Newborn Constipation: What You Need to Know

Nothing beats the exhaustion of middle-of-the-night wakings especially when your newborn is crying from discomfort. Babies have developing digestive systems, and it can take time for their bellies to work out all the kinks. We're turning to pediatric registered dietitians Alexis Cascone, MS, RD, LDN, CLC and Charlene Kennedy, RD, for insights on newborn constipation and how to get them into a regular pooping routine.

What is newborn constipation?

According to Kennedy, constipation in babies is defined as "painful and difficult to pass bowel movements." Their poop may look different, too. It may be small, hard balls or pebble-like poops, or your baby may not poop as often as usual.

Babies digestive systems are still developing, so changes in their bowel movements are normal. Babies are still figuring out how to use their muscles, so they might grunt or make funny faces even if they're not constipated, says Cascone.

They might also poop less often, but as long as their poop is soft, it's all good—it's not constipation. “Your newborn may not be constipated but actually learning how to create a consistent stooling pattern,” says Cascone.

What causes newborn constipation?

Newborns don't eat solid foods yet, making newborn constipation fairly rare. But there are certain factors that can contribute to it, such as:

• Dehydration: This is the primary reason for constipation in newborn babies. It's typically caused by drinking less milk when sick or incorrect formula preparation.
• Change in milk: Switching between different types of formula or transitioning from breast milk to formula can lead to constipation. “Formula is harder to digest than breast milk, so your baby is learning how to digest the new proteins,” explains Cascone.
• Prematurity: If your baby was born early, they may have a higher risk of experiencing constipation. “Preterm babies may have decreased muscle tone, compared to full-term babies, which makes it more difficult for the baby to stool effectively,” says Cascone.

Symptoms of newborn constipation

Here are some common symptoms of newborn constipation:

Consistency

Healthy baby poop should have a soft and mushy consistency. If it resembles hard balls or pebbles it could mean your baby is constipated.

Frequency

Kennedy explains that the frequency of your baby’s poops doesn't always signal constipation. Every newborn has a unique bowel movement pattern. But if your baby is pooping less than normal, and poops are harder, it's a good idea to discuss it with your pediatrician.

When it comes to how often a newborn should poop, Kennedy explains it varies based on age and whether they're breastfed or formula-fed. She explains that since breast milk is easily digested, breastfed babies may go up to a week without pooping, which is still considered normal. Cascone adds that formula-fed babies will typically poop more frequently, usually at least once every couple of days.

Straining

Babies often strain a bit during bowel movements, but if your baby seems to be straining excessively (like more than 10 minutes) and appears uncomfortable, it could be a sign of constipation.

Bloated belly

If your baby's abdomen appears distended and swollen, it might indicate that your baby is constipated, says Cascone.

When to seek medical help

A few signs that may suggest a more serious medical issue. Symptoms include:

• Bloody stools
• Refusing to eat
• Vomiting
• Fever

• Signs of distress or pain such as excessive crying or arching of the back

If your newborn consistently shows any of these signs, contact your baby's pediatrician for further guidance and support.

How to prevent newborn constipation

Here are some expert-approved strategies to alleviate constipation:

Try an infant massage

Giving your baby a gentle massage can help relax muscles that are needed to push out poop. Cascone says, “Massaging around your newborn’s stomach in a clockwise direction can be helpful in managing constipation.” Moving your baby’s legs in a bicycle motion can also relieve pressure in the abdomen and ease constipation.

Pay attention to formula preparation

Improper formula mixing can also cause some plumbing issues. Always follow the manufacturer's instructions to prepare it properly, ensuring you use the correct ratio of water to formula. “Too much formula powder will concentrate it and provide less water to your newborn,” Cascone warns.

Prepare a warm bath

A warm bath can work wonders in relaxing your baby's body and muscles, making it easier to poop. Consider adding a warm bath to your baby’s bedtime routine, giving them a chance ‘to go’ before they settle in for the night.

More often than not, constipation clears up on its own with a little time. If symptoms don't go away or they get worse, get in touch with your child's pediatrician for additional support.

Experts

• Alexis Cascone, MS, RD, LDN, CLC

• Charlene Kennedy, RD