Babies and Constipation

Dr. Greene, my 7-week-old son hasn’t pooped in three days. All he gets is breast milk. Is this normal? Is he constipated? I’ve heard both. If he is constipated, what should I do? Sometimes he acts like he’s about to poop, his face gets red and he strains, but nothing comes out. Otherwise he’s fine — including his nursing. Thanks in advance.

Babies and Constipation

Dr. Greene’s Answer:

As long as your son is in diapers, every single poop will be right there for you to see when the diaper is changed. During these years, the stools undergo several changes. The first poops are the thick, sticky, tarry meconium stools that consist partly of old skin cells that are shed and then swallowed while the baby is still inside you.

During the first week these give way, in breast-fed babies, to soft, yellow, breast-milk stools. These usually look like yellow mustard with little seeds.

How Often Should Babies Have a Dirty Diaper?

By the time a baby is one week old, he has an average of 8 to 10 of these pleasant (as stools go) stools each day.

You can imagine that if these were 8 to 10 stinky stools, or if even the pleasant (as stools go) stools kept up at this pace, changing diapers would get real old real fast.

For most breast-fed babies, the number drops to about 4 per day by 4 weeks old (although many kids have a different pattern).

Formula-fed babies usually stool less often at this age, and the stools do not change much with time until solid foods are introduced (because unlike breast milk, formula doesn’t change over time). Formula-fed stools are often tan or yellow at this stage, and a little firmer than breast-milk stools.

For any baby, tan, yellow, green, or brown stools can all be normal.

By 8 weeks old, the average drops to 1 per day. Most formula-fed babies will not go less often than daily, but many breast-fed kids will poop even less often than this. I know many babies who only go every three days.

If a happy formula-fed baby goes 4 days, or a breast-fed baby goes 7 days without a stool, I recommend that he or she be checked once by a pediatrician. If the child seems to be in pain, has vomiting, or has blood in the stool, he should be seen by the pediatrician immediately. Otherwise, it can be completely normal to go only once every eight days — as long as the stool is soft when it comes out. Breast milk is an amazing food that leaves very little in the way of waste.

Is Straining Normal for a Baby

Babies will strain from time to time to move the stool along through the intestines. If you want to do something when babies grunt, push, or strain, try picking them up to get gravity to help them in their efforts, or try holding the knees against the chest to help them “squat” — the natural poop position. Straining is usually normal. Crying while straining may be a sign of constipation.

Hard Stool: When to Contact Your Doctor

When a child is constipated, the stool in the intestines has backed up more than it should. What “more than it should” means varies depending on the age of the child and the diet. The longer stool sits in the colon, the more water is absorbed back into the body. When a child is constipated the stool tends to be hard, and passing it tends to be painful.

Stool that is hard (firmer than peanut butter) or foul smelling (you’ll know) in a child who has not yet had solid foods may represent something as simple as needing more to drink (especially during hot weather), but it may also be the sign of a disease. Contact your pediatrician to discuss the situation. If the baby is otherwise healthy, one teaspoon of pure maple syrup in 4 ounces of water will often get things back on track. Also, contact your pediatrician if the baby is less than a month old and hasn’t gone for 4 days. When kids begin to take baby food, the stools change once again. They may be either softer or firmer, but they will likely smell worse (kids also smile and laugh more at this age, more than making up for the unpleasantness). Most children’s intestines are very responsive to the foods they eat.

Babies and Constipation: Foods that Do, Foods that Don’t

Foods that tend to produce firmer stool:

  • Bananas
  • Rice cereal
  • Applesauce
  • Carrots and squash are constipating for some babies.

Foods that tend to produce softer stool:

  • Pears
  • Peaches
  • Plums
  • Apricots
  • Peas
  • Prunes

By balancing the diet, you can often keep the stools comfortably mid-range. If the stools are still too firm, juice is the gentlest medicine to soften them up. Two ounces of apple juice twice a day is a good bet. If this doesn’t work, prune juice is even better. Also, when your son is straining you might want to put him in a tub of warm water. This will relax his muscles and make the stool easier to pass.

