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Photography by Aya Brackett

The only thing worse than the dreaded poopy diaper? Worrying about why your baby isn’t having one.

If your baby has gone several days without a dirty diaper, you may be ready to tear out your hair trying to figure out what’s wrong.

As you run through all the potential causes, one thing likely to cross your mind is their diet — especially if you’ve recently started them on formula.

Is it true that formula can cause constipation? What should you do if your baby is constipated? When do you need to contact your child’s pediatrician? Let’s take a look.

It’s true: Formula-fed babies are more likely to be constipated than those exclusively on breast milk. Why is this?

Well, breast milk is generally easier for babies to digest and considered a natural laxative.

Formula, on the other hand, is thicker. It has larger proteins that can be harder to digest. This makes gastrointestinal problems — including constipation — more likely.

But keep in mind that this doesn’t mean it’s impossible for a breastfed baby to become constipated or that all babies on formula will be constipated.

Every baby is different. Also, whether formula-fed or breastfed, your baby may show signs of constipation when you introduce solids into their diet.

One other note: Some babies fed exclusively with breast milk don’t poop frequently, but in those cases it’s likely because their bodies are absorbing all the nutrient-filled breast milk they’re eating.

Wondering if your baby is constipated? Signs of constipation include:

  • infrequent or less common bowel movements
  • hard bowel movements that can appear like pellets, rocks, or hard balls
  • blood on the surface of the stool or when wiping
  • pain while passing bowel movements — for a baby who can’t communicate with words, this may appear as an arched back, a red face, and crying
  • a tight belly
  • lack of interest in food

The number of poop-filled diapers a baby will have each day or week can vary greatly. Use your baby’s normal — not your neighbor’s baby or your brother’s baby — as the baseline to help you determine if they’re constipated.

And it’s important to remember that constipation isn’t just about how frequently your infant is pooping, but also about how hard it is for them to do so.

If they poop once every 3 to 4 days, but the poop is soft and seems to pass easily, they may be just fine. On the other hand, if your baby poops every other day but is straining and crying while pooping and the poop is hard, they may be constipated.

If you’ve recently switched to formula after exclusively breastfeeding your baby, you may notice changes in your baby’s poop. It’s not uncommon for it to become harder or change color.

You may also notice an increase in gas, particularly if your baby is transitioning to using a bottle. Every baby is different though, and you may not notice much of a change.

Looking at supermarket formula displays can be enough to set your head spinning.

First, there are three different forms of formula you can choose from:

  • powders
  • concentrates
  • ready-to-use

Then, within these forms, they may be:

Some formulas advertise themselves as easier to digest.

This can be because they are homogenized, which means they’re processed in a way that breaks down molecules for easier absorption. Or they may be made with ingredients designed to be easier on the digestive system.

Despite this advertisement, there’s no guarantee that any formula will sit well in baby’s stomach. So, how do you choose?

For many parents, the answer lies in asking fellow parents and caregivers about their experiences with formula and researching the ingredients to find one that feels right.

After choosing a formula, you might decide that you’d like to change to another one. Is this a good idea?

Switching your baby’s formula may make a difference in their poop, since their sensitivity to some of the ingredients in the original formula may have led to their constipation.

However, changing formula styles or brands can also make things worse, especially if you do it too often.

In other words, it’s not a good plan to give your baby one formula for 1 or 2 days, then changing to another formula right away when you see that they’re constipated. Instead, try giving baby a few weeks to adjust to any newly introduced formula.

In some cases, though, changing formulas might be wise. Even so, it’s best to speak with your child’s pediatrician first.

Reasons to consider changing formulas can include:

  • food allergies
  • extreme fussiness
  • a need for more iron in a baby’s diet, as determined by a doctor (though most infant formulas do contain iron)
  • weakness or fatigue
  • vomiting (more than just spit-up)
  • bloody stools
  • diarrhea

Especially if your child is showing signs of allergies or wheat or dairy aversions, changing to a brand with different ingredients may make digestion easier.

It’s never a good idea to create your own homemade formula, however. Your child’s doctor can help you find an approved formula if your little one needs something special.

For many babies, a simple home remedy or two is all you’ll need to relieve constipation.

For an older baby, you can consider a dietary change.

If your child is over 6 months old, offer them a small amount of 100 percent apple, prune, or pear juice diluted with water. These include sorbitol, a type of sugar. It acts like a laxative and may be able to help with constipation.

Extra water can soften their poop, too. Of course, don’t forget to check with your doctor first for their recommendations on amount and types of liquids.

And if your baby is already eating solids, you may want to consider offering them fiber-filled options like peas and prunes. You may also consider baby cereals with whole wheat or barley instead of rice, since they include more fiber.

For younger babies, you can try the following:

  • Bicycle kicks. Gently bend baby’s legs toward their chest or circle their legs in a gentle bicycling motion. (It’s easier to get a poop out in a squat position than lying flat!)
  • Infant massage. Massaging their stomach and having skin-to-skin time may improve your little one’s digestive system.
  • Bathing. A warm bath can help your little one’s muscles relax and allow poop to pass.

If these remedies aren’t working, your doctor may suggest other treatments. It’s not recommended to use mineral oil, stimulant laxatives, or enemas to solve constipation in infants, so speak with your pediatrician for safer methods.

Most of the time, infant constipation isn’t a sign of a serious problem, and it can be easily addressed. On very rare occasions, constipation may be a sign of another underlying condition.

Reach out to your baby’s doctor if you notice:

  • consistent issues with constipation despite dietary changes to attempt to address it
  • vomiting
  • weakness
  • refusal to eat
  • blood in stools
  • black stools (after your baby has already passed their meconium, which occurs during the first few days of life)

A constipated baby is one of the few things worse than the smell of a really poopy diaper.

If you’ve recently switched your little one to formula, you may notice that their poops are a little harder and less frequent. You might also notice a change in bowel movements if you’ve introduced solids to your little one’s diet.

If constipation becomes severe or you notice other warning signs of poor health, don’t hesitate to reach out to your baby’s doctor. They can assist you in creating a plan to get your little one feeling better ASAP.