Constipation in infants is often temporary and not very worrying. A slightly modified diet, associated with an increase in the volume of water to moisten the stools, often allows the transit to be restarted. However, in rare cases, certain symptoms should alert parents and lead them to consult a doctor.
The symptoms of constipation in babies
First of all, it is important to remember that each child, just like each adult, has his or her own digestive rhythm and that we cannot draw hasty conclusions by comparing the transit of one baby to that of another.
Regarding the transit, the important element to take into account is the way the child is fed: is he bottle-fed? Is he or she breastfed? Has he started to diversify his diet?
In any case, infants under 6 months of age rarely suffer from constipation, especially if they are breastfed. Some babies grunt, squirm and cry at each bowel movement, but they are not necessarily constipated.
While exclusively breastfed babies usually have several bowel movements a day during the first few weeks (up to 6-8), it is quite common for them to have a bowel movement every 3-4 days or even every 10-15 days thereafter. This is completely normal and should not worry the mother. This change in transit rhythm can be sudden and happen overnight. In France, there is a record of a perfectly healthy breastfed baby who did not have a bowel movement for 27 days!
Bottle-fed babies generally tend to have between one and three firm stools a day, although others may only have a bowel movement every three or four days. This is not abnormal unless the stool is very compact and dry, like a ball. Constipation is real when the muscles of the lower intestine contract and block the stool, which then stays in the intestine and tends to make it hard and dry.
As soon as the child starts to have a diversified diet, often after 6 months, episodes of constipation are not rare. They manifest themselves through these symptoms
irritability, abdominal pain and gastric discomfort
bulky stool production and painful defecation
a bloated, swollen, hard and painful belly: if you feel your baby relieved when you put him/her on the belly, it is a sign that he/she has gastric pain
abdominal pain that persists after a bowel movement
Bloody stools, usually due to anal damage from passing hard stool
stools that look like small, hard balls
Causes of constipation
Most constipation in children is “functional”, meaning that it is not related to a specific disease. Most of the time, they are only temporary and due to simple dietary factors:
Poorly prepared bottles: the quantity of water is not sufficient for the quantity of powdered formula
Change of diet, such as during dietary diversification
Insufficient water intake, especially in summer when the risk of dehydration is high
Too little fiber in the diet – when the baby has a diversified diet
Constipation can also be a way for the child to express stress, often triggered by a change of environment (e.g. starting daycare).
If baby is constipated: consult a doctor
Although it is a source of great concern for parents, consitpation is common in babies and is not considered a pathology. In the vast majority of cases, it is sufficient to monitor the evolution of the child’s transit because the slowing down of the transit is often only temporary.
However, if the symptoms persist, it is important to have your child examined by your doctor or your baby’s pediatrician to rule out any medical or surgical condition. Especially if your child :
has constipation that has lasted for more than a week
has bloody stools
has a very sore tummy (the prone position relieves it)
In case of chronic constipation, the main complication is anal fissure, which is at the origin of a worsening of the constipation: the child suffers during any defecation, and therefore tends to hold back to avoid the pain.
If the stool is not sufficiently evacuated, there is also a risk of intestinal obstruction. The symptoms of the latter are usually quite characteristic: sudden and sharp abdominal pain, paleness, vomiting, sometimes traces of blood in the stool. If in doubt, consult a doctor without delay.
What diet should I follow to fight constipation in infants?
With an appropriate diet, your baby’s intestinal transit should return to normal within a few days.
Here are the rules of conduct to follow:
If your baby doesn’t have a big appetite, split his meals into several small meals
Increase the amount of fiber in these meals by offering more :
whole grains (pasta, bread, rice, flour in homemade preparations such as cakes)
green vegetables in the form of purees (green beans, leeks, spinach)
fruit in the form of compotes (e.g. apple-rhubarb or apple-plum)
Make sure your baby drinks enough water during the day: offer him/her to drink often, especially in summer. For the preparation of milk bottles, as well as for water consumed on its own, give preference to still water, which is rich in magnesium
Eliminate chocolate in all its forms
Eliminate flour in the bottles
Offer your child a few spoonfuls of prune juice during the day
Add a few teaspoons of vegetable broth, apple juice or freshly squeezed orange juice to the bottle.
Limit foods that cause constipation, such as rice, bananas, carrots and quince
Whatever your child’s age, abdominal massage can help speed up bowel movements and provide relief. To do this, move your child’s legs up towards his or her belly using small movements. You can also gently massage your baby’s belly several times a day, around his belly button, in a clockwise direction. This can stimulate the bowels and help the stool move down.
Self-medication is not recommended: laxative suppositories should only be given on the advice of your doctor or pediatrician. Do not be tempted to use an aggressive method on your own, such as an enema or the introduction of a rectal thermometer to stimulate the natural expulsion reflex, at the risk of causing lesions and increasing your child’s pain.