Infant Constipation

Infant constipation is a very common problem and is frequently seen by both pediatricians and family doctors. Constipation is usually diagnosed when an infant or child has hard stools or has difficulty pooping. Infants are noted to strain excessively and have difficulty passing stools, even though their stools are of normal consistency. The difficulty in passing stool is thought to represent a delay in maturation of intestinal motility.

What Causes Infant Constipation?

Normally, as digested food travels down the intestines, water and nutrients are absorbed and the waste material becomes stools. For a soft stool to form, enough water must remain in the waste material, and the lower intestinal and rectal muscles must contract and relax to move the stool along and out. A malfunction of either of these mechanisms, too little water or poor muscle movement, can cause constipation.

Being plugged up with a hard stool for three days can be very uncomfortable, so of course your baby might become quite colicky.

Your child should be checked by a pediatrician if the bowels do not move daily.

The first poops that come out of a newborn are the thick, sticky, tarry meconium stools. The newborn infant should have his or her first stool within 24 hours after birth. Failure to pass stool by 48 hours of life may signify a more serious condition such as Hirschsprung's disease, meconium ileus due to cystic fibrosis, or hypothyroidism. Further evaluation of the infant is needed if no bowel movement has occurred within the first 48 hours.

During the first week of your baby's life, these give way, in breast-fed babies, to soft, yellow, breast-milk stools. By the time a baby is one week old, an average of 8 to 10 of these pleasant (as stools go) stools should occur each day.

For most breast-fed babies, the number drops to about 4 stools per day by 4 weeks old (although many kids have a different pattern). Formula-fed babies usually poop less often at this age, and the stools do not change much with time until solid foods are introduced (because unlike breast milk, formula doesn't change over time). Formula-fed stools are often tan or yellow at this stage, and a little firmer than breast-milk stools. For any baby, tan, yellow, green, or brown stools can all be normal. By 8 weeks old, the average amount of stool drops to 1-2 per day.

Unfortunately, many doctors erroneously tell parents that many babies will go only every 3 to 8 days or less and that this can be completely normal. One train of thought is that breast milk is an amazing food that leaves very little in the way of waste.

Just like grown-ups, children need to move their bowels daily. In Childhood Diseases, Dr. John R. Christopher states that, "over ninety percent of all diseases and malfunctions of children's bodies (as with adults) stem from the unclean intestinal tract, constipation, with infrequent or difficult evacuation of the feces, retention of the feces, and lack of coordination in the nerve and muscle functions of the colon and bowel." I would agree that in order for your child to maintain optimal health throughout life, as well as to avoid many common childhood health related problems, your child needs to move the bowels daily.

Common Myths

A glycerin suppository could be useful at the outset to get that first stool moving, but even doctors discourage its regular use. A small amount of water inserted into the colon with an infant bulb syringe is just as effective and healthier.

Karo syrup: Sugar in any form is not healthy for babies

Mineral oil is a mixture of hydrocarbons dried from petroleum products. It is not safe. It has no nutritional benefits. This oil can interfere with vitamin absorption.

Many encourage parents to use fruit juice when an infant or toddler is constipated. I believe that babies, as well as adults, should limit the amount of juice that they drink as this can lead to all sorts of over consumption of sugar problems. Too much juice can cause tummy aches, tooth decay, and perhaps obesity. In addition, kids can fill up on juice and miss other important sources of nutrition. Even the American Academy of Pediatrics issued recommendations in May 2001 to limit the amount of fruit juice for children.

Solutions for Infant Constipation

The most important advice I can give to you is to not start your baby on any kind of laxatives whatsoever. Regular laxative use can result in many, many problems over your child's life.

If you want to do something when babies grunt, push, or strain, try picking them up to get gravity to help them in their efforts, or try holding the knees against the chest to help them "squat" — the natural poop position.

Breast milk is the easiest food for babies to digest. If at all possible, breast feed, for as long as possible.

Babies need water. As a newborn, offer a small eye dropper full of water. When your baby is ready, give a bottle of water to sip on throughout the day. You might add a bit of cooled off Rooibos tea to the bottle. Aspalathus Linearis, commonly known as Rooibosis, is a natural herb unique to South African Cedarberg Mountains. Rooibos is rich in nutrients and caffeine-free.

The best tool I have found to use is magnesium. The formula I recommend is largely magnesium citrate. Magnesium nutritionally stimulates the peristaltic muscles to evacuate the lower bowel. It also nourishes and strengthens the intestinal muscles to work better on their own. It also brings water into the bowel. With the Reacted Magnesium that I recommend, I have parents start with 1/16 of a tablespoon in some water and work their way up until a daily bowel movement consistently occurs.

Baby massage is a very fulfilling form of nurturing you can give your child, with an added advantage: Dad can perform this nurturing act. It aids digestion, relieves colic, eases tension, regulates breathing, and spurs growth. To help your baby's bowels move, try the "I love you" technique. With I L U in mind, start at bottom right of baby's abdomen and using small, gentle circular movements, gently rub toward top right, forming the letter I. Stop when you feel the rib cage. Repeat this action but then move across abdomen immediately above belly button toward left side, forming the letter L. Repeat this action and then go down toward bottom left to form the letter U. Repeat 5-10 times entire I love you massage.

Butter Oil is a healthy alternative to mineral oil. It not only has laxative properties, but is a valuable source of omega 3 fats as well. And, unlike mineral oil, which slides through the intestines taking vitamins with it, butter oil is a nutrient that facilitates absorption of the vitamins. The dosage of butter oil that I recommend for infants is one-fourth teaspoon a day taken orally with breast milk or another viscous liquid. Breast milk can be pumped into a bottle or spoon and the butter oil added.

Baby Enema

To administer an enema to a baby, lubricate the tip of a bulb syringe with olive oil. Insert the tip of the bulb syringe into your baby's rectum ½ inch. The bulb should contain approximately 1 to 3 tablespoons of lukewarm water. Gently squeeze the water into the colon. Assure that only the water goes into the colon, not any air that might be in the bulb. Wait a few minutes for your baby to pass a stool. Repeat this process if necessary.

Useful Items For Baby Enemas

Celtic Sea Salt

"All About Enemas" Instructional DVD

Castile Soap

Super Salve

Infant Bulb Syringe

Reacted Magnesium

Downloadable Childhood Constipation Booklet

I know from personal and professional experience that parenting an infant through constipation can be very trying. I hope that these tips help you and your baby.