Constipation in babies

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Constipation is a common problem and effects 5-30% of children [1]. While baby constipation can cause some discomfort, in most cases it will resolve naturally.

How can I tell if my baby is constipated?

Just like adults, baby’s bowel movements can differ from one baby to the next. Within the first three months of life, babies can pass anywhere from 5 to 40 bowel motions per week. Constipation in babies involves changes in the texture and consistency of the stools, as well as the frequency at which they are produced.

Signs of constipation in babies:

  • Dry, hard stools which can be difficult and painful to pass.
  • A hard, bloated belly.
  • Loss of appetite. Baby’s appetite should return once a substantial bowel movement has been passed.
  • Bright red blood in your baby’s nappy. While the sight of blood may cause panic in the parent, bright red blood is usually a result of tiny tears in the skin around the bottom caused by passing a hard stool.
  • Increased crying and irritability due to discomfort and straining while trying to pass a stool [2].

When is constipation a sign of something more serious?

In some instances, constipation in babies may be caused by allergies, absorption problems or structural bowel problems. Always seek the advice of your paediatrician if you are concerned or notice any of the following signs:

  • Blood in the stool.
  • Restricted growth, weight loss and lethargy.
  • Skin rashes, red eyes, mouth ulcers.
  • Constipation before 1 months of age [1].

What causes constipation in babies?

  • Infant formula – the lack of prebiotic fibre in some infant formulas may contribute to constipation as it has been shown that fibre (as prebiotic) in infant formulas has a stool softening effect [3].
  • Introducing solids – baby constipation and solids often go hand in hand. It is not uncommon for babies to experience constipation when they begin solids, as their bodies learn how to manage new foods.
  • Low fibre diet – eating processed foods and not enough wholegrains, fruits and vegetables can cause constipation due to lack of fibre [2].
  • Dehydration – if it is a warm day or baby has been unwell, dehydration can occur which causes the stool to dry and harden, leading to constipation.
  • Antibiotics – antibiotics kill the natural intestinal flora which are needed for healthy bowel function. Constipation after antibiotics may occur due to lack of beneficial bacteria present in the gut [4].

Why might a breastfed baby be constipated?

While baby constipation is more common in formula fed bubs, a breastfed baby may still experience constipation. Consider the maternal diet, has mum introduced any new foods into the diet? Also consider if baby has recently commenced solid food or taken a course of antibiotics.

How to relieve constipation in babies

If you’re wondering what to do when baby is constipated, it’s a good idea to talk to your paediatrician about your concerns, particularly if baby is less than 12 months old. Your GP or paediatrician may be able to advise you on what to give a constipated baby, for example, if baby is needing extra fluids or a baby stool softener.

How to relieve constipation in babies quickly

  • Massage and movement – to help relax baby’s muscle and encourage a bowel movement, try gently moving your baby’s legs in a bicycling motion. You can also gently massage baby’s tummy to stimulate the digestive system.
  • Extra fluids – for breastfed babies, try offering more feeds throughout the day. For formula fed babies, offer some cooled boiled water in between feeds.
  • Prune juice – for babies over the age of 6 months, you can offer some prune juice diluted with water (one-part juice to 10 parts water).
  • Fibre – if baby is on solids, include fibre rich foods and purees such a fruits and vegetables with the skin on and wholegrains such as brown rice [1].
  • Probiotics – an infant probiotic may assist with constipation especially if baby has taken antibiotics [5].
  • Prebiotics – if formula feeding, it may be helpful to switch to a formula that contains prebiotic fibre such as galacto-oligosaccharides (GOS) and human milk oligosaccharides (HMO) [6].

Black strap molasses for constipation in babies

Black strap molasses has a mild laxative effect which may aid babies over the age of 6 months, however using too much can have the opposite effect and cause diarrhea. Black strap molasses also contains sugar which is best to avoid in babies under 12 months so it may not be the best option. There are many tips on the internet for how to help a constipated baby, but it’s important to consult with your health care professional before trying any new remedies.

References

  1. https://www1.racgp.org.au/ajgp/2018/may/paediatric-constipation
  2. 2018. Constipation. Royal Children’s Hospital Melbourne, Kids Health Info. www.rch.org.au
  3. Moro et al. Acta Paediatr Suppl. 2003 Sep;91(441):77-9.
  4. Albert Palleja, et al. Nature Microbiology, 2018; 3 (11).
  5. Eirini Dimidi, et al. The American Journal of Clinical Nutrition, 2014 Oct; 100(4):1075–1084.
  6. Scholtens PA, et al. World J Gastroenterol. 2014;20(37):13446-13452.
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