There are a lot of misconceptions about constipation and what it means in babies.
Can a Few Bowel Movements Still Be Normal?
Because breastmilk is so nutritious, sometimes almost all of it is absorbed, leaving little to move through the digestive tract. Stools may come only once in a while -- perfectly normal breastfed infants may only have a bowel movement once a week. Other infants just have a slower (but completely normal) gut, so they don't go very often. However, if your baby seems to be in pain or you have any concerns, call your doctor.
Lasting, severe constipation rarely has a medical cause (for example, the muscles in the intestine don't work or there is some sort of blockage), while occasional, hard stools are very common.
Is It Constipation?
It's not simply the absence of stool but stool that is formed or looks like pellets thatshould tip you off that your child may be constipated.
Very firm or pebble-like stools require a call to the doctor. This can sometimes indicate that the child is dehydrated. Other signs of dehydration might include decreased tears, lack of saliva, and a sunken look in the eyes and the infant's soft spot. The soft spot, also called anterior fontanelle, is a space between the bones on the top of an infant’s skull. The soft spot can be present until about 2 years of age.
Most parents are concerned that the pained, red-faced look their baby gets while pooping means straining and constipation. That's usually not the case.
"A baby doesn't know how to ... contract the abdominal musculature and push," Steinmetz explains. "Plus, they don't have gravity helping them like when you sit on a commode."
By the age of 1, most kids have it worked out and lose the tortured look.
Constipation Defined
There is no medical harm if stool stays in the body for a long time, and how often your baby has bowel movements (BMs) does not really define true constipation. If your baby has soft, easy-to-pass stools every 4-5 days, he is probably OK. On the other hand, if he has a hard time making BMs, has hard stools, has bloody or black stools, seems uncomfortable, or doesn't have a BM at least once every 5 to 10 days, you should talk to your doctor.
Tips for Easing Baby's Constipation
1.Try a different brand of formula -- after checking with your doctor -- if you'rebottle feeding. (Constipation should never be considered a reason to stopbreastfeeding.)
2.Add a little non-absorbable sugar or dark fruit (prune or pear) juice to your baby's formula. Or just give some extra water (if your baby is older than 4 months) -- no more than 1-2 ounces per day -- after checking with your doctor.
3.Try a glycerin suppository or the tip only of a well greased thermometer if the addition of a little sugar does not work. Do not try this more than once without talking to your doctor first.
4.Remember that most babies with occasional BMs are not truly "constipated" and nothing needs to be done.
When to Worry About Baby's Constipation
Contact your pediatrician if the occasional, hard stools seem to be causing a lot of discomfort to your baby. But keep in mind that occasional but soft, easy-to-pass poops are not constipation and rarely require help.