When you have a baby, poop is likely a daily topic of conversation at your house. After all, those diaper changes can give you a good idea about your baby’s overall health.
But what if you’re worried that your breast-fed baby isn’t pooping enough? Could your baby be constipated? And if so, what can you do?
It’s important to understand that the normal range for baby bowel movements is broad.
Bowel movements in newborn babies
The frequency of your baby’s bowel movements will depend on their age. Babies up to about 3 days old will pass dark, tar-like stools called meconium. As mother’s milk comes in, the stools will soften in texture and color. Only a few soiled diapers in 24 hours is considered normal.
In the first six weeks, babies will usually have two to five bowel movements in a 24-hour period. Some healthy babies will have more, and other healthy babies will have less.
If a baby is under the 6-week mark and passes fewer than two poops in a day, it can still be considered normal. Your baby probably isn’t constipated if:
- they’re making lots of wet diapers
- they’re gaining weight appropriately
- those few poops are doozies
Bowel frequency in breast-fed babies
When a baby passes the 6-week mark, it’s typical for pooping frequency to drop as the colostrum in their mother’s milk disappears. Normal pooping patterns for a baby older than 6 weeks might be five times a day, after every nursing session, or just one big bowel movement every few days.
Other babies will only have a single poop in an entire week, though its volume will likely be impressive. As long as a baby is gaining weight appropriately and making lots of wet diapers, don’t assume they’re constipated.
Once you introduce solids, pooping patterns will again change. The stools themselves will be different. They will likely be more stinky, with a different consistency and color. Frequency can be impacted, too.
Signs of constipation in breast-fed babies
Straining during a bowel movement may seem like a dead giveaway that your breast-fed baby is constipated. But according to the American Academy of Pediatrics, babies have to work hard to poop.
It takes a lot effort, particularly for babies who aren’t big enough to sit up unassisted. You shouldn’t assume that your baby is constipated even if they’re red-faced or in tears during a bowel movement.
Use these guidelines to help you decide if your breast-fed baby is truly constipated:
- Is your baby very fussy?
- Is there blood in your baby’s stool?
- Is your baby spitting up more frequently than normal?
- Is your baby pooping much more or much less than before?
- Is your baby straining to poop for 10 minutes or longer before giving up?
- Is your baby’s poop noticeably hard and dry?
- Does your baby arch their back, tighten their buttocks, and cry while attempting a bowel movement?
These may be signs of constipation in your baby. But keep in mind that a soft poop after straining for a few minutes (even if your baby cries or seems frustrated) means constipation is unlikely.
Treatments for constipated babies
If you’re worried that your newborn baby seems constipated, contact your pediatrician. You can also ask them about your baby’s pooping pattern.
For babies over 1 year, or for babies who have started eating solids around this time and are exhibiting signs of constipation, try the following treatments.
In addition to your usual breast-feeding sessions, offer your baby a small serving of plain water once a day.
2. Fruit juice
If water doesn’t help your baby, try switching to a small serving of apple, prune, or pear juice. Your baby won’t be able to digest the sugars very well. This can help loosen the stool.
Make sure it’s 100 percent juice with no additional ingredients. Start with 1 to 2 ounces mixed with a 1-1 ratio of water. It may take some trial and error to see how much works for your baby.
3. Baby food
If your baby is eating solids, try offering them pureed prunes or peas. Avoid constipating foods like bananas. If you’re feeding your baby rice cereal, switch to barley cereal temporarily.
If these treatments don’t help, speak to your doctor about the possibility of using a mild laxative.
When to call your doctor
In rare cases, infant constipation is related to a more serious condition. These can include cystic fibrosis, hypothyroidism, and Hirschsprung’s disease.
Speak to your pediatrician right away if your baby’s signs of constipation continue after you make changes to their diet. Look out for symptoms like rectal bleeding and vomiting.
Don’t get too caught up in monitoring your baby’s diapers. Signs of true constipation will go hand-in-hand with other symptoms. If your baby is making plenty of wet diapers, gaining weight steadily, and is otherwise happy, a breast-fed baby who is pooping once a week doesn’t signal a problem.