Milk and Constipation

Dr. Greene, our 19-month-old son has seemed to have trouble since his birth. He wouldn’t be miserable all the time, just a good portion of the time. At 1 year, he was introduced to cow’s milk. Before this time, he had consumed cheese and a few other dairy products. He is a very unsettled, miserable-acting child. As his mother, I know something is wrong. He has been having trouble with constipation for a while now. We have tried increasing fruit, veggies, and whole grains to no avail. He goes for days between stools, and when he does eliminate, there is a very hard, very large “plug” of stool that comes out, followed by two to five diapers full of loose stool within a couple of hours. His father is lactose intolerant yet can drink skim milk with no problems. My question is: should we try skim milk? Or should we try a lactose-free type of milk or soymilk? Any help would be appreciated greatly!!!
Shannon – Woodstock, Nebraska

Milk and Constipation

Dr. Greene`s Answer:

A cranky, unhappy toddler may well be responding to physical discomfort. Tummy troubles of one type or another can make anyone feel miserable. Milk is a major part of most children’s diets. If a child is intolerant to milk, this can affect how he feels every single day of his life. Nausea, cramps, and pain can squelch the normal joys of discovery and mastery.

But the classic symptoms of milk intolerance are diarrhea, spitting up, or abdominal pain. Many kids with milk intolerance also wheeze, especially when they get a cold. They can also have the dry, sensitive skin of eczema and their noses always seem to be running. Ear infections are also more common than in other kids. Constipation, however, has not been typically associated with milk intolerance — until now.

The observation that constipation might sometimes be caused by milk intolerance has appeared in the medical literature from time to time, dating back as far as 1954 (Pediatric Clinics of North America, 1954; 4:940-962). But only recently has there been a well-designed study published showing that this is indeed the case. The results of this study, when widely known, can set many children free to enjoy the exuberance of childhood without pain.

Researchers at the University of Palermo in Italy worked with 65 children with chronic constipation. All of these children had been treated with laxatives when dietary measures had failed. Even with the medical treatment, these children were still constipated, having hard, painful stools only every 3 to 15 days. Forty-nine of the their little bottoms had fissures and redness or swelling from the hard plugs of stool.

Each child received either cow’s milk or soymilk for 2 weeks, with no one knowing which was which. Next, they had a week during which they could eat and drink anything they wanted to wash out the effects of the first 2 weeks. Then they switched sides for 2 weeks and got the milk that they didn’t get the first time. Careful recordings of the bowel habits were made.

When the secret code was broken at the end of the study, they found status quo constipation for each child while he or she was on cow’s milk. But while they were taking soymilk (which causes firmer stools in most kids), 68% of these kids were no longer constipated! The redness, swelling, and fissures on their bottoms healed (New England Journal of Medicine, 1998; 339:1100-1104). How wonderful to finally have relief after diet and medicines hadn’t worked for so long!

The results were most dramatic in kids who also had frequent runny noses, eczema, or wheezing. Nevertheless, sometimes constipation can be the only symptom of cow’s milk intolerance.

This has broad implications. The children in this study were those with severe chronic constipation that was unresponsive to medications. I am convinced that they are only the tip of the iceberg. There must be a much larger group of mildly allergic children whose constipation improves with laxatives. Time may prove that it is better for these children to avoid the offending protein by switching milks rather than being treated with laxatives.

Presumably, swelling of the intestinal lining causes the constipation. Whatever the exact mechanism, the problem is likely with the protein in cow’s milk, not with the fat or lactose (the sugar). Skim milk or lactose-free milk will not help with this one. Switching to soymilk and other soy products might transform the life of your son in only a couple of weeks!

Unfortunately, some children are also soy protein intolerant. As it happens, this is more common in kids who are allergic to cow’s milk protein. If you don’t get good results within 2 weeks, I suggest also eliminating soy from the diet for 2 weeks as a trial. You might use Alimentum or Nutramigen (protein hydrolysate infant formulas) as the milk for these next 2 weeks because your son is much less likely to be allergic to the protein in them. If they work, you can then experiment with other sources of calcium, protein, and fat for the future (perhaps rice milk).

It’s not that common for simple changes to relieve relentless, longstanding problems. But when a child is made miserable by an allergy, removing the source can result in a rapid, dramatic improvement in the quality of life. I hope, Shannon, that this turns out to be the case with your son and that this next season his smiles double to make up for those he has missed.

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.

Sign-up for DrGreene's Newsletter

About once a month we send updates with most popular content, childrens' health alerts and other information about raising healthy children. We will not share your email address and never spam.

  1. Pranay Pandey

    Thanks so much Dr. Greene.

    One of the best well researched answer to the problem. We have the same problem with our 18months son.

