Bowel habits and constipation in babies
Parents often wonder if their baby’s bowel habits are normal. It’s worth keeping in mind that each baby is different and they will develop their own bowel movement patterns.
This brochure is designed to help you understand what the bowel does, how it works and what’s important to look out for.
The digestive process
The digestive tract is a long tube that starts at the mouthand ends at the anus. Digestion begins when food enters the mouth and undergoes a series of changes until the gut has extracted most of the nutrients, which are then absorbed into the bloodstream. Any food not used by the body becomes waste and is passed in bowel motions or “poo”.
The first bowel motion a newborn passes is called meconium and is greenish black and sticky. It’s a good sign that the bowel is working and not obstructed.
As their digestion matures and they become used to feeding on milk, babies’ poos will change in colour and consistency.
Motions of breastfed and formula-fed babies
Your baby’s stools will change regularly as they develop from a newborn through infancy. What to expect will depend on their diet.
Comparing breastfed and formula-fed babies’ poo
|Breastfed babies||Formula-fed babies|
|Frequency||May poo several times a day until they are around six weeks old. Older babies may not have a bowel motion for several days up to a week.||Tend to poo less frequently in the first few weeks.|
|Consistency||May be very soft and loose enough to run out the sides of the nappy. It may also contain mucus.||More formed but can vary from firm or hard to soft and plasticine-like.|
|Colour||Varies from yellow to bright green.||Varies from yellowish brown to dark green or black due to the iron in the formula.|
|Smell||Generally don’t smell very strong or can be sweet-smelling.||Tend to be much smellier than breastfed babies’ poos.|
|Changes||Changes between poos are normal. Hard, crumbly poos may be a sign that they aren’t getting enough milk.||When weaning onto formula, or introducing or changing formula, the frequency, consistency, colour and smell often changes.|
|Constipation||Breast milk is suited to a baby’s digestive tract and has a natural laxative effect so they are rarely constipated.||It’s not unusual for some formula-fed babies to experience constipation.|
Many babies grunt, groan, pull up their legs and go red in the face when they’re doing a poo. Some cry and behave as if they’re in pain even when the poo is soft. Why babies behave like this is unknown, though it may be because they are lying down and can’t rely on gravity to help them or the poo is so soft it doesn’t put enough pressure on the anus. Sometimes motions can be explosive and can be alarming if accompanied with noise and wind.
- Constipation is when a baby passes hard, dry, crumbly or pellet-shaped poos, which are difficult to push out, causing them pain and discomfort
- Constipation is not usually about how often a baby has a bowel motion, but the consistency of poo. Infrequent bowel motions may be a baby’s normal bowel pattern.
- Sometimes bleeding from a small split in the anus can occur as a result of strained pushing.
Not enough milk to drink
Breast and formula-fed babies need enough milk to grow and for their gut to work effectively.
Incorrect preparation of formula
Tightly packed or overfilled scoops are too concentrated. Make sure to mix the right amount of formula powder to the right amount of water based on the manufacturer’s recommendations. Remember to pour the recommended quantity of water into the bottle first and then add the formula powder before shaking the bottle well.
Constipation may happen for a short while especially when changing to follow-on formulas.
Introducing solids for the first time
It can take some time for a baby’s digestive system to adjust to their new diet. Sometimes the combination of low fibre and not enough fluids can cause constipation.
A sluggish digestive tract
Some babies have naturally slow gut movement, which can lead to constipation.
Not enough fluids
Dehydration can cause a baby’s poo to become hard and dry, particularly on very hot days or when they are unwell and refusing fluids.
If your baby is constipated, there are a number of ways you can help them return to their regular bowel motions.
- For babies over six months, offer extra amounts of cooled, boiled water to help soften hard poos and help move bowel contents along.
- Give your baby a warm bath and a gentle tummy massage in a clockwise, circular direction to help to stimulate the bowel and relax an unsettled baby.
- Give your baby some floor time to kick freely without their nappy. Extra movement and exercise can often help them do a poo.
- Hold your baby’s ankles and gently move their legs in a bicycling motion. Flexing and extending their legs while they are on their back can help relieve feelings of discomfort.
- Babies over six months can be offered fruit juice mixed with water. Prune juice is often effective when diluted 1 part juice to 3 parts of water (e.g. 10 mL juice to 30 mL cooled, boiled water).
- For babies over six months of age who are eating solids, extra vegetables and pureed fruit can help to boost their fibre intake.
- Avoid giving your baby laxatives unless they have been prescribed by a doctor. If constipation persists, or there is blood in your baby’s poo, ask a healthcare professional for advice.
- Don’t offer solid foods before the age of around six months.
- Don’t put anything into your baby’s bottom or try to prise the poo out yourself.
- Don’t give enemas, herbal teas or home remedies. A baby’s rectum is very small and delicate and it’s easy to cause damage and trauma.
- Don’t compare your baby’s bowel habits with those of other babies. Your baby’s elimination patterns will be as unique as they are.
- Don’t become too preoccupied with your baby’s bowel habits. As long as your baby is thriving, gaining weight and happy, try not to be concerned.
Please consult your healthcare professional if you are concerned about constipation with your baby. For other information specific to your baby’s age, visit www.bubbahood.com.au
Our special thanks to Jane Barry, Registered Nurse, Midwife and Child Health Nurse, for her contribution to this brochure, based on her experience and professional knowledge (March 2015)
Breastfeeding is best for babies. It has benefits for the infant, such as reducing infection risk, and for the mother. It is important to have a healthy balanced diet in preparation for, and during breastfeeding. Infant formula is designed to replace breast milk when an infant is not breastfed. Breastfeeding can be negatively affected by introducing partial bottle-feeding, and reversing a decision not to breastfeed is difficult. Infant formula must be prepared and used as directed. Unnecessary or improper use of infant formula, such as not properly boiling water or sterilising feeding equipment, may make your baby ill. Social and financial implications, including preparation time and the cost of formula,
should be considered when selecting a method of infant feeding.