Constipation in babies often worries parents, especially when the little one appears to be in pain or has difficulty passing stool. However, this condition is quite common, especially when babies start eating solid foods or experience changes in their eating habits.
Constipation is a decrease in the frequency of stools from normal, or hard stools/difficulty in defecating, or a sensation of incomplete evacuation when defecating.
Constipation in children without a clear organic cause (≈ 90-95% of cases) is called “functional constipation”.
In children aged < 4 years:
at least 1 month with 2 or more of:
- history of excessive stool retention
- history of passing hard/painful stools
- history of large diameter stools
- felt stool in the rectum
While usually harmless, constipation still needs to be monitored to ensure your baby remains comfortable and fuss-free. With the right approach, parents can help their little one's digestion run smoothly without panicking.
What Causes Babies to Have Constipation?
Several factors can cause constipation in babies, most of which are related to changes in their diet and daily activities. Here's an explanation to make it easier to understand:
- Changes in eating patterns
One of the most common causes is a change in diet, such as when a baby starts solid foods or switches from breast milk to formula. A baby's digestive system is still adapting to new foods, so it takes time to adjust. - Lack of fluids
Inadequate fluid intake can also cause stools to become hard and difficult to pass. This often occurs during hot weather or when babies start eating solid foods but haven't yet drunk enough water. - Iron content or specific type of formula milk
Some formulas with high iron content can sometimes cause constipation in babies. This doesn't necessarily mean the formula is faulty, but rather that the baby's digestive system may not be suited to that type of milk. - Lack of movement or physical activity
Babies who don't move much, such as lying down for long periods, can experience slowed bowel movements. Body movements, such as kicking or crawling, actually help promote smoother digestion. - Certain medical conditions
Although rare, medical causes, such as digestive or nervous system disorders, can affect bowel movements. If constipation persists or is accompanied by other symptoms such as vomiting and abdominal swelling, it's best to consult a doctor immediately.
7 Ways to Overcome Difficult Defecation in Babies
Constipation in babies can be a cause for concern for parents, but don't worry, there are several simple steps you can take to help your little one's digestion. Here are 7 safe and effective ways to manage constipation in babies:
- Increase fluid intake
Ensure your baby gets enough fluids appropriate for their age. For babies who are exclusively breastfed, breast milk is usually sufficient to meet their fluid needs. However, once your baby has started solid food, you can gradually add water (around 60–120 ml per day, depending on age and doctor's advice) to help soften stools. - Provide fibrous foods (for MPASI babies)
If your baby is over 6 months old and starting solid foods, add high-fiber foods like fruit purees (papaya, pear, or steamed apple) and soft vegetables like pumpkin or broccoli. Fiber helps draw water into the intestines, making stools softer and easier to pass. - Do a gentle abdominal massage
Gently massage your baby's tummy in a clockwise circular motion using your fingertips. This technique can stimulate bowel movements (intestinal motility) and help push stool out. Do this slowly to keep your baby comfortable. - Move your legs like pedaling a bicycle
The movement of your baby's legs, like pedaling a bicycle, can help stimulate bowel activity. Do this gently for a few minutes, especially after your baby has eaten or drunk, to help promote digestion. - Try taking a warm bath
Bathing a baby in warm water can relax their abdominal and pelvic muscles. After a bath, many babies feel more comfortable and sometimes have easier bowel movements. - Pay attention to the type of formula milk
If your baby is formula-fed and frequently constipated, it could be that their digestive system isn't suited to a particular brand or ingredient (such as a high-iron formula). Consult your pediatrician before switching brands to ensure your baby continues to receive balanced nutrition without the risk of constipation. - Don't give laxatives carelessly
Avoid giving laxatives, suppositories, or bowel cleansing fluids without a doctor's advice. Improper use can irritate your baby's intestines or disrupt their electrolyte balance. If constipation persists for more than a few days or is accompanied by other symptoms (vomiting, fever, or a hard abdomen), consult your pediatrician immediately.
With these simple steps, most cases of constipation in babies can be resolved without medication. However, it's always important to monitor the frequency and consistency of your baby's bowel movements and seek medical advice if the condition persists.
When Should You Take Your Baby to the Doctor?
While most cases of constipation can be treated at home, there are some signs that indicate your baby needs to be seen by a doctor immediately. Look for the following:
- No bowel movements for more than 3-5 days
This condition could be a sign that the baby's intestines are actually blocked or that bowel movements are slowing down. - Very hard or bloody stools
This can happen due to injuries around the anus due to straining too hard. - The baby looks like he is in pain when he wants to defecate.
If your baby is crying, straining for a long time, or seems very uncomfortable, it's likely that the constipation is quite severe. - The stomach looks bloated and the baby doesn't want to eat or drink.
These symptoms could indicate gas buildup or other digestive problems that need to be checked out right away.
Immediately consult a pediatrician if one or more of the above signs appear so that your baby can receive safe and appropriate treatment.
The doctor will help find the exact cause, whether due to diet, milk intolerance, or other digestive disorders, and provide safe treatment according to the baby's age.
As a parent, it's important to remain calm and avoid trying laxatives or other measures without medical advice. Focus on monitoring your baby's condition, ensuring they stay hydrated, and recording their bowel movements to provide information to the doctor. This way, your little one can receive appropriate treatment and recover quickly from constipation.
The article was written by Dr. Darmady Darmawan, Sp.A (Pediatrician at EMC Pulomas Hospital).