Babies and Constipation: When Diet Doesn’t Do the Trick

Glycerin suppositories can be very helpful if diet and juice don’t work, but constipation that is stubborn enough to make these optimal should be discussed with your pediatrician. The same holds true for baby laxatives (hint: if your pediatrician does recommend a laxative, unprocessed bran, 1/2 teaspoon mixed with food twice a day is much cheaper than Maltsupex, and about as effective).

For most breast-fed babies, a 3-day break from dirty diapers is a reason to celebrate, not a cause for alarm. It’s nature’s reminder that breast milk is the perfect food for babies — or more broadly, that giving of yourself is a perfect gift for your child. This normal poop-pause is also a little foretaste of what life will be like when there are no more dirty diapers!

 

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Cherry

    We have found some brown sugar dissolved in water on the occasions when our son’s allergy issues have left him constipated. Would definitely push your GP for some allergy tests….

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  2. Chanell

    I will never let my kids rely on medication IMO. No matter adults or children, rely on medication in long term will cause health affected. When my children constipate, I will use natural remedy to heal him. Of course, normally I would let him eat more vegetables and fruits in order to be able to prevent constipation. However, as far as I know different brands of infant formula milk have different ingredients, children are quite sensitive with it. Is it your child is not fit to drink with the current formula milk brand?

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  3. Tabii

    My DD has always suffered from constipation since she was 2. She is now 4 1/2 and has terrible tummy aches and only passes a rock bowel movement once a week if lucky. I fed her food with high fiber and also lots of water and fruits. Still we have been having no luck. I took her to consult DOC and was told that she has a sensitive bowel and will probably always have trouble. He suggested to give her Laxettes. I am worried about this if long term use. Has anyone else had to use medication to treat constipation?

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  4. Jasmine

    My 2YO DD is diarrhea and constipated after start solid, any solution can help her to prevent this kind of issue?

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    • Claudia

      Try the food mentioned above. They works on my son.

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      • gayaputri

        i’ve also had that problem. my 3 years old daughter had fewer bowel movement. i guess it maybe cause of the travelling we did during our vacation which just messed up her routine and comfort zone. but i realize she felt hurt when she want to poo. she strained in toilet. so i gave her the food that mentioned above. but it just working for a short time. after a day, she felt hurt again when had bowel movement.

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  5. Gina

    Look into hemp milk, way better than any formula based milk for a one yr old

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    • nancyluu

      As what I understand that hemp milk is made from the seeds of the edible part of the same plant (Cannabis sativa L) used to make marijuana. that why, I always curious will it safe for my kids to consume?! Sound like making my kids taking drug.. I would rather take formula cow milk…

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      • serenemango

        No,that is not correct.Hemp ia a completely different plant. It is a cousin of marijuana, just like hops, but it contains practically no THC.There is no use for this plant as a drug but its seeds are high in omega 3 and 6 fatty acids making hemp milk nutritious.There are actually a bunch of great practical uses for this plant ranging from textiles to oils. But to answer your question, no, hemp milk would not hurt or dope up your baby!

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  6. azizah

    I am planning to stop bf my DS anymore. As now he is reaching 1 yo already.
    Anyway anyone can recommend any good milk powder that suitable for children at 1 yo?

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  7. Giva

    That’s really works. Thanks for sharing.

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  8. Same L0rrr

    great article

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  9. Mrs. Kwon

    thanks…

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  10. Tonq

    thanks!!!

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  11. Bita

    My 2 month old baby is exclusively breast fed, and she didn’t poop for 3 days. I gave her tummy oil massage, and with leg pumping but didn’t work. Finally with thermometer stimulation she passed poop.

    Again its three days and hasn’t passed poop. Any suggestions, many say fennel tea is good , or gripe water, I don’t want to give her anything other than breast milk.

    Should I be worried about this constant constipation. I’m very careful about what I eat and have increased vegetables and fruits ..
    there are Glycerin suppositories which I could use for her, but will she be dependent on them??

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  12. Mbali

    My baby gal she is 7month shes is suffering from constipation since shes been introduced to solids food,her stool is very hard and like d rock n she cry a lot when she passing it i have try all the remedy but non of them is working for her!please i need help.

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  13. sarita shrestha

    My daughter is 2 years old. She hasn’t done any poop for 2 days. She’s constipated.i dont know what to do to ease up her constipation. Should I be worried? What should I do?

