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Reviewed by Dr Stephen Collins, GP
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What is infant constipation?
Constipation is a condition where stools become firmer and
harder. Your child will be troubled or in pain when they need to empty their
bowels, and the bowels will not be emptied as often as usual.
What causes it?
The breastfed baby
A
breastfed baby will
very rarely get constipation because breast milk is more easily
digested.
Breastfed babies have several helpful types of bacteria in
their large intestine that are capable of breaking down some of the otherwise
indigestible proteins in milk. As a result, their stools are softer, making
bowel movements easier.
Breastfed babies also have higher levels of a hormone called
motiline that increases the movement of the bowels.
The composition of breast milk also changes as your baby grows
older, so it will supply the needs of your baby at all times.
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Other causes
Food is usually the cause of baby constipation.
But in some cases, it can be a symptom of a more serious
underlying disease.
If your baby isn't gaining weight or shows any other unusual
symptoms, seek the advice of a doctor.
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The bottlefed baby
Bottlefed babies
frequently suffer from constipation because formula milk is harder for a baby
to digest.
A baby who receives only formula milk will typically have
fewer bowel movements than a breastfed child. Their stools will be thicker and
have a different, more greenish colour.
Bowel movement in newborns (up to six months old)
It is equally normal for a young baby to have a bowel movement
several times a day or as little as once a week. In rare cases, there can be up
to three weeks between bowel movements.
A young baby should only be given a laxative if he or she is
bothered by the long intervals between bowel movements.
Breastfed babies usually have frequent bowel movements until
they are two to three months old. Their stools are typically yellow.
Bowel movement in older babies (from four months old)
Once a baby starts on
transition foods or
solids, the frequency of bowel movements and the consistency and
appearance of their stools will depend on the food they eat. Your baby's stools
will begin to look a bit more like ordinary stools in consistency and smell.
Once your baby starts eating solid food, the pattern in bowel
movements will change. Your infant will have movements several times a day or
as infrequently as once every two to three days.
At this point, some babies may get slightly constipated. This is
because the intestines have to get used to the new composition of the
nutrients.
Once a baby's food consists of more solid food, constipation may
be caused by dehydration.
A vicious circle
When a baby first becomes constipated, it can be the start of a
vicious circle.
This is because it will hurt your baby to pass the large hard
stools that have gathered in the intestine. Cracks around the anus may appear;
these may start to bleed and cause more pain.
To avoid the pain, your baby may subconsciously start holding
back stools, which makes the food stay longer in the large
intestine.
As a result, your baby's body will absorb more water from the
stools and make the stools even harder. This can cause your baby to remain
constipated.
A baby who is constipated often has
colic pains, because the large amount
of stool in the intestines makes the intestines dilate. In some cases, the
child may not want to eat and may even retch a little.
What can you do to treat constipation?
Massage your baby's tummy
Start at the belly button and then massage outwards in circles
in a clockwise direction. Some oil or cream on your fingers can also help.
Only continue if your baby enjoys the massage and is
comfortable and relaxed.
Move your baby's legs in a cycling motion
Place your baby so he or she is lying on their back. Hold
their legs and turn them gently in a quick cycling motion.
This will make the stomach muscles move and, in turn, put
gentle pressure on the intestines to make them move.
Give your baby a bath
A warm bath can make your baby relax so the stools are passed
more easily. Once your baby has relaxed in the bath, you can also massage their
stomach (see above).
When you wash your baby's bottom, apply some cream or
petroleum jelly (Vaseline) around the outside of the anus.
Don't use a thermometer to stimulate movement
Don't put a thermometer or anything else inside your
baby's anus to stimulate bowel movement, because this may cause damage.
Check you are making formula correctly
If your baby is on formula milk, you should follow the
instructions on the package carefully. Making the mixture too thick by putting
in more than the recommended amount of powder can lead to constipation and
other medical problems.
There are different brands of formula milk on the market, and
they are basically of equal quality. It's best to stick to the same brand,
because different formulas may require different dilutions.
Give cooled, boiled water
You can give your baby extra fluids with bottles of cooled,
boiled water.
Preventing constipation
Once your baby is between four to six months old, you can start
introducing more porridge and fruit or vegetable purées into their diet. These
are rich in fibre and will help prevent constipation. Prune purée is
particularly good for this purpose.
What if constipation continues?
If the above suggestions don't work for your baby, consult a
doctor about special
laxatives for chronic
constipation.
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Based on a text by Jane Tanghøj, health visitor
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Last updated 04.01.2005
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