True constipation is actually quite rare in babies. Unfortunately, there is no standard definition of constipation because “normal” bowel movements are different between babies. However, if your baby is having a hard or painful time passing stool (pellet-like) for more than 2 weeks, he or she may have constipation.
As babies get older, they will have fewer and fewer bowel movements. The chart below shows how often an average baby will have a bowel movement.
Age | Bowel movements/week | Bowel movements/day (average) |
0-3 months Breast-fed | 5-40 | 2.9 |
Formula-fed | 5-28 | 2.0 |
6-12 months | 5-28 | 1.8 |
1-3 years | 4-21 | 1.4 |
More than 3 years | 3-14 | 1.0 |
Breast-fed babies usually will have more bowel movements compared to formula-fed infants. During the first week, the number of bowel movements (and wet diapers) your baby has is used to figure out if he or she is getting enough to eat. However, after the first month, you may find that your breastfed baby will not have a bowel movements for 5-6 days or even longer. This is totally normal as long as the stool is still soft and your baby isn’t straining. If you find that your baby’s stool is hard, and he or she is straining to have a bowel movement, contact your doctor, nurse or nutritionist.
It is important to know that iron-fortified formula should not cause constipation in babies, so continuing to give your baby iron-fortified formula is important, especially if they are not eating other foods. Sometimes if formula is prepared incorrectly, it can cause constipation. Check to make sure that you are adding enough water to the formula so that your baby doesn’t become dehydrated, which can be a cause of constipation. If you still feel that the formula is the cause of your baby’s constipation, contact your doctor, nurse, or nutritionist.
Monitor what is ‘normal’ for your baby. If anything changes from the ordinary, talk to your doctor or nurse.
• If your baby is being breast-fed, make sure your baby is latching on properly, feeding enough (not dehydrated)
• If your baby is being formula-fed, make sure you are preparing it properly. Too little water can cause your baby to be dehydrated, which can contribute to constipation
• Give prune, pear, and apple juice (older than 6 months, max ½ cup a day)
• Include fruit, vegetables, and whole grain (bread, pasta, rice, cereal) foods in your baby’s diet (older than 6 months)
• DO NOT use mineral oil, enemas or stimulant laxatives
• If your baby stomach is hard and bulging, is not eating, has blood mixed with stool, losing weight or gaining weight slower than normal see your nurse or doctor.
Some older babies and toddlers end up having constipation because they have trained themselves to “hold it in”. This may be because having bowel movements is unpleasant for them. For example, it may be painful or they are busy playing. Signs that your baby or toddler is holding it in include tightening their anal sphincter and bum, rising on their toes and rocking back and forth while stiffening their buttocks and legs, wriggling, or fidgeting. These signs sometimes are confused with the constipation (straining to have a bowel movement). If your baby or toddler has trained himself or herself to hold it in, diet will not help with the constipation. If this is the case, talk to your nurse or doctor to see how you can retrain your baby to have regular bowel movements.
Other than food, there are other things that may cause constipation in your baby. These include medication (side effects), and other medical conditions. Again, monitor what is ‘normal’ for your baby. If anything changes from the ordinary, talk to your doctor or nurse.