Constipation in Newborns

I get so many calls about constipation in the first few months. The baby hasn’t pooped in more than 24 hours yet is straining, twisting, and even turning red in an effort to do so. Although this is tough to watch, it is common and often normal. The key is not how often your baby is pooping but the consistency of the stool. Hard, well-formed stool indicates constipation. It can cause bleeding, as the hard stool tears the fragile skin near the rectum, and this can cause pain and discomfort.

Not pooping every day can be normal. The intestines are not fully mature in a lot of babies, and their bodies need to learn how to break down the milk they’re drinking into amino acids, carbohydrates, fats, etc. Often the baby may also have a bit of colic, which adds to the digestion problems. The bottom line is that straining and turning red, even when coupled with no stool for a day or two is rarely a cause for concern. Some breastfed babies can even go for a week without pooping. As long as their stool is soft, this is just fine.

Treatment

If your newborn truly is constipated and his stool is hard, there are some solutions that are safe and effective. Start by giving 1 ounce of straight water. If that doesn’t work after 4 hours, give 1 ounce of straight prune juice. If you still don’t get results 4 hours later, give 1 ounce of water and 1 ounce of prune juice. If it’s still not working after another 4 hours, give a pediatric glycerin suppository.

Low thyroid (hypothyroidism) can cause constipation in a newborn, but all babies are screened for this when they are first born. There is also a rare but serious condition called Hirschsprung’s, where there are no nerves in the rectum. Babies with this condition will have had chronic constipation since birth.

Constipation in Older Children

A very common time for children to develop constipation is during toilet training. If too much pressure is placed on a youngster, they may subconsciously rebel by holding in their stool. This leads to their bodies absorbing more water, which makes the stool get harder. The harder it gets, the more the child will hold it in, and on and on it goes.

Treatment

Dietary intervention should be your first line of defense. Common offending foods are rice and bananas—neither should be eliminated completely from your child’s diet, but maybe don’t give it to them every single day. Increase your child’s water intake. You can also give him prune juice, either straight or mixed with apple juice or water. Dried prunes or apricots are also great. Offering him bran in the form of cereal (mix it with his preferred cereal, even if it’s sweetened, if you have to) or muffins (try low fat) helps a lot. It’s helpful to increase his roughage and fiber intake in general.

Mineral oil can work well but shouldn’t be given to young ones straight, as they may choke and accidentally get it in their lungs. Milk of Magnesia, Senna, Colace, and others have been around for a while and can be helpful, but Miralax is the medicine recommended most often by pediatricians and gastrointestinal specialists. It’s a safe, effective, and tasteless medicine that can be used as a quick cure or for maintenance. Younger kids can have half a capful of the powder, while older kids can have a full capful every day for weeks or even months without side effects. Mix the medicine with 8 ounces of juice or water.

During an exam, if your pediatrician feels hard stool gathered in the lower left quadrant of your child’s abdomen, it means that he is completely backed up, and you’ll need to turn to pediatric glycerin suppositories or even pediatric fleets enemas. These are usually given nightly for 3 nights and are without a doubt more effective than oral medications. Although they are safe and effective when used appropriately, administering them may potentially bring on emotional issues.

While parents will freely talk about colds, coughs, sleep issues, and growth percentiles, pooping habits tend not to be the hottest topic in the playground. But constipation is more common than you would think, and if your child is suffering from painful bowel movements, make it a point to speak with your pediatrician immediately, before the vicious cycle of pain and retention begins.

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