Babies & 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. 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 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. 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.

Foods that Constipate, Foods that Don’t

Bananas, rice cereal and applesauce all tend to produce firmer stools. Carrots and squash are constipating for some babies. 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.

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. 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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  2. sam

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

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  3. 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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  4. 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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  5. 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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  6. 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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  7. 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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  8. 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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  9. 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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  10. 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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  11. 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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    • [email protected]

      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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  12. 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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  13. 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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  14. 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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  15. 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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  16. 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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  17. 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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  18. 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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