Being a parent, your baby’s crying is your only sign to maintain his feeding schedule, change his wet diapers, or give him a cuddle time.
As the baby grows, his body develops to adjust to the outside world. The cues that come to your aid to help you keep track of his well-being are his developmental milestones, such as his little coos, motor skills, and crawling and walking abilities.
What also needs a worthy mention when it comes to your baby’s health is a healthy bowel function. As your child makes a transition from breast milk to formula and finally to semi-solid and solid foods, a change in your child’s bowel movements is bound to occur.
A healthy bowel function is determined by the consistency and regularity of your child’s bowel movements. This largely depends on your baby’s age, the type of milk he is consuming, and introduction of semi-solid foods and solid foods in his diet.
What is Considered as Normal?
Ranging from one bowel movement a day to once every four days, the frequency of bowel movements can differ significantly in infants. As long as the infant passes soft and firm stools, both situations can be completely normal. This variation makes constipation in infants a difficult code to crack.
During the first month of life, babies can have multiple bowel movements a day. As your baby develops, the count may go down to once a day or once in several days.
The frequency and consistency of your infants’ stools are the parameters of a healthy bowel function in babies. A healthy bowel function relies primarily on the nutrition source that is either breast milk or formula feed. Accordingly, what might be a normal bowel movement in a child can be a case of constipation in another.
Breastfed infants can have a bowel movement more frequently than formula-fed babies. Breastfed infants tend to pass stools more often due to the better absorption of nutrients. Formula-fed newborns may have fewer bowel movements due to the milk proteins that can firm up the stools.
Breastfed babies usually pass 1–3 loose and runny stools a day. With a transition to formula feed and semi-solid to solid foods (at about 6 months of age), they may have firm and fewer bowel movements.
Why is Your Baby Getting Constipated?
The various causes that can lead to constipation in infants are:
- Mother’s diet when the child’s diet is breastmilk
- Formula feeds, which can affect stool consistency
- Lack of toilet training habits
- Lack of activity
- Switching to solid foods, which can put a load on the digestive system
- Insufficient fluids and fiber when making a switch to semi-solid and solid foods
- Premature birth of a baby, which can lead to an underdeveloped gastrointestinal tract
- Getting sick, which can disturb the eating patterns of the infant and throw the digestive system off track
In rare cases, infants diagnosed with underlying medical conditions, such as hypothyroidism, specific food allergies, and metabolic disorders, may also be constipated.
How to Know If Your Child is Constipated?
Keeping in mind the texture and regularity of your baby’s stools, check for these symptoms to consider medical advice:
- Hard and dry stools
- Being crankier than usual
- Spitting up more often (infants)
- Difficulty passing stools
- Pain during a bowel movement
- Taut belly
- Blood on the stools, the diaper, or toilet paper
- Traces of stool or liquids in a child’s underwear (involuntary stool leakage in the innerwear, a sign of fecal impaction)
- Change in bowel movements or having less than three bowel movements a week (older infants)
- Straining, which is part of newborn behavior due to their weak abdominal muscles. It is not a stand-alone symptom of constipation in infants. However, straining accompanied by other symptoms such as crying, pain, and a taut belly is a red flag that needs medical attention.
Treating Your Child’s Constipation
You should consider prompt medical consultation once you notice persistent symptoms indicative of constipation in your infant. The line of treatment depends on the age of your child.
Constipation in children who have recently switched to semi-solid and solid foods can be cured with laxatives paired with doctor-recommended dietary changes. The treatment may take time. Continued use in recommended doses can help treat your baby’s constipation.
Alternatively, lubricating your child’s anus with a medically approved glycerin suppository can be done to ease your baby’s constipation.
The red flags for constipation must not be undermined as prolonged constipation can cause a great deal of discomfort to your baby. Consult a pediatric gastroenterologist if your child’s condition does not improve with standard treatments or doctor-approved remedies.
Medic for Infant Constipation
Several home remedies have been passed down from generation to generation to relieve mild cases of constipation in infants.
These include strategies such as a tummy massage if your child is below 6 months old to keep your child’s bowels moving. Infants who have been introduced to pureed or solid foods can be relieved of their constipation by including adequate fluids and fiber in their diet.
Outlined below are such natural remedies that can be considered to help you clear your child’s constipation problem.
1. Help Him Exercise
Physical activity can help improve digestion and keep the bowels moving. To help treat constipation in infants, you can help him exercise.
Physically active babies suffer less stomach pain, gas, and constipation.
- Leg bicycle exercises help a lot. Put your baby in a lying position, hold the legs in a half-bent position, and gently begin to move your baby’s legs as if riding a bicycle.
- If your baby has started crawling, encourage him or her to do a few laps.
- If your baby has started walking, help him or her walk around a bit after eating.
2. Massage His Tummy
Gently massaging your baby’s stomach and lower abdomen can stimulate bowel movements. They even help relieve gas and colic pain in infants.
