Identifying Infant Constipation
{Photo by Avi Reem}
A baby's bowel health is a vital factor in assessing her wellbeing.
A regular and functioning digestive
system communicates good feeding and healthy absorption.
Constipation makes it difficult to make those
judgments. If nothing is coming out, that means it's just sitting there…and
just sitting there is, at the least, uncomfortable, and at the most, deadly.
Both of my children have struggled with chronic constipation. It is such a horrible feeling to watch your
little baby crying, trying to poop. It's a helpless and agonizing few minutes. My doctor and I have had
countless conversations about this subject.
A Dangerous
Intussusception
In rare cases, the intestine telescopes on itself and creates a blockage.
The baby will
intermittently and abruptly cry and pull her legs toward her stomach. This is followed by periods
without pain or any signs of distress.
Contact your doctor immediately if you feel your baby has this condition.
What Causes Infant Constipation?
Infant constipation is the consequence of hard and infrequently passed bowel movements.
Don't get caught up in
"infrequently passed".
Every baby is different and needs to be assessed differently. Some babies
have bowel movements every day, and others every 5-7 days.
"Infrequently passed" will look different
for both of them. Constipation is rare in younger infants, tending to occur to babies after they've
started solids (around 6 months).
The colon in every animal on the planet stores excess, non-absorbable waste and water.
The balance of these two things is essential in maintaining a healthy digestive system.
The imbalances
that lead to infant constipation are:
- Not enough water in the colon, preventing bowel movements.
- Not enough bulk in the waste, preventing bowel movements.
Constipation can also occur when the urge to relieve the bowel is ignored or suppressed
(perhaps because of painful bowel movements in the past). This causes the retained stool to dry out, become hard and
difficult to pass.
Most infant constipation is not serious. It's usually more difficult for us than our babies! Fortunately, there
are several things you can do to help give him relief.
Identifying Constipation in a Newborn
Oh the Memories!
Some of the funniest videos we have are of our children pooping.
Both my daughters went flat-smile and slant-eyed when they were "bearing down".
Every poop was a mad-dash for the camera.
We're definitely well-stocked
for their first date.
There is no hard and fast rule to help you diagnose infant constipation.
However, there are some general questions you can ask to help that can guide you toward an answer.
- Is he leaving hard, dry pellets in his diaper?
- Does the bowel movement seem thicker than peanut butter?
- Has her bowel movement schedule suddenly shifted? Have poopy diapers abruptly stopped for no reason?
- Do his stools have streaks of blood on the outside, that could be from an anal tear? (Blood
can also be a sign of something more serious. Check out these warning colors and what to do about them.)
- Is she abnormally fussy? Does that fussiness seem to stop after a large poop?
Your baby may strain, grunt, and turn red-faced when having normal bowel movements. This is not necessarily
a sign of infant constipation.
It's a sign that he is learning how his body functions. Once that becomes
routine, his vocalizations will cease. If it still bothers you, sit him some warm water or hold him in the s
squat position for gravity to help him poop.
Breastfeeding
If you are breastfeeding and your baby is older than 8 weeks, it's possible for your baby to have a bowel movement only
once a week and still be normal. Read
this section for more information on breastfeeding and infant constipation.
Bottle Feeding
If you are bottle feeding, a good average is one poopy diaper a day. You will need to consider this
recommendation in the light of your baby's personal bowel habits.
Although these are the "suggested" time frames, none of my children have followed them.
As I mentioned before, my kids all struggle with constipation.
A "good" schedule for them is once every other day. Any longer than that and I start considering
infant constipation remedies (which you can read by clicking here).
If you or anyone in your family has had a history of irritable bowel syndrome, ulcerative colitis, Crohn's disease, or bowel motility disorders, or serious food allergies, be sure to share that with your doctor.
Newborn Constipation with Soft Stools
If your newborn cries hard before passing a soft stool, he may have infant dyschezia. Infant dyschezia
is a self-limited form of constipation.
Find out more information about this condition here.
Constipation in Infants that are Breastfeeding
If your newborn is younger than 6 to 8 weeks, frequent stooling is extremely importantin breastfed babies. It is the chief pre-indicator of whether your baby is going to grow at a healthy rate.
There are two kinds of breastmilk: foremilk (the "first" milk) and hindmilk (at the "hind" end). The
foremilk comes right away, is more plentiful, but has less fats and calories than the hindmilk.
Getting hindmilk (not just foremilk) is key to a healthy breastfed baby.
Doing wet diaper checks helps to monitor wether your baby is being properly hydrated. However, those wet diaper
checks only show he is getting foremilk. It doesn't show if he is getting the nutritious
hindmilk he needs to thrive. Breastfed babies (before solids) should have daily, or at most
every-other-day bowel movements.
Elena's happy face is a good indicator
things are functioning properly.
Instead, it is
most likely that he is not getting enough hindmilk (good nutrition) in your breastmilk.
This doesn't mean
that your milk is inferior, but probably means your technique and position needs to be improved.
These articles can help you do just that.
If your baby's stools are consistently green, watery and foamy, it may also be a sign of "oversupply
syndrome", a foremilk-hindmilk imbalance.
Your baby may act colicky, gain weight slowly and have forceful,
explosive bowel movements. Again, adjusting your breastfeeding technique can help with this problem.
As your baby grows, those bowel movements will get more and more spread out, sometimes even lasting
several days between movements - especially when solids are introduced.
Use consistent weight gain,
appetite and the firmness of the bowel movements to help you gauge digestive health. Anything firmer
than peanut butter should be treated.
This research was obtained from The Importance of Newborn Stool Counts an article by Denise Bastien for the La Leche League, the nation's largest breastfeeding organization.
Infant constipation ranks high on the list of a mother's worries. It truly is mind-blowing how much time
and energy we spend on making sure our babies are eating and eliminating on a regular basis.
Knowing how
to diagnose baby constipation in a short amount of time can quickly ease those worries.
All the photos on this page can be found at www.flickr.com and
were used
according to licensing requirements.
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