    He is having severe hard and painful stool problem since last 5 months. Since the time when we started feeding him pasteurized milk.

    Consulting Drs suggested to reduce milk intake and we did that with fibre rich diet. But it didn’t solve the problems as we still needed to feed him with milk 3-4 times a day. Laxative Cremafin is the only medicine which worked, but we need to give him everyday. We also tried changing milk with lesser fat but it also didn’t help.

    Finally just before a couple of days we decided to completely stop his posturated milk intake and replaced it with Isomil soy.

    We are hoping problem goes away, fingers crossed.

    Added:
    Reply
  2. Grace

    Thank you everyone who shared your distress with others. I am happy to know that I am not alone.

    I have been breastfeeding my daughter until her doctor told me to stop breastfeeding for medical reasons. Now I am trying formula milk, but she is constipated.

    Today I will try another type of formula.

    Anyone who can breastfeed your baby, please do it. Your milk is the best for your baby. I breastfeed my other 2 kids without any problems. Now all I am getting is stress seeing my little one suffer, but I don’t know what to do next. Thanks doctor Greene.

    Added:
    Reply
  3. Grace

    My baby is 5 months old. She is in formula milk for 6 weeks now, but she is suffering from constipation. Thanks for doctor Greene answer. I will try as he said.

    Added:
    Reply
  4. LTiger

    Thank you for publishing this article. My youngest two children are half Native American so prone to lactose intolerance, as is their father. But, I also suspect a milk allergy coming from my side of the family, so I eliminated cow milk and soft cheeses for a month. Just to verify my suspicions, I went ahead and bought a gallon of milk (my youngest daughter loves her milk) and guess what? Constipation for everyone including my oldest who has no Native blood in her.

    After being up with my 11 month old and my 4 year old for 22 hours last night, I think it’s time for a major, permanent change in our dietary choices.

    Added:
    Reply
  5. Lenora

    Thank you Dr. Greene for your post on cow’s milk and constipation. My 2 1/2 year old son has struggled for almost two years and we tried EVERYTHING and nothing worked until going off cow’s milk. Now he’s been going on his own for two whole weeks since switching to almond milk.

    Can you tell me why no doctor has recommended going off cow’s milk in the past two years?

    I certainly hope this will change!

    Thank you again for your post.

    Lenora

    Added:
    Reply
  6. Ahmed shahin

    My daughter 7.5month have consitipation after starting artificial milk from 1.5 month we changeg milk type from promil gold to similac at last beblac 2 and still have dificult pooping and straining when she defecata up to milk come out from nose and mouth in past 1.5 month we started also some cerelac with rice and we stop it what solution ?

    Added:
    Reply
    • LTiger

      It may sound strange, but what about breast milk? There are ways to stay your own lactation or there are milk banks all over the place.

      Added:
      Reply
      • LTiger

        Start your own lactation***

        Added:
        Reply
  7. Umesh Bhatia

    My son is 8 month old and he has suffered from constipation since he was 2 months old. We have tried so many medicines in his formula milk, but nothing is going good for him. Please tell me what to do for my son.

    Added:
    Reply
  8. bonisiwe xulu

    Hello, ever since my little girl was born she has been constipated. I have tried different formulas, but she is still constipated. I give her weet bix and soft porridge in the morning, then in the afternoon and at night. I give her potatoes, pap and soup. I’m stressed. Please help my little girl.

    Added:
    Reply
  9. Teran

    My daughter is 3 months old and ever since she was born she has been constipated. We have tried 5 different formulas and nothing seems to help. The pediatricians we’ve seen don’t seem concerned because she is gaining weight properly and is over all healthy. She will have an incredibly hard bowel movement and be crying and screaming for hours after wards. I don’t know what is wrong with her or what to do to help. We’ve tried everything from switching formulas to warm prune juice and nothing helps. I just want to help my babygirl feel better. I just don’t know what else to do or what could be causing this. And no doctors will help my little girl.

    Added:
    Reply
  10. shasta

    My son is a little over 1 and since he was born he’s been on soy formula. He was put on milk (2%) and he has been have diarrhea.

    Added:
    Reply
  11. Kat

    Try goats milk instead of soy. Soy can lead to lots of problems, especially for boys since it has estrogen mimicking compounds. Goats milk is closer to human milk and easier to digest. My oldest can’t have cows milk or soy products.

    Added:
    Reply
  12. meg

    Did any one else guffaw at the idea you couldn’t tell if you were drinking cow’s milk vs soy milk?

    Added:
    Reply
    • Lenora

      Yes they can tell, and I was worried it wouldn’t work, but I explained it to my two and a half year old and he said ok, and switched to almond milk and he’s been going on his own for two weeks now, after two years of constipation trauma.

