A two part series on baby poo by our resident GP, Melissa. This article focuses on baby constipation. It follows on from an article about what is and isn’t normal.
Many parents are concerned about constipation in their baby, because it is common for little ones to really push and strain while doing a poo, often seemingly in pain. As discussed below, this can be normal and what tends to define constipation in babies is the passage of hard/dry stools.
Infant dyschezia
Do you worry that your baby seems to go red, cry, push and strain in order to do a poo? This is a common occurrence and generally normal as long as the poo that they do is nice and soft. It is called infant dyschezia and it is a condition that involves at least 10 minutes of crying and straining before the baby passes a soft poo. It is generally seen in babies less than six months. Watching your baby go through this can be quite distressing and it is common for parents to worry that their baby is constipated. It is not constipation (if the poos are very firm then this would be the case and that is a problem).
The act of doing a poo requires two things to happen at the same time
- Relaxing of the pelvic floor muscles and anal sphincter
- Increasing the pressure in the abdomen (which can be achieved by pushing down)
Some babies have not developed the coordination for these two events to occur together so they can’t easily do a poo. We think the crying is an attempt to increase the pressure in the abdomen (before they learn to bear down more effectively), rather than in response to pain.
If this is happening in your baby (who is otherwise healthy and growing normally), no further treatment or investigation is required. Suppositories or laxatives are NOT required. It resolves on its own as the baby develops (usually by 4-6months)
Constipation in babies
Unlike infant dyschezia, constipation is defined by passing hard (dry, pellet-like) or painful stools. There is a huge range of normal in how often a baby does a poo – from several times a day to every 10-14 days in breastfed babies. Generally if your baby is feeding well, gaining weight and passing soft poos when they do go, there is probably not an issue.
True constipation in young breastfed infants is rare and it may mean they are not getting enough milk or be the sign of other medical problems so see your doctor if you are worried about constipation. In older babies, particularly once solids start, constipation is a bit more common.
So, why might baby constipation develop?
- More common in formula fed than breast fed babies
- More common after the introduction of solids (particularly iron fortified cereals)
- Change in diet
