Breast milk is easy for babies to digest. In fact, it’s considered a natural laxative. So it’s rare for babies who are breastfed exclusively to have constipation.

But that doesn’t mean it can’t happen.

Every baby poops on a different schedule — even ones who only are fed breast milk. Read on to learn more about constipation in babies, including symptoms, causes, and how to treat it.

How can you tell if your baby’s constipated? It’s important to note that the frequency of bowel movements isn’t always an accurate indication of constipation. Neither is seeing your baby grunt or strain while having a movement.

Many babies look like they’re pushing when they’re having a bowel movement. That may be because babies use their abdominal muscles to help them pass stool. They also spend a lot of time on their backs, and without gravity to help them, they may have to work a little more to move their bowels.

Better indications of constipation in a breastfed baby are:

  • firm, tight, distended belly
  • hard, pebble-like stools
  • crying while having a bowel movement
  • not wanting to feed
  • bloody stool that is hard (which may be caused by hard stool tearing some of the anal tissue as it passes)

For the most part, breastfed babies don’t experience constipation until solid foods are introduced, around the time they’re 6 months old. Some foods that may be constipating include:

  • Rice cereal. Rice is binding, meaning it absorbs water in the gut, making stool hard to pass. Consider switching to oatmeal or barley cereal if your baby show signs of constipation.
  • Cow’s milk. This is usually introduced at about a year.
  • Bananas. This fruit is another common culprit of constipation in babies. You can try feeding it to your baby pureed with some water or 100-percent fruit juice mixed in.
  • A low-fiber diet. White pastas and breads are low-fiber foods. Without enough fiber, it may be harder for your baby to pass stools.

Other things that might produce constipation include:

  • Not giving your child enough liquids. Always try to breastfeed your baby before offering solids. Liquid will help your baby pass their stools more easily.
  • Stress. Travel, heat, a move — these can all be stressful to a baby and cause constipation.
  • Sickness. Stomach bugs can cause vomiting and diarrhea, which can lead to dehydration and constipation. Even something like a common cold can decrease your child’s appetite and, because of nasal congestion, make it uncomfortable for them to nurse. Less liquid means more chance for constipation.
  • Medical condition. A medical issue, such as having an abnormality in the digestive tract, may cause constipation, although this is rare.

A normal amount for a baby to poop varies by age, and, yes, the baby’s diet. Here’s a sample poop timeline for breastfed babies from Seattle Children’s Hospital:

Days 1–4Your baby will poop about once a day. The color will change slightly from dark green/black to dark green/brown and it’ll become looser as your milk comes in.
Days 5–30Your baby will poop about 3 to 8 or more times day. The color will change slightly from dark green/black to dark green/brown and it’ll become looser and then more yellow as your milk comes in.
Months 1–6By the time they’re about a month old, babies are pretty good at absorbing all the breast milk they drink. As such, they may pass a few soft stools each day or just one soft stool every few days. Some babies don’t poop for up to two weeks, and that’s still considered normal.
Month 6–onwardAs you start introducing solid foods to your baby (at about 6 months) and cow’s milk (at about 12 months), your baby may poop more frequently. That’s because your baby’s digestive system is still immature and has to figure out how to digest all these new foods. On the flip side, your baby may now become constipated. Some foods are naturally constipating, and cow’s milk can be hard for even some mature digestive systems to handle.

Here are some tips to prevent and treat constipation:

  • Add more fiber to their diet if your baby’s started solid foods, Switch from rice cereal to barley, which has more fiber. When you start introducing fruits and vegetables, try high-fiber ones like pureed prunes and peas.
  • Pump your baby’s legs back and forth as if they’re riding a bicycle. Also, put them on their tummies with some toys and encourage them to squirm and reach. Activity can encourage a bowel movement.
  • Give your baby a tummy massage. With your hand just below the navel, gently massage your baby’s tummy in a circular motion for about a minute.

Can a nursing mother’s diet cause — or relieve — a baby’s constipation? The short answer is probably not.

According to a 2017 study of 145 women in the Korean Journal of Pediatrics, there are no foods a breastfeeding mom needs to avoid unless the baby has an obvious negative reaction to it.

Gas and fiber are not passed from mom to baby. Neither is the acid from acidic foods like citrus and tomatoes. A breastfeeding mom can have pretty much any food she wants in moderation.

According to La Leche League International, it’s not what or how much you eat or drink that stimulates your milk — it’s your baby’s ability to suck that gets the milk coming. Also, breast milk is made from what’s in your bloodstream, not your digestive tract.

Still, it’s important to eat a nutritious, well-balanced diet when you’re nursing, more for your own health and well-being than your baby’s.

Don’t hesitate to call a doctor if:

  • these simple remedies for constipation don’t work
  • your baby seems in distress
  • your baby refuses to eat
  • your baby has a fever
  • your baby is vomiting
  • your baby has a hard, swollen belly

Your doctor will examine your baby and may even order special tests, like an abdominal X-ray to check for intestinal blockages. You can ask your doctor about using suppositories and which ones are safe, though these are not often recommended or needed.

Never give a baby a laxative or suppository without checking with a healthcare provider first.

Most breastfed babies don’t become constipated until they start solid foods. Even then, it’s not a sure thing. Simple diet and activity changes are often effective. But if the constipation continues, see your child’s doctor for medical advice.