A study published in the Journal of Child Health Care supported the role of regular massages in normal bowel function. Researchers found that the experimental group of premature infants who received massage therapy twice daily for 14 days, 15 minutes per session, had a significant increase in the number of bowel movements.
- Lay your baby down.
- Using warm olive or coconut oil, gently massage the abdomen in a clockwise direction for 3–4 minutes.
- Do several massages throughout the day until your child has a bowel movement.
3. Soothe Your Baby with a Warm Bath
Giving your constipated baby a warm, relaxing bath can also help a lot. It aids in the motions inside the body and even brings relief from gas pain.
- Fill your baby’s bathtub with warm water.
- Bathe your baby in the water and pat him dry.
- Give a gentle tummy massage after that.
4. Clean Your Baby’s Gut with a Probiotic Dose
Probiotics are abundant in live active cultures of bacteria that are similar to intestinal microflora. Some constipated infants can benefit from probiotics.
In a 2014 study published in JAMA Pediatrics, researchers highlighted the prophylactic use of Lactobacillus reuteri during the first 3 months of life. The experimental group of infants showed reduced functional gastrointestinal disorders, such as constipation, infantile colic, and gastroesophageal reflux.
- You can give probiotics to your child by feeding him infant formula supplemented with probiotics.
5. Address His Fluid Intake
Adequate hydration is essential for regular bowel movements.
Besides having essential nutrients, milk contains more than 80 percent water, which makes it a necessary part of an infant’s diet.
Water helps your baby stay hydrated and aids in the smooth functioning of his digestive tract. Adequate fluid intake ensures regular bowel movements and helps prevent constipation and gas pain.
- Give your baby water to drink at regular intervals. To improve digestion, you can give cooled boiled water to your baby.
- In addition to water, breastfeed your baby or give him milk as per his requirements.
6. Give Fennel Seed Water to Drink
Fennel seeds encourage smooth muscle movement in the digestive tract, resulting in healthy digestion and regular bowel movements in infants who have switched to semi-solid and solid foods.
Fennel also relieves gas.
- Add 1 teaspoon of crushed fennel seeds to about 2 cups of water. Boil it and allow it to simmer for 10 to 15 minutes. Strain the liquid and let it cool. Give ½ to 1 teaspoon of this solution to your baby a few times a day.
- To alleviate constipation in infants less than 6 months of age, breastfeeding mothers may drink fennel tea two or three times a day.
7. Offer Apple Juice
Apple juice contains pectin that has a mild laxative effect and encourages regular bowel movements in your baby. You can give your baby a small amount of diluted apple juice to help relieve constipation.
However, applesauce should be avoided as a part of your baby’s diet. Applesauce may contain a higher level of pectin that could harden your baby’s stools and lead to constipation.
- Give 4 tablespoons of ¼ diluted apple juice once a day to your toddler.
Instead of buying prepackaged juice, extract the juice at home from organic apples.
8. Give Prune Juice
Prunes are a high-fiber fruit that can help fight constipation in infants. Their natural laxative property helps regulate bowel movements.
- For older infants, add ¼ diluted prune juice to your baby’s formula before feeding.
- If your baby has switched to solid foods, you can try feeding him pureed prunes diluted ½ times.
9. Give Brown Sugar Water
Brown sugar has a laxative effect and may be used to treat constipated infants. It helps soften the stool so your baby can produce a bowel movement more quickly and regularly.
A 2018 study published in Gastroenterology and Hepatology from Bed to Bench demonstrated the use of brown/red sugar to treat constipation in children aged 2–10. The brown/red sugar treatment was effective in improving constipation in children without any known toxic effects.
- Mix ½ teaspoon of brown sugar in 2–3 tablespoons of cooled boiled water.
- Stir thoroughly until the sugar dissolves completely.
- Give this solution to your baby three times a day before his feed.
10. Feed Fiber-Rich Foods
Fiber is the mainstay of a healthy bowel function. It adds bulk to the stools and softens them by drawing water into them, facilitating their easy movement down the anus.
If your infant has started eating solid foods, try to introduce some fiber-rich foods into his diet.
- Add high-fiber foods, such as pears, peaches, or skinless apples, to your baby’s diet. You can feed these pureed or boiled.
- You can even try infant diets that contain barley or bran.
Breastfeeding mothers should also incorporate fiber-rich foods into their diet.
- Always choose to breastfeed your baby during the first 6 months of his life.
- Avoid formula feeds thickened with rice cereal.
- Avoid feeding your baby constipating foods such as rice, bananas, applesauce, and cooked carrots.
- Establish a regular toilet time and encourage your child to pass stool.
- Ensure a good position for your baby while he has a bowel movement.
- Lubricate your child’s anus with a plant-based oil to aid in the smooth passage of bowels.
- Breastfeeding mothers should limit dairy products in their diet.
- Avoid giving cow’s milk to your baby, as it is difficult to digest.
