Help! My baby has constipation

While talking about your tot’s bowel movements may be a little icky, constipation in babies is not uncommon. Constipation is when there are dry, hard, pellet-like or crumbly stools that are also irregular and your child will usually be in pain. If your little one doesn’t have a bowel movement every day but his stools are soft, he doesn’t have constipation. Sister Lilian says that this may indicate another problem, like insufficient intake of food, but it may also be totally within normal limits too.

We chat to Sister Lilian for her advice on the causes and treatment of constipation.

Baby poo – here’s what’s normal and what’s not

• A small or bigger stool at each nappy change during the first few weeks of life, especially for breastfed babies.
• A daily stool is common for formula-fed babies or those who already have solids, although, in the first six weeks of life, babies often have more stools each day. Babies with more sensitive digestive systems may have two or three stools a day without anything being amiss.

What causes constipation?

Baby formula

• One of the main causes of constipation is your baby’s diet. Baby milk formula is a common trigger, as it’s far less easily digested. It’s also common for a baby to suddenly start having digestive discomfort with painful cramping and bloating when changing from breastmilk to formula milk, and this often precedes or accompanies constipation. Wherever possible, try and breastfeed, as this helps to avoid constipation. If you can’t breastfeed, chat to your pediatrician about the best formula for your little one.
• Adding boiling water to your baby’s formula powder may alter the protein structure, making it a lot less digestible. This could also lead to constipation, cramping, and bloating. If you’re formula feeding, make up formula bottles with slightly cooled boiled water.
• The added iron in formula milk may lead to hard, dry, dark, constipated stools. Try a few different formula milks to find one that agrees with your baby – although one should give baby a few weeks to adjust to any particular brand unless discomfort is very bad.
• Many moms believe that changing to a soy formula will help for constipation when on dairy-based formula milk, but this may even make the problem worse – beans are associated with bloating and painful digestive cramping too. Sometimes the allergy formula milks ease constipation or goat’s milk ‘powdered milk’ might have to be considered in extreme cases.
• Follow-on or number 2 formula milks can trigger constipation in babies whose digestive systems are not yet mature enough for the new composition. Revert to the former number 1 formula milk for a few more weeks or months, until your baby’s system is more mature.

Solids

• Don’t introduce solid foods before six months, as your baby’s digestive system may not yet be able to cope easily with this.
• Cereals are another trigger for constipation. Pureed fruit is a great breakfast alternative.
• New foods often cause constipation as well. When this happens simply avoid the food until a few weeks later.

5 Ways to stop constipation

1. Offering water to your baby if she’s younger than five to six months won’t really relieve constipation as he can’t yet drink enough to make a difference. For older babies, offering water bottles between feeds or frequent sips throughout the day will mostly help with constipation.
2. Beverages like weak Rooibos baby organic tea can replace water for babies who won’t drink water, but cut out other drinks like fruit juices and cold drinks.
3. Apply a little petroleum jelly around your baby’s anal area and ride ‘bicycle’ with your baby’s legs when he’s straining.
4. Add a few drops of olive oil to two to four of your baby’s bottles a day.
5. Holding your baby upright and massaging his lower back while he strains can also improve constipation and associated discomfort.

When to see the doctor

If your baby doesn’t pass a stool within 7 – 10 days, see your doctor, or earlier if your baby seems ill. It’s not good to use laxatives on a long-term basis as the bowel will get progressively lazier.