Baby constipation

Breastfed babies have several helpful types of bacteria in their large intestine that are capable of breaking down some of the otherwise indigestible proteins in milk. As a result, their stools are softer, making bowel movements easier.

Breastfed babies also have higher levels of a hormone called motiline that increases the movement of the bowels.

The composition of breast milk also changes as your baby grows older, so it will supply the needs of your baby at all times.

Other causes
Food is usually the cause of baby constipation.

But in some cases, it can be a symptom of a more serious underlying disease.

If your baby isn't gaining weight or shows any other unusual symptoms, seek the advice of a doctor.

The bottlefed baby
Bottlefed babies frequently suffer from constipation because formula milk is harder for a baby to digest.

A baby who receives only formula milk will typically have fewer bowel movements than a breastfed child. Their stools will be thicker and have a different, more greenish colour.

Bowel movement in newborns (up to six months old)
It is equally normal for a young baby to have a bowel movement several times a day or as little as once a week. In rare cases, there can be up to three weeks between bowel movements.

A young baby should only be given a laxative if he or she is bothered by the long intervals between bowel movements.

Breastfed babies usually have frequent bowel movements until they are two to three months old. Their stools are typically yellow.

Bowel movement in older babies (from four months old)
Once a baby starts on transition foods or solids, the frequency of bowel movements and the consistency and appearance of their stools will depend on the food they eat. Your baby's stools will begin to look a bit more like ordinary stools in consistency and smell.

Once your baby starts eating solid food, the pattern in bowel movements will change. Your infant will have movements several times a day or as infrequently as once every two to three days.

At this point, some babies may get slightly constipated. This is because the intestines have to get used to the new composition of the nutrients.

Once a baby's food consists of more solid food, constipation may be caused by dehydration.

A vicious circle
When a baby first becomes constipated, it can be the start of a vicious circle.

This is because it will hurt your baby to pass the large hard stools that have gathered in the intestine.

Cracks around the anus may appear; these may start to bleed and cause more pain.

To avoid the pain, your baby may subconsciously start holding back stools, which makes the food stay longer in the large intestine.

As a result, your baby's body will absorb more water from the stools and make the stools even harder. This can cause your baby to remain constipated.

A baby who is constipated often has colic pains, because the large amount of stool in the intestines makes the intestines dilate. In some cases, the child may not want to eat and may even retch a little.

What can you do to treat constipation?

Massage your baby's tummy Start at the belly button and then massage outwards in circles in a clockwise direction. Some oil or cream on your fingers can also help.

Only continue if your baby enjoys the massage and is comfortable and relaxed.

Move your baby's legs in a cycling motion
Place your baby so he or she is lying on their back. Hold their legs and turn them gently in a quick cycling motion.

This will make the stomach muscles move and, in turn, put gentle pressure on the intestines to make them move.

Give your baby a bath
A warm bath can make your baby relax so the stools are passed more easily. Once your baby has relaxed in the bath, you can also massage their stomach (see above).

When you wash your baby's bottom, apply some cream or petroleum jelly (Vaseline) around the outside of the anus.

Don't use a thermometer to stimulate movement
Don't put a thermometer or anything else inside your baby's anus to stimulate bowel movement, because this may cause damage.

Check you are making formula correctly
If your baby is on formula milk, you should follow the instructions on the package carefully. Making the mixture too thick by putting in more than the recommended amount of powder can lead to constipation and other medical problems.

There are different brands of formula milk on the market, and they are basically of equal quality. It's best to stick to the same brand, because different formulas may require different dilutions.

Give cooled, boiled water
You can give your baby extra fluids with bottles of cooled, boiled water.

Preventing constipation
Once your baby is between four to six months old, you can start introducing more porridge and fruit or vegetable purées into their diet. These are rich in fibre and will help prevent constipation. Prune purée is particularly good for this purpose.

What if constipation continues?
If the above suggestions don't work for your baby, consult a doctor about special laxatives for chronic constipation.

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