      Added:
      Reply
  13. Kristy Mazariegos

    I have the exact same issue with my 3 yr old hes been on laxatives since a infant and was covered with eczema from head to toe as a baby cried for first 6 months till dr tried every milk then nutramigen is where we ended up now thats hes 3 he stays sick all the time on antibiotics 4 times in 6 months I brought he back to dr I wanted answers he did allergy blood work and told me he is allergic to cows milk and then left me for the holidays with mo answer of what to do so im here looking for what now also. Good luck to ur baby I hope we get answers

    Added:
    Reply
  14. tenille

    I loved this article. Since my baby girl was born she has had a constant runny nose and eczema. I nptice she would get red after i would feed her and her nose would just run! I have took her to my doctor about four times and he acted like it wasnt a big deal. So long story short I have finally come to the conclusion its dairy and thia article has helped so much! Im going to try it out and see what happens. Thank you for your article!!!!

    Added:
    Reply
  15. Lauren

    Some doctors have suggested that my 9 week old baby could have a milk allergy and some other professional say that he hasnt, he was given neocate milk and has been on it for around 5/6 weeks but just recently we have changed him back to aptimal as he would only take 2 oz bottles of neocate and his symtoms were still the same he didn’t seem any better on neocate, he is now taking 5 oz of apitmal milk. His symptoms are very colicky/silent reflux, he hasn’t got dirrera or his never projectile sick or got skin rashes, he will cry for hours on end in the evening and will cry during the end of his last feed at night! We do get quite a few smiles in the day time, if he had a milk allergy would he be in pain/poorly all day long?? I wish he could have a test so we knew for definite but doctors say that there isn’t one for him, any advise would be great thanks

    Added:
    Reply
  16. Lauren

    Some doctors have suggested that my 9 week old baby could have a milk allergy and some other professional say that he hasnt, he was given neocate milk and has been on it for around 5/6 weeks but just recently we have changed him back to aptimal as he would only take 2 oz bottles of neocate and his symtoms were still the same he didn’t seem any better on neocate, he is now taking 5 oz of apitmal milk. His symptoms are very colicky/silent reflux, he hasn’t got dirrera or his never projectile sick or got skin rashes, he will cry for hours on end in the evening and will cry during the end of his last feed at night! We do get quite a few smiles in the day time, if he had a milk allergy would he be in pain/poorly all day long?? I wish he could have a test so we knew for definite but doctors say that there isn’t one for him, any advise would be great thanks

    Added:
    Reply
  17. Crystal Ogden

    I have an two year old daughter. Who seems to get constipated every time she drink any type of milk. I have taken her to several doctors who just put her on Miralax, which helps for a day or two and the third day she’s constipated again. I honestly think she is lactose intolerant because I’m lactose intolerant myself. Can someone help me please?

    Added:
    Reply
    • Karlie

      My daughter will be 3 in April and I’m going through the same thing. Since she was born she gets constipated every month and no one does anything except for freaking miralax. And it helps, like you said, for 2-3 days and she’s back to being in pain. I have taken my daughter to the ER 4 times for constipation because I’m crying over how bad she’s crying from pain. We have an appointment Thursday to see if I need to change her diet and I’m thinking she is allergic to dairy or lactose because she was formula fed and its been her whole life. Everyone keeps telling me if you’re lactose intolerant that you get diarrhea. But I noticed that when I switched her from 1% to whole milk for a couple of days (my dad grabbed me the wrong kind at the store) that she got extremely constipated, the worst she’s ever been. I hope you find relief for your toddler!

      Added:
      Reply
  18. Jennifer Colaizzi

    I find it very disheartening that the parents leaving these comments, do so with such terrible grammar. These are the adults raising the children of the future?? Scary

    Added:
    Reply
    • Hi Jennifer,

      Please keep in mind, this is site is visited by parents from all over the world. For many of them, English is their second or third language.

      Best,
      MsGreene

      Added:
      Reply
    • Spelling B runner up

      Oh please, cut the sanctimonious BS lady. Half of the university grad parents that I know are full of themselves and divorced…with great spelling and punctuation I might add. Love and a kind heart are what a child needs, to which I bet with your smug attitude you have very little of either. Get a grip on yourself.

      Added:
      Reply
    • LTiger

      Hey Jennifer,

      Does it make you feel good to pick on exhausted, stressed out parents who are worried about their children? Maybe you were trying to sound intelligent, but you only succeeded in proving your own ignorance, narrow-mindedness and immaturity by bullying people who are just trying to help their sick kids. Bravo, Jennifer, bravo. I’m super impressed.