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  14. Sumedha

    My son was constipated and my mom use to put tamarind dipped in oil in his bottom and hold his legs up. It helps us alot. Even now i put it Lil bit in his butt and make him sit on a potty seat. He tries and does it in potty seat now. He completed five months yesterday :) i hate to see my baby cry in pain all constipated. So i always keep him happy by making him sit on potty seat with tamarind. Also i give karo syrup sometimes. I tried prune juice diluted in water. All the best with your babies :)

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  15. Nicole

    My son is 4 month old and only breastfed. He has been going poop every 10 days or so and by the end of those days he screams and cries and is clearly in A LOT of pain. The doctors keep telling me he’s not constipated, but he isn’t pooping… He keeps going longer and longer without pooping and his fussiness gets worse and when he’s in pain he freaks out.

    We were told to start him on sweet potatoes and prunes and so we have the past week and he still hasn’t pooped! Its day 10 and he’s had 2 freak outs where he is basically inconsolable and I’m at my ends wit with the stress of not knowing if something is wrong or not. Like is this normal because I know my son better then anyone and this is NOT normal. He is NOT a fussy baby at all. So for him to scream in pain, like seriously scream, at the top if his little lungs till he passes out of exhaustion isn’t normal. I can’t even get him to latch and he NEVER refuses the boob, so it’s not normal. What should I do??…

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    • This must be so difficult.

      As a mom, if it were me, I’d take him to see a different doctor.

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    • Val

      My daughter is having a similar problem. Her pediatrician keeps telling me it’s normal that she goes between 3-6 days with out a bm. Have you found anything that helps?

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    • Mayra

      Hi. So sorry to hear the issue. Hope I’m not too late to help, but my LO had the same exact problem so I feel your pain. It’s so hard because all you want to do is help them. But my doctor said everything was fine. In my gut I knew that was not the case. My mother told me chamomile tea would help, so I fed him some warm tea with a medicine dropper, gave him a warm bath, some gas drops and wrapped my baby tight. 30 minutes later he popped. Felt much better for a week (no inconsolable crying, longer naps, less irritable) but still no poop after the one poop the week prior. Almost lost hope!

      Scheduled an appointment with the main doctor owner of the place (only there once a week for circumcision) and I explained everything with detail. He told me that my LO was having a different problem and the constipation was just a coincidence… I was close to screaming! But he got into more detail, he explained BF babies can easily go up to 6 days without bowel movements (which if normal will not affect baby) but my LOs problem was worse. ACID REFLUX…. I was feeding him every 2hrs, and sometimes soothing him with nursing him. My LO refuses any pacifier. He told me to cut caffeine, sodas and spicy food from my diet. As well as only feeding him every 3 hours. Now I tried the feeding schedule since the diet restrictions were already something I was doing, it was hard to be honest since my LO always wanted to nurse, but I tried everything to soothe him instead (walks, singing, baths and car rides)… I saw results instantly.

      I am sooooo thankful that I got a second opinion and listened to my gut. My baby no longer has this issue, acid reflux is under control due to a feeding schedule and the constipation is still there with poop only every 2-4 days, but no pain or discomfort. Now I understand all his symptoms, specially the one where he would refuse my breast or would grunt and pull away while nursing. He was having heartburn. Glad it’s all gone now, just wished I would of acted sooner. —-hope my story helps.

      Trust your gut, your mother senses never fail.

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    • Sheila

      Sounds like a case of purple crying. Purple crying is just a description of a time period when baby cries without any particular reason other than an important part of development. Most parents new to this term without knowledge think something could be wrong with baby, such as baby is colic or in pain. It can begin between 2-3 weeks, and last until 3-4 months.

      http://purplecrying.info/what-is-the-period-of-purple-crying.php

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  16. Terryterry

    Thanks for the info!

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  17. cindy

    Hi my son is one month old now. He’s only on formula. The name is similac advance and he sometimes poops and when he does, his poops is almost all the time green all type of green and sometime he doesn’t poop and when he doesn’t he cries. He won’t sleep. He does try to poop. He makes noise and sometimes gets all red by trying to forse himself to poop. I’m a new mom. I don’t know what to do need helps please.

