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Constipation in infants less than one year old is common, but it can be a source of concern for parents. Constipation refers to the compactness of the stools and the difficulty passing them, not the frequency of bowel movements. The consistency and number of stools vary according to age and from baby to baby.

At first, breastfed babies tend to pass more stool than formula-fed babies since breast milk is easy to digest. Breastfed babies may start having fewer bowel movements at around 3-6 weeks of age, like only one or two a week. Formula-fed babies usually continue to have daily bowel movements.

Sometimes your baby is not constipated but needs time to get into a schedule for having bowel movements. Typically, an infant’s stool is soft and quickly passed.

Even if an infant is not constipated, their bowel movements may be irregular. It is also typical for infants to strain when passing a stool while they are lying flat, as they don’t have the force of gravity to help move things along. As long as the stool remains soft, regardless of how frequent the bowel movements are and if there is straining, your baby probably is not constipated.

Babies who cry when passing a bowel movement or have complex or log-like stool might be constipated. This condition is not only uncomfortable but also can be indicative of more serious concerns. If you think your baby’s constipated, and your baby’s symptoms do not improve or they have signs of illness like vomiting, fever, lethargy, lack of appetite, or blood in the stool, call your doctor right away.

In rare cases, constipation may be caused by a lack of nerves or structural problems in the lower large intestine. Your baby can be tested for these conditions if your doctor feels it is necessary.

Signs of Baby Constipation:

The most apparent sign of constipation in infants is a lack of stool. Bowel patterns can change based on age and consumption of breastfeeding, formula, or solids, making this symptom challenging to observe and understand. Babies who go more than five days without passing a stool may be constipated. A sudden change in bowel patterns may also indicate that your baby is constipated, especially a baby who used to pass stool daily suddenly goes several days without doing so. Recognizing the signs and symptoms of constipation is very important for making your baby more comfortable and ensuring proper nutrition.

Hard stools:

It’s normal for babies to pass stool irregularly or even to strain a bit during bowel movements. It is also normal for babies to pass the stool that is a soft, grainy, or seedy texture. If stool becomes hard, resembles pellets, or if the baby is passing stools that are wide and large, it likely means your baby is constipated.

Excessive straining while passing stool:

Some straining is to be expected during infant bowel movements, especially among newborns. Weak abdominal muscles can make it difficult for them to pass stool and cause them to strain a bit. But if your baby is straining more than expected to have a bowel movement and arching their backs, drawing their legs up on their abdomen, and getting red-faced or crying for extended periods means the baby is constipated.

Black stool:

Many colors are standard for newborn and infant stool, including yellow, brown, and even dark shades of green right after birth. After a few weeks, however, the stool should not be excessively dark. Black poop in particular indicates that something is wrong with your baby’s digestive system.

Passing blood in stool:

Under ordinary circumstances, infant stool should not include blood. However, it may appear when babies strain excessively to poop or experience a small fissure while passing the pebble-like stool. It means the baby is facing difficulty while passing the stool. This is also the sign that your baby is constipated.

Causes of constipation in babies:

Many factors can lead to constipation in babies. Some of these are more concerning than others. For example, infants who consume formula primarily may experience constipation upon switching brands or consuming solids. In other situations, several issues can contribute to the problem. These include:

Cow’s milk allergy:

The most common reason for constipation among infants is an allergy to cow’s milk, leading to various digestive issues, including constipation. This allergy causes the immune system to overreact to the protein in cow’s milk. It commonly accompanies formula feeding but may occasionally occur in breastfed infants too.

Changes in diet:

Not enough fluids or fiber-rich fruits and vegetables in your child’s diet may cause constipation. One of the more common times for children to become constipated is when they’re switching from an all-liquid diet to solid foods.

Medications:

Certain medications can make it more difficult for babies to pass stool, especially if given in excess. Pain relievers may prompt constipation in some cases. Constipation can also be a side effect of ibuprofen, leading to stomach aches and nausea in babies.

Family history:

Children with family members who have experienced constipation are more likely to develop constipation. This may be due to shared genetic or environmental factors.

Illnesses:

In sporadic cases, baby constipation can be a sign of specific illnesses. Examples include cystic fibrosis, Hirschsprung’s disease, diabetes insipidus, and hypothyroidism. Rarely, constipation in children indicates an anatomic malformation, a metabolic or digestive system problem, or another underlying condition.

When to call the doctor:

Call your child’s doctor if any of the following occurs:

· Your baby is irritable and seems to be having abdominal pain.

· You see blood in your baby’s stool.

· Your baby’s constipation does not improve with current treatment.

Remember to talk openly and honestly with your doctor about your baby’s bowel movements, ask any questions or concerns you may have, and answer each question. Constipation may be a temporary situation, a long-term problem, or a sign of a more severe condition.

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