Constipation in Infants: Causes and Treatments

Ever wondered if your infant’s stooling pattern is normal?

It is very hard to define normal stooling in infants and this can be due to many factors. One major factor that may change how frequently your baby has a bowel movement is how you feed your baby (breastfeeding vs formula feeding).

In the first three months of your baby’s life, breastfed infants typically should pass an average of three stools per day. However, some babies that are breastfed may have a bowel movement after each feeding and some breastfed babies may not have a bowel movement for seven days.

It is common for formula-fed infants to have an average of two bowel movements daily, but this can vary depending on the type of formula your infant gets. As your child grows, you may notice they have a slow decrease in how often they have a bowel movement, which is totally normal. By the age of two years old, your child should be having just under two bowel movements per day.

Isn’t straining while trying to stool a sign of constipation?

Not always. Straining is common in infants and is not worrisome as long as stools are soft - this is called infant dyschezia. If your infant is straining to have a bowel movement and their stools are hard, this is constipation.

When to pay extra attention to your child’s bowel movements.

Constipation tends to develop when infants transition to a solid diet and can often happen during the transition due to insufficient fiber and fluid, or it can be related to cow’s milk intake.

How much fiber does my child need?

For infants and children under two, it is recommended they get 5 grams of fiber per day, although there are no real clear guidelines on infants under one. Once your infant is old enough to introduce solids (around 6 months), make sure to include a variety of pureed vegetables, fruits and fiber-containing infant cereal to ensure adequate fiber intake.

What to do if introducing cow’s milk to your child causes constipation:

If transitioning from breastmilk or formula to cow’s milk plays a role in constipation, it is reasonable to do a trial of limiting cow’s milk to 24 oz daily or trial a dairy-free alternative. This will help to rule out if it is the cow’s milk or something else that is contributing to constipation. If you choose to do a dairy-free alternative, make sure you are choosing options that have protein.

How do I help my baby’s constipation?

For infants less than 4 months old, 1-2 ounces of diluted prune juice can be used. For infants over 4 months old, try 2-4 ounces of 100% fruit juice. Once constipation has been relieved, stop giving your baby juice, while monitoring bowel movements, in hopes to avoid unnecessary juice intake.

If your baby has started solid foods, try increasing fiber by giving more fruit/vegetable purees and choose multigrain or barley cereal instead of rice cereal.

As always, talk to your pediatrician to ensure these suggestions are appropriate for your baby.

What about constipation in children? Learn more about that here!

_{Sood, M. R. (2022, April). Recent-onset constipation in infants and children. UpToDate. Retrieved June 20, 2022.}

 _{Sood, M. R. (2022, May). Constipation in infants. UpToDate. Retrieved June 20, 2022.}