- Do not give your baby medicines for constipation unless prescribed by a doctor.
Prolonged constipation in infants can take a chronic form and lead to:
- Rectal prolapse
- Fecal impaction
- Anal fissures around the rectal area
When to See a Doctor
A case of constipation in infants under the age of 1 should be medically reviewed.
In older infants, visible signs of constipation such as bleeding in stools and withheld bowel movements for more than 3 days require medical intervention. Consult a doctor for medication.
Because normal bowel function is a parameter in evaluating the health of your child, constipation in infants is a common cause of concern. As your baby progresses from breastmilk to formula feed and finally to solid food, his body needs to make efforts to allow smooth bowel movements.
If your baby is breastfed and below 6 months of age, offer him breastmilk whenever he demands. Seek prompt medical attention if the constipation persists.
If your baby has switched to semi-solid or solid foods, make his diet bowel friendly by including enough fluids and fiber to give bulk to his stools.
In case, these changes don’t help, instead of resorting to over-the-counter medications, seek prompt medical attention to relieve your child’s constipation.
- Biggs WS, Dery WH. Evaluation and Treatment of Constipation in Infants and Children. American Family Physician. https://www.aafp.org/afp/2006/0201/p469.html. Published February 1, 2006.
- -Dorna MG, Piątek J. Functional constipation in children – evaluation and management. Przegląd Gastroenterologiczny. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4178044/. Published September 16, 2014.
- Singh H, Connor F. Paediatric constipation: An approach and evidence-based treatment regimen. Australian Journal of General Practice. https://www1.racgp.org.au/ajgp/2018/may/paediatric-constipation. Published May 5, 2018.
- Lämås K, Lindholm L, Stenlund H. Effects of abdominal massage in management of constipation-A randomized controlled trial. International Journal of Nursing Studies. https://www.sciencedirect.com/science/article/pii/S0020748909000108. Published June 12, 2009.
- Choi HJ, Kim S- J, Oh J. The effects of massage therapy on physical growth and gastrointestinal function in premature infants: A pilot study. Journal of Child Health Care. https://journals.sagepub.com/doi/abs/10.1177/1367493515598647. Published August 26, 2015.
- Philichi L. Management of Childhood Functional Constipation. Plum X Metrix. https://www.jpedhc.org/article/S0891-5245(17)30131-1/fulltext. Published 2018.
- Coccorullo P, Strisciuglio C, Martinelli M, Miele E, Greco L, Staiano A. Lactobacillus reuteri (DSM 17938) in infants with functional chronic constipation: a double-blind, randomized, placebo-controlled study. The Journal of Pediatrics. https://www.ncbi.nlm.nih.gov/pubmed/20542295. Published October 2010.
- Indrio F, Di A, Riezzo G, et al. Prophylactic use of a probiotic in the prevention of colic, regurgitation, and functional constipation: a randomized clinical trial. JAMA Pediatrics. https://www.ncbi.nlm.nih.gov/pubmed/24424513. Published March 2014.
- Boilesen SN, Tahan S, Dias FC. Water and fluid intake in the prevention and treatment of functional constipation in children and adolescents: is there evidence? Jornal de Pediatria. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572017000400320. Published 2017.
- Badgujar SB, Patel VV, Bandivdekar AH. Foeniculum vulgare Mill: A Review of Its Botany, Phytochemistry, Pharmacology, Contemporary Application, and Toxicology. BioMed Research International. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137549/. Published August 3, 2014.
- Pannu A, Pannu A. FENNEL: A BRIEF REVIEW. European Journal of Pharmaceutical and Medical Research. http://www.academia.edu/32203858. Published 2017.
- Heyman MB, Abrams SA. Fruit Juice in Infants, Children, and Adolescents: Current Recommendations. Pediatrics. http://pediatrics.aappublications.org/content/139/6/e20170967. Published June 1, 2017.
- Evaluation and Treatment of Constipation in Infants and… : Journal of Pediatric Gastroenterology and Nutrition. Journal of Pediatric Gastroenterology and Nutrition. https://journals.lww.com/jpgn/fulltext/2006/09000/evaluation_and_treatment_of_constipation_in.28.aspx. Published September 2006.
- The Royal Children’s Hospital Melbourne. https://www.rch.org.au/kidsinfo/fact_sheets/constipation/. Published February 2018.
- Xinias I, Mavroudi A. Constipation in Childhood. An update on evaluation and management. Hippokratia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574579/. Published 2015.
- Tajik P, Goudarzian AH, Shadnoush M. Effect of red sugar on functional constipation in children compared to figs syrup; a randomized controlled trial study . Gastroenterology and Hepatology from Bed to Bench. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204243/. Published 2018.
- Kranz S, Brauchla M, Slavin JL. What Do We Know about Dietary Fiber Intake in Children and Health? The Effects of Fiber Intake on Constipation, Obesity, and Diabetes in Children. Advances in Nutrition. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262613/. Published June 5, 2012.