Infant Constipation

What should I do if I think my baby is constipated? He looks like he’s straining sometimes.

Infant Constipation

Dr. Greene’s Answer:

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.

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. And contact your pediatrician if the baby is less than a month old and hasn’t gone for 4 days. At two months old, healthy breastfed babies may go 8 days between stools without being constipated. Healthy formula-fed babies at that age usually go every couple of 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.

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. 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).

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. javaid ahmad

    My two month brestfed baby is stressing grunting and pushing forcefully. Although he poos everyday, he sips out milk sometimes curdy sometimes pure milk. He has abdominal pain, also he cries while stressing. What shall I do?

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  2. javaid ahmad

    My 55 days brestfed baby is stressing and pushing forcefully. He does stool, but before doing stool he has some watery anus. He also has abdominal pain on and of. We are giving him xymax drop and figolax drops. What shall I do.

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  3. Javaid Ahmad

    My newborn baby is stressing, pushing forcefully, although he does stool everyday. What should I do? He has abdominal pain, also.

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      • javaid ahmad

        My baby is 50 days old and is brestfeeding. Everytime he feeds he is stressing and pushing forcefully although he does stool. He also has abdominal pain and bloating.

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  4. Valerie

    The set of twins2-4 months old, I am the Governess to were always constipated, the Pediatrician suggested corn syrup (yuck) or 1/2prune juice1/2 water, the juice did terrible things to their stomach, so what I did was give them two ounces of pedialyte twice a day. It worked perfectly.

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