What is constipation?

Constipation 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's common for babies to have constipation when they are changing from formula or breast milk to solid foods. This article will discuss constipation in babies from birth until 1 year of age.

If your child is older than 1 year, read more about constipation in children.

What is normal for babies?

All babies are unique, and this includes how often they poo. There is a very wide range of 'normal'. Some newborn babies poo after every feed. Others will only poo once every few days. When it comes to how often a newborn poos; once in 7 days, or 7 times in a day are both fine, so long as your baby is growing, happy and well. But 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, you should speak with their doctor or child health nurse for advice.

Your baby's poos will also change over time as they grow and develop, and their diet changes.

What are the symptoms of constipation in babies?

The main symptom of constipation is hard, dry 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, may seem 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, which may at times bleed.

In some cases, if your child is constipated, they may look bloated, or their stomach may appear larger than usual. It can sometimes be possible to feel their poo (hard, solid lumps) while pressing softly on their stomach.

What causes constipation in babies?

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

• changing from being formula-fed
• changing from being breastfed
• exposure to new foods and flavours
• not drinking enough liquids (breastmilk, formula or water)

It is more common for bottle (infant formula) fed babies to have constipation than breastfed babies.

If your baby has started eating solid food, a lack of fibre in their diet may also be a cause of constipation. Some babies simply have a natural tendency towards constipation, even when they have a good diet and drink enough fluids. This doesn't mean they are unhealthy or unwell.

When should I see my doctor?

Constipation is common. It will often pass without intervention. If you are worried your baby has constipation, is uncomfortable or in pain, your doctor can assess them and recommend baby-safe strategies. There are medical treatments for constipation your doctor may consider, based on your baby's circumstances.

If your baby was previously treated for constipation but still struggles to poo, it is important to go back to your doctor for a review. There are several treatments they can try.

Sometimes constipation can be due to more severe medical problems. Signs that suggest a more worrying medical problem include:

• a baby not passing meconium (the first poo in their life) within 48 hours of birth
• constipation from birth or the first weeks of life
• passing ribbon or pencil thin stools
• blood in stools
• having a developmental delay or poor growth
• being generally unwell with fever, vomiting, rash or lethargy

How is constipation treated?

Try these tips to help babies who have difficulty passing poos:

• If your baby has infant formula, always measure the water first before adding the formula powder — this helps ensure that the ratio of water-to-formula is correct.
• If your baby is old enough to drink water, offer extra drinks (boiled and cooled first).
• Gently rub their stomach to help stimulate the bowel — your baby might also feel better with gentle massage to help manage the pain of constipation.
• A warm bath can help calm and settle your baby and relieve discomfort.

If your baby is older than 6 months, add some extra fruit and vegetables to their diet to boost their fibre intake.

If your child is older than 9 months, adding stewed prunes or apricots to their meal may help. They can have up to 3 tablespoons, 3 times a week. Cereal that has bran may also help mild constipation. Older babies can try prune juice diluted with water (half prune juice and half water). Start slowly, with 10 millilitres. Increase as needed until they can do a soft poo.

If this doesn't help, your baby may need medicines to help them poo. See your doctor to discuss treatment options.

Resources and support

• Learn more about your baby's poo with Pregnancy, Birth and Baby's Baby poo guide.
• Do you prefer to read languages other than English? The Royal Children's Hospital offers a constipation fact sheet in multiple languages.