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    • Heather

      As long as your baby’s stools remain a yellow or greenish color at this age, it’s perfectly normal. Maybe consult your doctor about things you can do to make passing the stools easier. Such as: rectal thermometer stimulation (can also use a q-tip with Vaseline of course, and don’t enter too far in), adding 1 tsp Karo syrup to formula bottle, adding Miralax to his diet (this would be the more recommended and safest brand to use I believe). Obviously don’t use all of the techniques. Good luck with baby ☺

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  18. mj

    My daughter is 1 month old. I breast feed her and formula feed. She hasn’t done any poop for 2 days. She’s constipated. Should I be worried? What should I do?

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  19. normalmalay

    My son also has the same issues.

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  20. Tebogo Mokoena

    My baby is a month old and had already started eating solids like Purity Maizeand (I am also brastfeesding) but has not passed stool in two days now. Should I be worried.

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    • Brit

      A one month old baby should not be consuming solids of any kind. Only breastmilk for formula is recommended by both the WHO and the AAP.

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    • maygun

      Uhm.. whut
      Your breastmilk is enough. Pumping is.definitely not a good way to measure how much you’re actually producing.

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  21. sam

    It so helpful the info provide about stools. Thank you doctor.

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  22. lesliemui8888

    fyi, a cheap milk formula will not do any good to your child because it may lack ingredients that will help in the growth of your child. It’s better to invest to find the right milk formula for your baby because a good one that suit your child might eliminate constipation problems.
    NEVER go for cheap milk formulas, but PROVEN ones.

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  23. Halley Leong

    Well there’s a lot you can find in the market now which contains Prebiotics. I used Mamil from Dumex myself for my LO. You can try it for your LO too because it really works in solving constipation problems in toddlers. IMO Mamil is a pretty good treatment for constipation in babies which you can see definite results in a week time. Hope it helps!

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  24. bunnyjerry

    I only know that milk formula will help kids to be smarter. Never heard of milk powder containing Prebiotics and could solve constipation. Heaty are the main reason why kids having constipation. Maintaining a healthy digestive system is very important to prevent child’s constipation problem. There are some common good habits that I train my kids by drinking lots of water, eat fruits frequently and avoid oily and fried foods.

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  25. joellerollokostor

    I have a son who is turning 2 this year, but recently he has been constipated off and on. At times I was so worried when he was constipated for 1 week straight he could be seen agitated, annoyed and lethargic. I sent him to the doc to check up. The doc just gave him a pill to make his stool softer. After that the problem came back. I went to my parents for a second opinion. What they told me could be the formula that he’s consuming that is making him constipated. They said get a formula that contains prebiotics. Are there any formulas that contain prebiotics around?

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  26. Goretty

    My baby is 4 months old. He’s on soy formula since his first month because intolerant to lactosa and that makes his stool a little hard. Can I introduce him to avocado instead of cereal?

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  27. Alex

    My 5 month old wakes up at night straining and crying. She won’t eat much if anything for couple days now and I can see the feces when I change her diaper, but can do nothing to help her. I feel so bad for my little dumb dumb head. What should I do?

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  28. Shannon

    My son is 8 months old and he’s had a number of different GI issues. More recently, he’s extremely constipated and the only way to get the blocked hard stool is to use 3 glycerin liquid suppositories. This, of course, after we remove a good amount of hard stool. Before I give his history, my question is how can we keep him from getting constipated to this point?

    He was exclusively breastfeed up to 5 months when I introduced formula. He was constipated before introducing the new formula. GI thought it was dairy in my diet so I modified. Still didn’t get better. He gets 5ml of Lactolose daily, which doesn’t seem to help, unless it takes a few weeks to kick in. He’s now solely on 95% lactose free Earth’s Best Formula, eating prunes and other solids, no yogurt, bananas, applesauce, but he’s still in terrible pain. Can this really hurt him long term or it’s just a phase? GI really is not cutting it or is this just common in some babies? Also, he never has blood in his stool.
    Thank you!

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    • Shannon

      Dr Greene, how can I get advice on this post? Thank you.

