As new parents, you'll always be looking for your baby's next smile, laugh, and coo—little reassurances that they're happy and healthy. Poop, although not nearly as pleasant, is another thing you will probably monitor.
When your baby is pooping regularly, it's likely a sign that they're taking in enough food and disposing of the rest, says Jennifer Shu, M.D., an Atlanta-based pediatrician and co-author of Food Fights: Winning The Nutritional Challenges of Parenthood Armed With Insight, Humor, and a Bottle of Ketchup. So it's understandable that the absence of poop or a change in your baby's poop can cause concern.
And when your baby has hard, clay-like poop or trouble passing stools, it's reasonable to suspect constipation. Keep reading for a lowdown on baby constipation symptoms, causes, treatment, and more.
What Does 'Normal' Baby Poop Look Like?
Before you can understand what constipation looks like in babies, it helps to know what healthy baby poop looks like, and an important piece of that is knowing the difference between poop in formula-fed babies and poop in breastfed infants so you know what to expect for your baby.
Babies who are formula fed have poop that has a stronger odor, occurs between once or twice a day to once every couple of days, has a paste-like consistency, and is tan in color. Meanwhile, breastfed babies will have poop that may smell more mild, like buttered popcorn, and appears seedy and mustard-like. The frequency may range from after every feeding to only once a week.
And when solid foods enter the picture, parents should be prepared for the frequency, form, and color to change again. But as a frame of reference, babies 0 to 4 months of age poop on average three to four times a day, and after the introduction of solid foods, that decreases to approximately one bowel movement per day.
Many baby poop situations can be normal as long as their bowel movements look healthy and your baby does not appear uncomfortable or in pain.
How Often Should a Newborn Poop?
Signs of Constipation in Babies
With such a wide variation in normal, knowing when a baby is constipated can be tricky. But there are some symptoms to watch out for.
According to the National Library of Medicine, some signs of constipation in babies include:
Excessive fussinessSpitting up more often than usualTrouble passing stoolsHard, dry stoolsPain during bowel movementsA belly that's hard and painfulLarge bowel movementsBlood in the stoolTraces of liquid or stool in a diaperClenching their buttocks
“Consistency is key to defining constipation in breastfed babies. Rather than liquidy, seedy, pasty stools, the constipated baby's stool will be more like little clay balls,” says Jane Morton, M.D., a clinical professor of pediatrics at Stanford University School of Medicine, “though it is extremely rare for an exclusively breastfed baby to be constipated.”
The same holds for formula-fed babies: Harder, clay-like baby poop is a tip-off for constipation.
Another noticeable sign of constipation in babies is a prolonged absence of poop. Dr. Morton says if your little one doesn't have at least several bright, yellow (not dark brown or green) poops on day five of life, something could be wrong, regardless of whether they're breast- or formula-fed. This usually has to do with the baby not getting enough to eat.
But consistency and frequency are not the only clues of constipation. When poop is hard, like clay, it can be difficult to pass. So, if you notice long bouts of straining, that's another clue. In addition, harder poops can stretch and put stress on the anal walls, which can cause some bleeding and a small streak of bright-red blood in the stool.
Finally, if your baby is making straining faces and their antics are coupled with a firm belly that's painful to the touch, their intestines could be backed up. Your baby could also have constipation if they refuse to eat. Dr. Shu says that if nothing's coming out, a baby might feel so uncomfortable that they won't take any more in.
(Note that clay-like stool in the sense of stool being white or very pale can be a sign of liver disease, and parents should see their pediatrician if concerned.)
The Ultimate Baby Poop Color Chart
What Causes Baby Constipation?
Although it's rare for a baby on an all-liquid diet (i.e., breast milk or formula) to experience constipation, it can happen and exclusively formula-fed babies are more likely to have trouble with constipation, Dr. Morton says. This is because formula can firm up poop much more than breast milk can, Dr. Shu adds.
Causes of constipation in babies include:
Milk protein allergyLactose intoleranceIntroducing solid foodsNot drinking enough fluidsCertain bowel diseasesSome medicines
Though relatively rare, cow's milk protein allergy and lactose intolerance can cause a host of symptoms in babies, which sometimes include constipation. If your child has either an allergy or intolerance, cow's milk-based formula, milk protein and lactose passed through breast milk, or dairy products such as yogurt and cheese may be contributing to your baby's constipation.
When a baby is around 6 months old, pediatricians often give parents the green light to offer an array of foods other than breast milk or formula. What your infant eats will largely determine the kind of poop you can expect, Dr. Shu says—and many different foods could contribute to constipation.
If your child is eating solids, Dr. Morton says to start by considering your ABCs: applesauce, bananas, and cereal. Too much of these, especially rice cereal, can get you into constipation territory. When you start introducing table foods, pinpointing the constipation culprit might be even harder, so try to offer a variety of foods as part of a balanced diet to help prevent constipation.
What Causes Green Baby Poop?
How To Treat Baby Constipation
A change in formula or the nursing parent's diet could help combat constipation in formula-fed and breastfed babies, respectively. But before switching your baby's formula, be sure to consult a pediatrician. Sometimes a switch isn't necessary, so you can save yourself the time, effort, and cost.
Dr. Shu says that when babies start eating solid foods, which are often the cause of constipation in babies 6 months and older, diet changes can also be the cure. Several kinds of fruits and veggies, such as pears and broccoli, can get things back on track, along with fruit juice (in moderation) and water. Other foods to try include stone fruits (peaches, plums, prunes, nectarines, cherries, and dates).
When To Call a Health Care Provider
When a change in diet isn't doing the trick for your baby's constipation, talk to a pediatrician before employing other methods. In addition, always seek medical attention in the following situations:
When an infant who is not exclusively breastfed goes three or more days without poopingWhen an infant younger than 2 months experiences signs of constipationWhen an infant is not passing stools and is also vomiting or irritableWhen there is blood in the stool
A doctor may perform some tests, like blood work, a rectal exam, or abdominal X-rays. They might suggest gentle rectal stimulation using a cotton swab or rectal thermometer. Dr. Shu says this usually produces a bowel movement within several minutes of stimulation.
Another possibility is a glycerin suppository. If it works, it could take about an hour to produce a poop, Dr. Shu says. Other suggestions may include Miralax, a tasteless powder you can mix into a drink; senna, a natural vegetable laxative; and lactulose, a synthetic sugar for treating constipation. Always ask your pediatrician before trying any of these treatment options.
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