfed poos can be explosive and noisy.

Bottle Feeding and Constipation

Bottle fed babies may poo everyday, or have a poo every 2-3 days.  Their poo is generally firmer, more pasty and a different colour to breastfed babies. 

  • Formula-fed babies tend to have poos which are smellier than breastfed poos.
  • Formula-fed babies may also have poo which is yellow-green with specks of darker green or khaki.
  • Iron in formula tends to cause bottle fed babies to have darker poos.

Extra drinks of cooled, boiled water between bottle feeds can help to soften firmer poos.

Make sure you are preparing your baby’s formula accurately. Always follow the manufacturer’s instructions provided on the Tin.

Solid Food and Constipation

One of the first foods babies eat is rice cereal. Parents often find that the frequency of their baby’s poos slows down when they start having solids. Rice cereal, especially, can cause poos to become firm, especially in breastfed babies. 

Pureed fruits and vegetables which contain fibre help to keep poos soft enough so they can be passed without discomfort.

Important Tips about Baby Constipation

  • Every baby will have their own pattern when it comes to frequency of bowel motions. Some will poo every day and others every few days.
  • If your baby is not concerned, then try not to be worried yourself.
  • The first poo which newborns pass is called meconium. Seeing this in the nappy is a sign that the bowel is working as it should. When a newborn doesn’t pass meconium this does not mean they’re constipated. It is a sign that the baby may need to be checked.

    Remember

    Speak with your Child Health Nurse or doctor if you are concerned about your baby’s bowel habits. See your doctor if simple dietary changes aren’t helping or if your baby is distressed.