In the words of children’s author, Taro Gomi; ‘everybody poops’, and, I believe, becoming a parent marks the transition where most people start thinking about poo in a very different way than they ever thought possible! In the book of the same title, Taro tells us a ‘one humped camel makes a one humped poop, and a two humped camel makes a two humped poop’. Bowel habits are shrouded in mystery and humour, and it can be hard to know what is to be expected and when we should worry.

Constipation is the passing of a hard bowel motion with associated pain and discomfort. It is a common problem affecting up to 30% of children. This article will try to explain what is normal for young babies, and what to do when things go awry.

Breast fed babies can open their bowels from as often as five times a day to as infrequently as once a week. This is all normal! Their poo is soft, and generally yellow/mustard in colour. Formula fed babies usually poo 1-2 times a day and this tends to be firmer and green/brown in colour.

It is not unusual for a baby under the age of 6 months to strain and cry before passing soft stools. This is not constipation and reflects the bowel developing better coordination to pass the motion, normally this will settle with no intervention needed.

When a baby is constipated, their poo will be dry and crumbly, or harder and pellet like.

It is rare for a breast-fed baby to become constipated, but if this is the case, it may be as simple as you baby not getting quite enough milk and needing to be offered more frequent feeds. This happens especially during hot weather.

Sometimes formula fed babies can become constipated due to the formula not being made correctly. It’s an easy mistake to make and always worth checking that everyone involved in making the baby’s feeds are making it according to the instructions on the packet. During hot weather, formula fed babies may need to be offered extra drinks, such as cooled, boiled water between formula feeds.

Some solids are more constipating for younger babies. This includes legumes (peas and lentils etc) and high fibre cereals. These foods should be avoided when weaning little babies.

If a baby’s stool has become firmer, they may get a little tear in their anus or rectum, the pain from this might make your baby hold on, which allows the stool to get harder still, and compound the situation.

If you are worried your baby might be constipated, please come along to your local Maternal and Child Health Nurse, or your GP. We would be particularly keen to see them if your baby was showing any of these ‘Red Flag Symptoms’ –

– if your baby seems to be constipated under the age of 6 weeks

– is losing weight or not showing good growth

– persistent vomiting

– passing blood from the anus either on the nappy or mixed in the poo

– if your baby passed their first ‘meconium’ stool more than 24 hours after birth

Your baby will be fully assessed, and diagnoses such as low calcium levels and hypothyroidism will be considered. Usually, though, we are able to give some simple advice, and it will settle quickly. These tips can include, more fluids, gentle tummy massage, or even letting baby relax in a warm bath, which can act as a muscle relaxant, (just be ready for a little poop in the bath!)

There are some tips circulating which really aren’t a great idea for younger babies! Prune juice is a popular, effective, gentle remedy for constipation in young children, but is not suitable for babies under the age of 6 months, as it is a bowel irritant, even if diluted.  We often hear people try brown sugar as a remedy, sometimes added to cereal, but there is no scientific evidence to back this up.

It is important to introduce solids between 4-6 months, as recommended by your Health Professionals. Doing this earlier will not help treat constipation.

So it’s true, every body poops, constipation is common in children, but less so in babies. Normally it will be resolved by them having a little more fluid in their diet, but if you are worried, or they are showing any of the red flag symptoms listed in their article, get them checked!

More resources

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation-and-children

https://www.rch.org.au/kidsinfo/fact_sheets/Constipation/

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