Constipation in babies is a common concern for parents, and understanding what is normal and when treatment is necessary can help alleviate worries.
Normal Bowel Movements in Babies
● Frequency: Newborns typically have several bowel movements a day, often after each feeding. This frequency can vary greatly, with some babies having bowel movements after every feed and others less frequently.
● Consistency: The stools of newborns change from meconium, a thick black or dark green substance, to yellow-green as their digestive system matures. Breastfed babies' stools are usually yellow and liquid with some particles, while formula-fed babies' stools are firmer.
● Variability: It's normal for breastfed infants to have a bowel movement once a week, as long as normal soft stools are passed. Breast milk is highly nutritious and much of it can be absorbed by the body. Infants who breastfeed are rarely constipated. Cow’s milk and soy-based formulas may cause constipation.
When Treatment for Constipation is Necessary
● Signs of Constipation: Look for hard or pellet-like stools (Bristol stool chart Type 1 & 2), bowel movements that appear painful or difficult to pass, infrequent bowel movements, or a change in the baby's usual pattern.
● Home Remedies: Before considering medication, try ensuring the baby is well-hydrated. If your baby is at least four months old you can use prune, apple or pear juice (60-120 ml/day) for one to two weeks only. Too much juice can be unhealthy. Include high-fibre foods if they have started solids. Prepare apricots, sweet potatoes, pears, prunes, peaches, plums, beans, peas, broccoli or spinach as a purée. Avoid bananas until constipation relieved. Use gentle exercises like bicycle leg movements to stimulate the bowels. Enemas are not recommended.
● Medical Advice: If baby is younger than 4 months, home remedies don't work or if the baby shows signs of distress, such as not eating normally, having a swollen belly, or blood in their stool, it's important to consult a doctor. Note that iron drops can worsen constipation and use may have to be discussed with your doctor. If constipation persists, rare conditions like Hirschsprung disease, hypothyroidism, cystic fibrosis or spinal cord pathology may have to be excluded.
Source:
UpToDate Patient Education: Constipation in infants and children.
Written with the help of Copilot, GPT-4 and UpToDate.
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