Constipation

If your baby is straining to do a poo, it doesn't necessarily mean she's constipated. Before long, you'll recognise your baby's particular grimaces and grunts as she works on her bowel movements. You’ll also become very familiar with what looks normal (or not!) in your baby’s nappy. We take you through how to tell if your baby is constipated, what may have caused it and how it can be treated.

How can I tell if my baby is constipated?

When it comes to a baby’s bowel movements, there is often no normal number or schedule. Just as in adults, babies’ bowel patterns vary – and poo can change in texture from day to day.

If you’re concerned that your baby may be constipated, look out for these signs:

• Crying and discomfort, irritability or pain before doing a poo.
• Dry, hard, pellet-like poo she has trouble passing.
• Fewer than three bowel movements a week.
• Foul-smelling wind and poo.
• Loss of appetite.
• A hard belly.

It may sound odd, but very liquid poo can be also be a sign of constipation. Liquid poo can slip past the blockage of hard poo in the lower intestine. If you see this, don't assume it's diarrhoea – it may be evidence of constipation.

What causes constipation?

There are several possible reasons why your baby may be constipated:

• Formula milk. A formula-fed baby is more prone to constipation because formula can be harder to digest than breastmilk, causing poo to be firm and bulky. A breastfed baby is unlikely to get constipated. Breastmilk produces poo that is almost always soft, even if a baby hasn’t done a poo for a few days.


• Introducing solids. Babies often become constipated when they start solids, as their bodies learn how to manage new foods. Low-fibre foods and not enough fluids also contribute to constipation.


• Dehydration. Your baby may be refusing milk because she's teething, has thrush, a throat infection, a cold, or an ear infection. Or your older baby may not be drinking enough milk or water with her solid foods. Whatever the reason, if your baby isn’t getting enough fluids she can become dehydrated – causing dry, hard poo that is difficult to pass.


• A medical condition or illness. Occasionally, constipation can be a symptom of a food allergy, food poisoning (such as botulism), or a problem with the way the body absorbs food, known as a metabolic disorder.
  
  Very rarely, constipation in babies can be caused by certain congenital conditions. These can include a disease where the large intestine doesn’t function properly (Hirschprung's disease), a condition where the anus and rectum have not formed properly (anorectal malformation), spinal bifida and cystic fibrosis.

How can I treat constipation?

Check with your doctor or paediatrician before trying anything to ease your baby's discomfort. You may be asked to bring her in to be examined. Here are some home treatments your doctor may suggest:

• Gently move your baby’s legs in a bicycling motion to help move the hard poo along her intestine.


• If your baby is drinking formula, give her extra water in between feeds, but don’t dilute the formula. Make sure you are using the recommended amount of milk powder when making up a bottle, as too much powder can dehydrate your baby, causing constipation. Your doctor may also recommend trying a different brand.


• If your baby has started solids, give her plenty of water or diluted fruit juice. Plenty of fibre in your older baby’s diet could also help. Pureed or chopped apples, grapes, pears, plums, prunes, oranges and papaya are all high in fibre. You could also add a small amount of high-fibre cereal to your baby’s usual breakfast cereal.

If these home treatments have not worked, or if your baby’s constipation is severe, your doctor may suggest a laxative, probably lactulose.

Try not to worry too much if your baby becomes constipated. It's likely to happen now and then, especially if she is formula-fed or eating solids. With your attention, necessary treatment, and time, she'll soon establish easier, regular bowel movements again.