How Can You Tell if Your Baby Is Constipated?

The most obvious sign of constipation in babies is a simple lack of stool.

Newborns and infants have immature digestive systems that can be vulnerable to a variety of problems. Like adults, they can suffer constipation, which makes it difficult for them to pass stool. This condition is not only uncomfortable but also can be indicative of more serious concerns.

While constipation is far from unusual in babies, it can be difficult to detect because such a wide range of bowel habits are normal. For example, some breastfed babies rarely pass stool, as their bodies absorb nearly all nutrients from the breast milk as it passes through the digestive tract. 

Recognizing the signs and symptoms of constipation is important not only for making your baby more comfortable but also for ensuring proper nutrition.

The most obvious sign of constipation in infants: a simple lack of stool. Bowel patterns can vary based on age and consumption of formula or solids, however, so this symptom can be difficult to observe or understand. 

Pediatric research suggests that upwards of four defecations per day can be normal in newborns. In general, however, infants up to 3 months old have, on average, 2.9 bowel movements per day. In later infancy, this decreases to an average of 1.8 defecations each day.

Babies who go more than five days without passing stool may be constipated. A sudden change in bowel patterns may also indicate constipation, especially if babies who previously passed stool daily suddenly go several days without doing so.

Other warning signs of constipation in babies include:

Hard, pellet-like stools

It’s normal for babies to pass stool infrequently or even to strain a bit during bowel movements {La Leche League International: “Constipation.”}. In either situation, however, stools should be soft. Grainy or seedy textures are perfectly normal. If stool becomes hard or resembles pellets, constipation may be to blame. 

Excessive straining during bowel movements

Some straining is to be expected during infant bowel movements, especially among newborns. Weak abdominal muscles can make it difficult for them to pass stool, causing them to strain as a result. 

Constipated babies, however, take this to the next level by arching their backs or crying for extended periods of time. If they obviously seem comfortable, they may be constipated.

Black stool

Many colors are normal for newborn and infant stool, including yellow, brown, and even dark shades of green right after birth. After a few weeks, however, stool should not be excessively dark. Black poop, in particular, indicates that something is not quite right with your baby’s digestive system. 

Passing blood in stool

Under ordinary circumstances, infant stool should not include blood. It may appear, however, when babies strain excessively to poop or experience a small fissure while passing the pellet-like stools referenced above. 

Many factors can lead to constipation. Some of these are more concerning than others. For example, infants who primarily consume formula may experience constipation upon switching brands or beginning to consume solids. In other situations, underlying issues may contribute to the problem. These include the following: 

Illnesses

In rare cases, baby constipation can be a sign of specific illnesses. Examples include cystic fibrosis, Hirschsprung's disease, diabetes insipidus, and hypothyroidism. 

Cow's milk allergy

Among the most common intolerances among infants, cow’s milk allergies can lead to a variety of digestive issues, including constipation. This allergy causes the immune system to overreact to the protein in cow’s milk. It commonly accompanies formula feeding but may occasionally occur in breastfed infants.

Certain medications

Select medications can make it more difficult for babies to pass stool, especially if given in excess. The pain reliever acetaminophen, for example, may prompt constipation in some cases. Constipation can also be a side effect of ibuprofen, which may also lead to stomachache and nausea.

Consult a doctor if infant constipation persists for more than a few days. Medical attention may also be needed if babies pass blood in their stool or experience other symptoms such as weakness or vomiting. 

Doctors can often determine constipation based on information parents provide about the frequency, color, and constituency of stools. Typically, constipation is not seen as a diagnosable condition in and of itself, but rather, as a sign of other concerns, such as dietary issues, medication use, or underlying medical problems.

Prune and pear juice are age-old recommendations for helping babies pass stool when they’re constipated. The sorbitol in these types of juices act as a mild laxative. These should be offered in addition to regular feedings but not as a replacement. 

After babies have begun eating solids, pureed prunes or peas can help with constipation, as they contain more fiber than other types of produce. Replacing rice cereal with oatmeal may also help, as can the occasional use of water.