Qn of the Month: Help! Baby May Be Constipated…What Can I Do?

First, what is considered constipation? According to the American Academy of Pediatrics (AAP), a baby is more likely to be having constipation if he/she displays the following signs and symptoms: being excessively fussy; spitting up more; unusually hard stools or stools containing blood; a big difference in bowel habits or bowel patterns; straining for more than 10 minutes without success.

Before I talk about some strategies that may help, I want to mention two key points. First, while many babies may follow the ‘book’ in terms of stooling and wet diaper patterns, this may not always be the case for some babies. For breastfed babies, especially, there can be a wide range of normal, with baseline stooling patterns varying from a few times a day to some only going once a week. This is fine, as long as feeding is not affected, and the baby does not seem bothered. Second, prevention (fluids, fiber and frequent movement) is easier and still better than treatment. For more on that, see some upcoming posts dealing with this topic.

Now here are a few simple strategies that may help your little one:

  • Food: If your baby has started on solids, you can try mixing in a bit of home or commercially prepared prune puree or a tiny bit of diluted prune, pear or orange juice into your baby’s food
  • Fluids: For an older baby, you could offer fluids like water more frequently during the day (in between breast or formula feeds). For a younger baby, you could offer some water after a breastfeed, so as not to impact the breastfeeding, as well as add a bit more liquid (expressed breast milk, formula or water) into his/her solids. Just make sure that you don’t compromise the texture too much. It is still important to make the texture appropriate to your baby’s age and abilities, so that it won’t be a choking risk.
  • Movement: A bit of bicycling/cycling motion with the legs (with baby on his/her back and facing up) a few times a day can always help!
  • If medicine is really needed, the doctor may prescribe something like lactulose. Don’t worry, lactulose mainly works by just helping to draw water into the gut to help with softening and moving the stools along baby’s gastrointestinal tract.

Lastly, I just want to mention that some bowel pattern changes are normal. For example, over time as my little one got older and began to eat more solids, her stooling also gradually changed. At first it was a few times a day, then there was a transition period with the introduction of solids, so that it eventually became once a day, or once every other day. As she started to eat more, of course the quantity was also a lot more (and as my husband would say, “More pungent!”). And let’s not forget that teething is another factor, often making stools looser/more frequent during those periods!


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