About Infant Constipation

One of the most common questions parents ask pediatricians is whether to worry about their baby's bowel habits. Is this normal? Should my baby have more dirty diapers than this? Should their bowel movements look like this? When is it a problem? All the questions are really about one thing; is this normal? The difficulty is that there is a pretty wide range of normal, so the doctor will need to find out some basic information to appropriately answer that question.

Identification

First, what indicates a constipation problem in an infant? Constipation generally deals with two things. First, infrequent passage of stool means constipation. Secondly, the passage of hard, dry stool that often presents with painful elimination is also considered to be constipation.
What is infrequent bowel movement in a baby? The average range for a younger infant is between two and four, with breastfed babies passing stool more frequently than bottle-fed infants. The average number of soiled diapers will decrease as baby grows into the toddler years. Most babies will develop a schedule all their own that parents will grow to recognize.
The second sign of constipation is more easily identifiable. A baby who has formed pebbles of stool in the diaper, who cries and flexes legs or draws them up towards abdomen and shows much strain while defecating is most likely suffering from constipation.

Considerations

Constipation is a very common condition with children, perhaps up to 10% suffer from it. However, very often it is a limited event, only occurring due to some upset in the diet, schedule or lifestyle of the child.
If a new food has been introduced into the baby's diet prior to the onset of constipation, that could very likely be the culprit. Conversely, if a regular food has been skipped recently then constipation starts, perhaps the child's system is having trouble adjusting to the food's absence.
Schedule changes can affect bowels as well. If the child has not been getting to bed, or getting naps at the regular time, or meal times have been changed in the time period that the constipation appeared, that may have been the cause for the problem.
Sometimes, a child will have dry stool that is difficult to pass and will try to avoid the bowel movement by delaying as much as possible, fearing the pain of eliminating hard stool which only exacerbates the problem.
Another common cause is simply not getting enough fluid intake to keep them regular.

Misconceptions

Well-meaning friends and family members will often be there to give unsolicited advice that they are quite positive works, because they did it with their kids, or their parents swear by it or so on. However, sometimes even harmless treatments can be dangerous to infants, so never attempt to treat any medical condition, even one as typical as constipation, without speaking with your child's physician.
Some uninformed people will insist you just give the baby mineral oil or an enema, as those are two of the older methods commonly used with older patients with constipation. However, neither of those is typically recommended by doctors for infants. And the use of such treatment can lead to more serious problems than constipation.
Another suggestion may be to give the baby undiluted prune or similar juice. This may be problematic depending on your child's age and diet, and again, the physician should be consulted before making big changes in the infant's diet.

Prevention/Solution

Always seek medical attention for a medical problem with your infant. Some common advice doctors give regarding constipation include increased feedings for breastfed babies, or supplementing formula-fed babies with couple bottles of water. Depending on the age of the child and the present diet, introducing some juice may be recommended. If the doctor sees that the child is backed up and can feel solid matter in their tummy, often the solution is to insert a glycerine suppository into the infant's rectum to facilitate a bowel movement. Often once things get moving, they stay moving and it won't continue to be a problem.
If the doctor suspects a problem with the child's digestion of their formula, the doctor might recommend trying a different type of formula to remedy the condition. Again, let your doctor know before you decide to make any such abrupt changes in an infant's diet.
Finally, if a baby has a tendency to get constipated, watch carefully to make sure that the problem isn't beginning again and take the recommended action earlier than later. Constipation especially the type that creates bowel movements that are painful will create a cycle of avoidance and more constipation.

Warning

Rarely constipation is a sign of a more serious problem. That's another reason to always consult a physician whenever you notice a problem. One such serious problem could be Hirschsprung's disease, a congenital condition where certain nerve cells are missing from the colon. Other symptoms typically include being small, vomiting, and ribbon-like stools. It's more common among boys and those with Down's Syndrome.
Hypothyroidism can also cause constipation, but this is usually diagnosed soon after birth from newborn blood screening procedures. Also, conditions that affect the nervous system, such as cerebral palsy or spinal cord conditions frequently have difficulty with constipation.
Certain medications may cause constipation, so never overlook that possibility if the constipation begins soon after beginning a new medicine.
Also, it may be a sign of emotional stress stemming from changes in the lifestyle or possibly even abuse.
Constipation in a newborn can be serious if the baby has not had a bowel movement within the first 48 hours of life, and a doctor should be consulted immediately.
Finally, constipation that goes untreated can lead to an impacted bowel. Signs of this include vomiting and fatigue and diarrhea that isn't fully emptying the bowel.