Constipation in babies (0 to 1 years)

Constipation (Opens in new tab) is when your baby's poo is hard and dry, making it difficult for them to poo.

Sometimes, doing a hard poo can be painful. It is common for babies to have constipation when they change from breast milk or formula to solid foods. Your baby's poos will also change over time as they grow, develop and their diet changes.

All babies are unique and this includes how often they poo. There is a very wide range of 'normal'. Some breastfed newborn babies poo after every feed — up to 7 times a day. Others poo only once every 7 to 10 days. Formula-fed babies will usually poo every 1 to 2 days. All these options are healthy, if your baby is growing, happy and well.

While the number of poos is not critical, if your baby seems to have pain when trying to poo or has a very hard, dry poo, speak with their doctor or child health nurse for advice.

The main symptom of constipation is hard poos. Here are some other signs of constipation in young babies:

• Your baby may show signs of straining when trying to pass a poo.
• Your baby may be unsettled, fussy or irritated.
• Your baby may be eating less or feeding less well than usual.
• A tear or crack might appear in the skin around the anus (bottom), which may sometimes bleed.

Sometimes your baby may look bloated or their stomach may appear larger than usual.

Usually, constipation in babies is functional. This means that their constipation is not caused by an underlying medical condition.

One of the main causes of functional constipation in babies is a change in their diet. A change in diet may include:

• changing from being formula-fed
• changing from being breastfed
• trying new foods and flavours
• not drinking enough liquids (breast milk, formula or water)
• not eating enough fibre (Opens in new tab)

Your baby's doctor will try to find out what is causing their constipation by:

• asking you questions about your baby's medical history and symptoms
• examining your baby
• referring your baby to have some medical tests done

They may diagnose functional constipation if your baby has had at least 2 of any of the following for one month:

• 2 or fewer poos per week
• painful or hard bowel movements
• pass very large poos

There are different ways you can manage your baby's constipation. These can include basic approaches and strategies to reduce discomfort. Your baby's doctor may also recommend or prescribe medicine.

Caring for your baby at home

Making changes to your baby's diet is often one of the first ways to manage their constipation. Treating constipation early can help relieve it quickly. Here are some tips:

• If your baby is younger than 6 months — speak with your child health nurse or doctor.
• If your baby is older than 6 months — offer prune, pear juice or extra water. Add extra fruit and vegetables to their diet to increase fibre intake.
• If your child is older than 9 months — add stewed prunes or apricots to their diet. They can have up to 3 tablespoons, 3 times a week. Cereal with bran may also help mild constipation.
• Older babies — offer juice diluted with water (half prune juice and half water). Start slowly, with 10 mL and increase as needed until they have a soft poo.
• If your baby has infant formula — always measure the water first before adding the formula powder. This helps ensure the water-to-formula ratio is correct. Ask a pharmacist or child health nurse if you aren't sure how to make a bottle of formula.

Some other tips to help your baby pass a poo:

• Gently rub their stomach to help stimulate the bowel. A gentle massage can also help relieve any pain your baby may feel.
• Give your baby a warm bath to help calm them and relieve discomfort.

If these tips do not help, your baby may need medicines to help them poo. See your doctor to discuss treatment options.

Medicines

If changes to your baby's diet do not help, their doctor may recommend some oral laxatives. Give them exactly as your baby's doctor (Opens in new tab) or pharmacist advises.

For babies older than 1 month, if oral laxatives do not help, their doctor may recommend inserting a suppository in your baby's bottom. Your baby's doctor will want to follow up within about 4 weeks to see how they are doing.

Limited research has shown that probiotics (Opens in new tab) do not help treat constipation.

Usually, constipation does not cause any complications. Sometimes, however, your baby may develop another condition, such as:

• anal fissure (Opens in new tab)
• stomach pains
• dehydration — if laxatives are not given with enough fluids
• faecal impaction — hard poos become stuck in your baby's intestines
• megarectum — your baby's rectum stretches if large stools collect there, reducing the urge to poo

Here are a few tips to prevent functional constipation:

• If your baby is older than 6 months, make sure they drink enough water.
• Once your baby has recovered from their constipation, continue treating them. Together with your baby's doctor you will make a treatment plan. This could include laxatives or making sure your baby eats enough fibre to prevent constipation from coming back.
• Successfully toilet train your toddler when they are old enough to help them develop healthy toilet habits and behaviours.
• Watch for signs that your baby may be becoming constipated or has just become constipated so you can treat it as quickly as possible.

• The Royal Children's Hospital Melbourne has a resource on constipation in babies (Opens in new tab), which has been translated into many community languages.
• Perth Children's Hospital has a resource about constipation (Opens in new tab) for Aboriginal and/or Torres Strait Islander peoples.