Springdale Mason Pediatrics

Constipation (Baby)

Definition

  • Can't pass a stool or pain (crying) when passing a stool
  • Can't pass a stool after straining or pushing longer than 10 minutes
  • Passes stools infrequently
  • Your child is less than 1 year old

Call or Return If

  • Constipation lasts more than 1 week after making changes to diet
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Normal Frequency of Stools

  • Once children are on normal table foods, their stool pattern is like adults. The normal range is 3 per day to 1 every 2 days.
  • Kids who go every 4 or 5 days almost always have pain with passage.
  • Kids who go every 3 days often drift into longer times. Then, they also develop symptoms.
  • Any child with pain during stool passage or lots of straining needs treatment. At the very least, the child should be treated with changes in diet.

Normal Stools and Normal Behaviors

  • Breastfed and over 1 month old. Stools every 4-7 days that are soft, large and pain-free can be normal. Occurs in 20% of breastfed babies. Caution: Before 1 month old, not stooling enough can mean not getting enough breast milk.
  • Straining in babies. Grunting or straining while pushing out a stool is normal in young babies. It's hard to pass stool lying on the back with no help from gravity. Becoming red in the face during straining is also normal.
  • Large stools. Size relates to the amount of food eaten. Large eaters have larger stools.

Causes

  • True constipation is uncommon in babies.
  • Sometimes, caused by formula only diet.

After Care Advice

Overview:
  • Constipation is common in children.
  • Most often, it's from a change in diet. It can also be caused by waiting too long to stool.
  • Passing a stool should be pleasant and free of pain.
  • Any child with pain during stool passage or lots of straining needs treatment. At the very least, they need changes in their diet.
  • Here is some care advice that should help.
Diet for Infants Under 1 Year Old:
  • For babies over 1 month old, can add fruit juice (e.g., apple or pear juice). After 3 months, can use prune (plum) juice.
  • Amount: 1 ounce (30 mL) per month of age each day. Limit amount to 4 ounces (120 mL) per day. Reason fruit juice is approved for these babies: treating a symptom.
  • Age over 4 months old, also add baby foods with high fiber. Do this twice a day. Examples are peas, beans, apricots, prunes, peaches, pears, or plums.
  • If on finger foods, add cereals and small pieces of fresh fruit.
  • Give enough fluids to stay well hydrated. Reason: This keeps the stool soft.
Flexed Position to Help Stool Release:
  • Help your baby by holding the knees against the chest. This is like squatting for your baby. This is the natural position for pushing out a stool. It's hard to have a stool lying down.
  • Move the legs like your baby is riding a bike.
  • Also gently massage or pump on the left side of the belly.
Warm Water to Relax the Anus:
  • Warmth can help relax the anus and release a stool.
  • For straining too long, help your baby sit in warm water.
  • You can also put a warm wet cotton ball on the anus. Vibrate it side to side for about 10 seconds to help relax the anus.
What to Expect:
  • Most often, changes in diet helps constipation within a few days.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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