Every baby is unique when it comes to how many and at what times he has bowel movements. One baby has them at the same time every day; the other always has them at different times. Neither is healthier than the other and there is nothing to be gained by trying to make the irregular one regular in his movements. There is, instead, a chance of upsetting the baby emotionally in the long run.
The function of the large intestine (colon) is to hold undigested and indigestible food and absorb water from it. If, for some reason, the food stays there for longer and an excess of water is absorbed, the stool becomes hard and dry. Conversely, if the food does not stay there for enough time and the appropriate amount of water is not absorbed (as in the case of diarrhea) it can lead to dehydration.
For such a basic function of the human body, there are many misconceptions about bowel habits. Thus, it is important to know what is constipation and what is not.
Is my baby constipated?
Constipation has nothing to do with the number of times a baby has bowel movements, it only has to do with the hardness of the stool. The clearest indication of constipation is when the stool is hard and dry, no matter the number of bowel movements in a day. Other clues you should look for is the number of times your baby has bowel movements. There is no ‘normal’ number for a baby; each baby has his own routine that you will come to know in a few weeks. If your baby is not passing stool as often as he does (especially if he exceeds three days) then he might be constipated. Discomfort at passing stool is a sign of constipation too. However, straining might be normal for a baby, crying means greater discomfort and demands greater attention to the matter.
Is there a difference in the tendency of breast-fed and bottle-fed babies to get constipated?
Breast-fed babies rarely get constipated. This is due to the fact that breast milk contains a perfect balance of fats and proteins so the stool it produces is almost always soft. Breast milk is easily digestible and has several helpful types of bacteria that are capable of breaking down some of the otherwise indigestible proteins in milk. Breast milk is a low residue diet and almost all of it is absorbed and used by the baby’s body.
Bottle-fed babies are more likely to become constipated. This could be due to something in the formula composition. Consult your doctor about changing the formula brand. It is important to note however, that the amount of iron in formula milk has no bearing over constipation. Formula milk is also harder to digest so babies receiving only formula milk have lesser bowel movements with a thicker, more greenish kind of stool.
Why is my baby getting constipated?
There could be several causes for constipation:
Formula Milk: As discussed above, if a baby is on formula milk, something in the milk might be causing the constipation. Consult your doctor for suitable changes.
Diet Imbalances: Constipation is also caused if the diet is imbalanced and does not have enough fiber which passes into the colon and stays there to retain water. This makes the stool softer. A diet without enough fiber does not have the natural softening effect.
Introduction to Solids: A baby can also get constipated when introduced to solids. This can happen as rice cereal (usually the first solid given) is low in fiber. When a baby is introduced to solids the texture and color of his stool changes. As the intestines are getting used to this new kind of nutrition the baby might have lesser bowel movements. This does not necessarily mean he is constipated as long as the stool is soft when it appears.
Dehydration: In warmer climates babies lose more water. Sometimes, due to other reasons, if a baby is not getting enough fluid, it will make his body absorb more water from wherever it can get. This makes the colon absorb excessive water from the food, making the stood hard and dry and difficult to pass.
A Medical Condition: In a very few cases constipation may be due to some medical condition that the baby suffers from e.g. hypothyroidism, a metabolic disorder, a food allergy or a condition called Hirschsprung’s disease. In some cases constipation can also arise due to some medicines a doctor has subscribed to the baby. In these cases, contact the baby’s doctor for guidance.
Poor Bowel Habits: Having poor bowel habits means a baby does not have a bowel movement when he feels the urge. As the stool stays in the colon for longer than required, excess water is absorbed leaving it drier and harder. A baby might hold back a bowel movement subconsciously if he has already had a painful experience before. To avoid that pain, he does not want to pass stool. For children being toilet trained, a very strict mother who is very determined to train her child, could be the reason he holds back his stool to assert his independence. Once he does that the stool becomes harder making him more hesitant to make a bowel movement. This can start the vicious cycle of chronic constipation. If a child reacts in this manner it means he is not ready for toilet training yet. It is better to delay it.
How do I treat constipation?
Infant constipation, if it persists, should be brought to a doctor’s notice immediately. There are a few things you can do at home to help the baby with his bowel movements.
Increasing Fluids: It is helpful to increase the fluids in the baby’s diet. You can do this by making him drink water between the feeding times. You can also introduce fruit juices in his diet e.g. prune, apple and apricot juice. They are rich in sorbitol, a non-digestible sugar that passes through the body to the colon and causes the water to be retained or drawn into the stool mass. Otherwise, chances are that the extra water would only pass out of the body as urine.
Massaging the Tummy: You can also massage your baby’s tummy in a clockwise manner, starting at the navel and moving outwards. Apply gentle pressure. A little cream or oil on the mother’s fingertips might also help with the massage. Only continue massaging if the baby is comfortable with it.
Exercising the Baby: It is also helpful to get the baby some exercise. If he has started crawling, let him do a few rounds. If he is not crawling yet, lay him flat on his back and turn his legs in a quick forward cycling motion. Exercising makes the stomach muscles move and puts gentle pressure on the intestines that would in turn, help the easy passage of the stool.
Giving a Warm Bath: If your baby enjoys bathing, give him a warm bath. It helps him to relax and pass the stool easily. You can also use some cream or vaseline near the outside of the baby’s anus to make it softer.
Checking the Formula Milk: If your baby is on formula milk, check if you are preparing it right. Follow the instructions as given on the back of the box. Putting in lesser water and making a thicker mixture can lead to constipation. If the baby’s constipation persists, change his formula milk with the doctor’s consultation. There might be something in that particular brand that is making him constipated.
Changes in Diet: If your baby is eating a variety of foods you can also boost his fiber intake by adding a spoon of bran to his cereal. You should also cut down on foods that are more prone to causing constipation e.g. rice, bananas, cooked carrots, cheese, yogurt, pasta etc. If your baby is younger and only takes breast milk, increase the number of feeds. If he is bottle fed, give him extra boiled and cooled water.
The Anal Tear:
Sometimes, when the baby passes very hard and dry stool, the anus may get tear. You will be able to see these tears or see blood in his stool. You can apply aloe vera lotion or Vaseline to that area to protect it and help its healing. It is important to alert your baby’s doctor about these tears and take all steps with his consultation.