Constipation in babies – causes, signs and treatments

What is constipation?

Constipation is when your baby’s poo is hard and dry, making it difficult for them to poo. Sometimes, doing a hard poo can be painful. It’s common for babies to have constipation when they are changing from formula or breast milk to solid foods.

What is normal?

All babies are unique, and this includes how often they poo. There is a very wide range of ‘normal’. Some babies poo after every feed. Others will only poo once every few days. When it comes to how often they poo, once in 7 days, or 7 times in one day are both fine, so long as your baby is happy and well. But while the number of poos is not critical, if your baby seems to have pain when trying to poo or has a very hard, dry poo, you can speak with their doctor or child health nurse for advice.

In extreme cases, rare illnesses can cause constipation such as:

• problems with nerve endings in the bowel
• problems relating to the spinal cord
• thyroid deficiency
• other metabolic disorders

All babies are checked for these conditions, so this is usually not something you need to be concerned about. But if you are worried about your baby or are notice that pooing is painful for them, seek medical advice.

How to recognise the signs of constipation

The main signs of constipation are hard, dry poos. The following are other signs of constipation:

• Your baby may show signs of straining when trying to pass a poo.
• Your baby may be unsettled, may seem fussy or irritated.
• Your baby may be eating less or feeding less well than usual.
• A tear or crack might appear in the skin around the anus, which may at times bleed.

In some cases, if your child is constipated, they may look bloated or their stomach may appear larger than usual. It can be possible to feel their poo (hard, solid lumps) while pressing softly on their stomach.

How to treat constipation at home

Try these tips to help babies who have difficulty passing poos:

• If your baby has infant formula, always measure the water first before adding the formula powder — this helps ensure that the ratio of water-to-formula is correct.
• If your baby is old enough to drink water, offer extra drinks (boiled and cooled first).
• Gently rub their stomach to help stimulate the bowel — your baby might also feel better with gentle massage to help manage the pain of constipation.
• A warm bath can help calm and settle your baby and relieve discomfort.

If your baby is older than 6 months, add some extra fruit and vegetables to their diet to boost their fibre intake.

If your child is older than 9 months, adding stewed prunes or apricots to their meal may help. They can have up to 3 tablespoons, 3 times a week. Cereal that has bran may also help mild constipation. Older babies can try prune juice diluted with water (half prune juice and half water). Start slowly, with 10 millilitres. Increase as needed until they can do a soft poo.

Does my child need to see a doctor?

Constipation is common. Often it will pass without intervention, or with the help of the strategies listed above. If you are worried that your baby has constipation, is uncomfortable or is in pain, their doctor can assess them and recommend baby-safe strategies. There are medical treatments for constipation that your doctor may consider, based on your baby’s circumstances.

If your baby was previously treated for constipation but still struggles to poo, it is important to go back to your doctor for a review. There are several treatments they can try.