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  29. Lucyca

    Dr, Greene,

    Thank you for your nice and effective advice. One more concern from my side is that at the time when stool not coming out for 2-3 day, wearing diaper is natural or not? Please advice.

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  30. ashley

    My son is straining to poop and he cries and his face turnd red and I have tried what his doctor told me to do and he still ain’t pooped and what else can I do to make him poop?

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    • emma.zubiri@yahoo.com

      My grand daughter is 6months old she is constipated with her milk. What is the remedy for this? Does apple juice do for her? Hope I can hear a rely as soon as possible.

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      • Dr. Greene Recommends: Pears, peaches, plums, apricots, peas and prunes make stools softer. By balancing the diet, you can often keep the stools comfortably mid-range. If the stools are still too firm, juice is the gentlest medicine to soften them up. Two ounces of apple juice twice a day is a good bet. If this doesn’t work, prune juice is even better. Also, when your son is straining you might want to put him in a tub of warm water. This will relax his muscles and make the stool easier to pass.

        These are all foods you can buy from your local market. The fresh fruits should be cooked and mashed into a smooth puree. The juices can be added to a bottle, but do NOT add juice to a bottle on a regular basis. This is for constipation only.

        Hope that helps.

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  31. JP

    My son turned 1 today and has not pooped for the past 4-5days. We have previously had to use suppositories, but really don’t like doing that as it seems to be causing excruciating pain for the little man. PLEASE can someone help and advise on what to do?

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  32. maria

    Hi. I am a new mother my son is 3 months-old. He only has breastmilk, with a little bit of organic oatmeal cereal. He hasn’t pooped since yesterday morning. Today nothing. He farts a lot, but that’s it. I was suggested to give him drops of prune juice in his milk. If that’s Ok how much? What can I do?

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  33. Ilana

    Thank you for this very useful information. My 9-month-old is on breast milk, vegetables and a little water, usually. She has been so constipated that she cries terribly for up to half an hour and sometimes intermittently through the night, waking her up every couple of hours (though not every night, thank God). I gave her jarred prune baby food which seemed to help, but not 100%. I was also concerned that the added ascorbic acid preservative was not ideal. However I’ve been giving her lots of butternut squash and have not heard til reading this that it could constipate. I will try eliminating it. How about green beans and lentils? I like to feed her these. Would they pose a constipation or gas problem??
    My other question is why you recommend Karo syrup?! Recent research has been showing the harmfulness of Genetically Modified Organisms, such as the corn that is used to make corn syrup. Surely this is bad for fragile and nutritionally impressionable babies, let alone adults! If sugar is the hung that helps soften the stools, then wouldn’t dried fruits (like, as you mentioned, prunes or apricots) be the more ideal option?

    Thank you.

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    • alex

      Ascorbic acid is vitamin C.

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  34. Eli

    My baby is four weeks old and her stools are soft and yellow. She has been straining and grunting all the time she is awake. Sometimes the straining and grunting wakes her up and she feels uncomfortable, she begins crying and wants to be held in my arms. I am worried about this issue. Any ideas what this should be and how long will this last. She has begun this from week 2.

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    • stephanie kay

      If her stool Is soft and yellow, then she may likely be affected my gas, she may be colic… She would outgrow it. I only gave my son gripe water at that stage.

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  35. halima

    my son is 14 months old formula and breast milk fed. he is always constipated yet i give all soft foods foreaxample yorghut,yellow bananas grapes at times even forced to give blue band(margarine) and alots of juices and water cos he like drinking and eating so every thing i give he eats with love but he ends up being constipated. wat should i do because im worried

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  36. busani

    my daughter is 1 month old and she is constipated,i dont know what to do to ease up her constipation

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    • stephanie kay

      Iron multivitamin could also cause constipation. You can give at intervals instead of everyday.

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  37. cathryn

    my son is 14 days old, formula and breast milk fed. He hasn’t pooped in three almost four days :( he pushes like he needs to go however, nothing comes. He smells when he passes gas and he’s clearly uncomfortable. I’ve tried adding 1/2 tsp of brown sugar to his food, twice and still nothing.. what should I do? do i need to be worried?

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    • Nancy

      Buy laxatte solution,it’s sold over the counter n it helped my 1 month old son.he was going thru the same thing.

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