      Added:
      Reply
  19. Nichole

    My daughter was diagnosed with Milk and Soy Protein Intolerance (MSPI) when she was 3-4 weeks old. We gave her hydrolyzed protein formula, and it was like she was a new baby. Happy, healthy, perfect. A little over one yr we introduced cows milk slowly. Soon after that she started to get constipated. The doctor said it was probably withholding. He said it is common for children, especially girls to deal with constipation. I personally have always thought that the mspi was the cause. We limit her milk intake and outlaw cheese, as that is a constipation guarantee. I have never before been able to find studies correlating milk protein intolerance to constipation. We will try almond milk and see if that helps. Thank you for addressing this issue. There isn’t enough research into this area.

    Added:
    Reply
    • Charlene

      I was having the same problem and switched to almond milk which is working great. No more constipation and he goes more regularly. My only concern now is that he starts daycare soon and they will not give him almond milk; only lactose free, soy, or rice – none of which my son has had. A little nervous as to how the new diet will affect his digestion.

      Added:
      Reply
      • ElisabethG

        I had this concern for my daughter when we first realized dairy was the cause of her years of horrible constipation (which stopped the day after I cut the dairy out of her diet). We spent hours trying to help her poop (prunes, all the other “p” foods, miralax, lots of water, exercise, belly rubs, warm baths). Stopped the dairy and she immediately could poop on her own. Any significant amount of dairy and she immediately can’t poop again. Anyways….her daycare must provide her with milk and also adheres to a tree nut free facility. She was able to have coconut milk there (not actually a nut) and continued with her *beloved* almond milk at home. Hope maybe your daycare can do the same. Best of luck!

        Added:
        Reply
  20. Katie

    My youngest (now 15 months old), was very young he would go 6-8 days without a bm and was a fussy baby every few days until he went. He was so happy and content normally that I knew he was only fussy because he didn’t feel good. I took him to see an allergist who suggested soy formula…LIFE CHANGING!! He began having a bm everyday and was the super content baby I knew he was! I have recently tried cow’s milk (pediatricians suggestion) with him and as long as he has enough fruits and veggies that keep things moving he does well with it. If he ends up seeming like he’s starting to get belly aches/constipated again though, I won’t hesitate for a minute to switch him back!

    Added:
    Reply
  21. Sooky Das

    I don’t believe that Study in Palermo, Italy of 65 Constipated babies. Having given myself a fissure from ignorantly ‘pushing’, & it took all my strength, which is the typical reason, a baby, not having the ability or knowledge or capability of ‘pushing’, I’m sceptical a baby is capable of developing a fissure. I more likely believe Anal Child Abuse has taken place & doctors & Mothers are dumb to it. These Doctors in Palermo also noted “Redness” on babies bottoms.

    Added:
    Reply
  22. Danielle Patterson

    This article has made me so happy finally a dr saying the cows milk can cause constipation, previously my daughter had diarrhoea and odd sickness we ended up having to gradually wean her onto cows milk from formula which the full transition was completed in May when my daughter was 17month and then since 17 month on full cows milk it has been chronic constipation…the laxatives didn’t work she seemed worse if anything. I am now on day 3 of soya milk and I am really hopefully this is going to help her constipation! Will update the results!!!

    Added:
    Reply
  23. destiny

    My son has been like this as well, but only since switching for 1 yrs old. We switched to almond milk and did amazing!! But I grabbed Kroger lactose free and back to the same problem, horriblely. Poor gut! Not sure the difference between almond milk and Kroger lactose free milk.
    He has been though so much! Colonoscopy, 2 capfuls of Miralx a day, ex lax per doctor. Ughh. Definitely a different boy when using almond milk!

    Added:
    Reply
  24. Savannah Kaye

    Well I had the same problem with it as well when u was a infant. Doctors told my mom I was iron deficit. Well that made it worse. So my mom started feeding me yogurt. And I have ate yogurt ever since and I know when I don’t get any yogurt in me because I become constipated. And I also only Finn 1% or 2% milk. I can not drink whole milk.

    Added:
    Reply
  25. Sinem Alanyurt Yalçın

    My daughter was hving chronşc constipationnfor the last one year. Even though the milg alergy test came out positive our dr told me i can fed her with any diary product. Now i changed our dr and we cut all mşlk productd as of today. For the last 2 weeks i ve been readin and readin annd this was the best article i have ever read. İ hope our const. Wil end very soon. Thx for all he information provided.

    Added:
    Reply
  26. Ang

    My little girl has had a constipation problem since birth but it is only when she drinks whole milk or 2% milk or anything to with milk period. I have took her to several doctors and done everything they have asked nothing has helped

    Added:
    Reply
    • Sara

      Ang, how old is your daughter? and what is she like with appetite?

      Added:
      Reply

Enter your message.

Your email address will not be published. Required fields are marked *