Constipation in babies: what causes it and how to detect it

Constipation in babies is a common cause of pediatric consultation and it causes a lot of anguish and concern for parents because the normal number of bowel movements varies greatly, depending on the age and what our little one eats.

Although 95% of constipation cases have a functional origin, I mean, it does not have a specific organic cause, nor is it indicative of any disease, but it is important to know the symptoms.

How do I know my baby is constipated?

According to the book, Las 50 principales consultas pediátricas (Top 50 Pediatric Visits), a child is constipated when difficulty passing stools and a decrease in the number of bowel movements cause the discomfort in the patient. Mayo Clinic, in its article Signos del estreñimiento en bebés (Signs of constipation in babies), gives us other signs that could indicate that your child could have infant constipation:

• Stools in the form of separate hard lumps
• Bowel movements that seem hard to pass, causing your baby to arch their back or cry
• Infrequent or less frequent bowel movements
• Pain or swelling in the abdomen

How should the baby’s poo be? How many times does he poop a day?

The first bowel movements of the newborn are called meconium and are made up of the substance that the baby has before birth. It has a thick texture and can be black or dark green. After the first 24 hours, it begins to turn light green and it also contains the waste from breast milk or formula. After the first week, the appearance of the stool varies depending on whether he is having breast milk or formula or if solid food has been introduced. “Bottle-fed babies typically have 1-3 bowel movements a day. The stools are yellow, well-formed, but should not be hard or ball-like. Breastfeeding stools are liquid, yellow (sometimes they can be greenish, but only once breastfeeding is well established and the baby breastfeeds well)”, says Dr. Lee Johnson, a pediatrician at Mayo Clinic Health System in La Crosse Wisconsin, USA, in response to Baby Creysi.

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Why is my baby constipated?

Constipation is more common in formula-fed babies than in breast-fed babies. In both cases it is linked to an immature colon that causes slow bowel movements. It usually resolves spontaneously over time.

“Babies who are breastfed poop more often, several times a day, but sometimes, around the 2 months of age, some breastfed babies may suddenly stop pooping daily. They may be gassy, eat well, but have liquid, ‘explosive’ stools every 2-7 days. This is normal!”

“It’s frustrating, but it’s a normal pattern, and it’s not really constipation! This happens because breast milk is the perfect food for the baby and is completely digested. Not all babies skip bowel movements this way, but some do”, says the Mayo Clinic expert.

What should we do when a baby is constipated?

Your pediatrician will tell you what to do depending on your case. If your baby has formula milk, it may be convenient to lower the density of the bottles or your doctor may recommend that you use some type of probiotics added to the milk. Always consult the expert and do not do anything without his advice. In both bottle-fed and breastfed babies, you can try a warm water bath, gently flex their legs and make movements on their stomach as a massage. Lee Johnson tells us, “If it’s been more than 3 days without a bowel movement and your breastfed baby is uncomfortable, it’s okay to try some ‘rectal stimulation’ using a rectal thermometer and insert it about 1 cm into the rectum. This will sometimes cause a poop (or you can use a Vaseline covered cotton swab)”. “A gentle massage can also help. Lovingly, rub your baby’s abdomen starting on the lower right side, moving up, over the upper abdomen, and then down to the left side. The movement of the knees and legs as riding a bicycle can also help relieve gas”, says the doctor.

Is prune juice useful against constipation in babies?

Generally, no juice is recommended for babies under 6 months, except for prune juice to treat constipation and only under the recommendation and supervision of your pediatrician.

“If bottle-fed babies have hard, pellet-like stools (or if your breastfed babies develop them after the introduction of solid foods), adding 1 ounce of prune juice to 1 bottle of formula or breast milk may help”.

“Karo dark corn syrup is not recommended for any reason (as it can transmit botulism). If your baby is having solid food, you can add pears, prunes and peaches as purees to the daily food. This can also be useful if constipation occurs in the weaning stage, when your baby is trying new foods”, explains the pediatrician.

If the baby continues having problems, some doctors might recommend glycerin suppositories, but keep in mind that they are designed for occasional use only. Mineral oil, stimulant laxatives, or enemas (introduction of water) should not be used to treat infant constipation.

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Could your baby’s constipation be a symptom of something more serious?

Very rarely, in only 5% of cases, infant constipation is caused by an underlying condition such as Hirschsprung’s disease, hypothyroidism, or cystic fibrosis.

If constipation persists or is accompanied by other symptoms such as vomiting, weakness, difficulty in gaining weight, abdominal swelling and lots of gas, it is very important that your pediatrician evaluate other possible causes. But beware, always consult your doctor for advice.

Translated by: Ligia Mabel Oliver Manrique de Lara

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