Today we’re gonna discuss baby constipation: what it is, why it happens, and how to solve it.
First of all, I just want to start this episode off by saying that this mostly applies to children and babies who have already started solids. Whether you started solids at four months, six months, or nine months (typically we don't have constipation issues with babies who are exclusively breastfed - they will poop anywhere from 10 times a day to once every seven days and that’s normal).
You know, I’m not a doctor.
Consult with your pediatrician for anything I've said today, I am not a doctor. I do not give medical advice, these are all just my opinion and other people's opinions that I've collected over the internet and over all of our experiences with our own babies. So, consult with your doctor if you have any questions and before doing any kind of medical treatment with your baby.
Do ECed babies get constipated?
Now that the disclaimer is done, I want to define constipation. But before that, I just want to say that babies who are ECed from whatever age usually suffer far less constipation, and a definite majority of them (99%) avoid any kind of medical constipation whatsoever. Medical constipation is very common if you toilet train after two or three years old.
With EC they're in a deep squat, which shortens the length of the colon and it definitely makes poops easier to pass. When they start to sit on their own and sit on their toilet seat reducer, they have more control over things in general and in life (like a young toddler, 12 to 18 months).
Sometimes we ECers can come across constipation because one hard poop, one experiment of “How long can I hold this?” or “Let me see how my bowels work?” can ruin everything. It causes the poop to become harder and dryer and then hurt when it comes out - even bleed - and that can ruin it all. That can start a battle with constipation as well as (with any kind of illness) possibly a potty pause.
What’s the definition of constipation for babies?
Let's quickly define constipation because it's important to know what it is and what it isn't. Constipation in children is a condition in which your child may have fewer than two bowel movements a week and some, say three. Stools that are hard, dry, or lumpy like little balls or little nuggets, and stools that are difficult or painful to pass. That’s all from The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Also, constipation can occur with stools that are wide and abnormally large - like adult or teen size - and you've got a baby pushing one of those out. Not good.
Reasons Babies Get Constipated
There are reasons that constipation happens.
Some of the reasons include diet - changes in diet like starting solids, for example, a change in the mom's diet (if we're doing breastfeeding), or if we've introduced new foods to the child's diet.
Any kind of illness can definitely cause constipation and this is usually related to the medication, if anything, that the child is taking.
Refusal - if you're going through a potty pause, please check out my potty pause resolution mini course. It's very short, very digestible (no pun intended), and we can very much get you out of a potty pause if you've had a refusal for more than one or two weeks out of nowhere.
Refusal can cause constipation because of the way your body works - I've learned this from working with my pelvic floor therapist after having my fifth baby (which if you haven't done that, please do, you learn so much). So if you wait too long because you've got a crying baby or you need to nurse or whatever, and if when you get that first urge to poop, you don't go right then and you just wait and you hold it, your body sucks it back in (for lack of prettier terms) and it's still there near the end, near the opening, and so it dries out and accumulates.
You've got this dryer, larger poop that's accumulated at the exit and then when you're really ready to poop it out, you've got to strain extra hard to get it out. It's really wide and difficult (especially if you have pelvic floor issues or you've never worked on it after having a baby) - you can have really painful poops that will cause you to have little capillaries pop and get a little bit of blood.
For a baby, the same thing happens if they wait too long. That accumulates, gets hard, gets dry, and it's very hard to pass. So, when they finally do stop refusing long enough to pass it, it hurts. Again, one hard and hurtful poop can ruin it all.
Not enough fluids can also cause constipation, obviously, and a good sign is to check your baby's fontanelle for dehydration (that’s the little soft thing on the top of their head and the back of their head that closes up as they get older). My pediatrician told us that you can tell if a baby is dehydrated when it's depressed and it's not plump and full. Not enough fluids can obviously cause constipation and that can happen after a child's been sick. If they're dehydrated and they're not getting fluids and absorbing them, they can get constipated.
Too many constipating foods - if you don't get a chance to Google it, I'm going to do it for you. “Alcohol, (no worries with that kids), gluten containing foods, processed grains, milk, and dairy products can constipate.” If you introduced milk or dairy to your child's diet, it could constipate. They also say that red meat, fried or fast foods, and persimmons also constipate. (Persimmons! Who knew that?)
Foods that can ease constipation, which we’ll cover when we talk about solutions here in a sec, include water, yogurt and kefir. So, something that is dairy that is fermented, clear soups, prunes, wheat bran, broccoli, apples, and pears can ease constipation.
Bananas are also known to constipate, and what do they start eating when they start eating solids? Babies love bananas, of course. We want to make sure that if we're having constipation, we limit those.
Another cause of constipation is to have that hard poop once and then just wanting to avoid pooping because you don't want to recreate that same situation for yourself.
We have poop refusal, which can cause more constipation. It's a vicious cycle and that in turn makes it dry, large, hard, and often harder to pass as well.
So, those are just a few causes of constipation for babies.
Let’s now discuss the side effects of constipation - they are fairly interesting.
Side effects of constipation in babies
Oftentimes people will come to me with their EC issues in my Q&A's or my book owners group and say, "Hey, we've got lots of small pees happening over a short period of time - why?" And my first instinct is to say, “because your baby might be constipated.”
Even if a baby is pooping every single day, they still might be constipated. They might not be letting all that go, they might have some poop that's just lodged in there and just won't come out. It's being stubborn because there is a big lump of it and that pushes against the bladder and causes less urine to come out in little spurts over a short period of time. Constipation can be something to rule out.
Resistance can be caused by constipation because I don't want to put myself through that again so I'm not going to potty willingly.
Constipation can cause children to get up and not stay seated on the mini potty or try to get off the toilet reducer. If your child has a sitting problem, maybe it's just because they really don't feel comfortable pooping since they started solids or had a diet change.
Another thing that constipation can cause is for your child to poop just a little and then 10 minutes later poop another little bit and poop another little bit. They're trying to let it out a little bit at a time to exercise control, maybe, but probably because there's some underlying constipation.
In that case, we want to soften the stools and make them happen daily, if possible, and help your baby relax so they can pass them easily. I do have some solutions for that, we'll get to those.
Sometimes constipation can cause your child to have blood in their stools or on the toilet paper, which might shock you and surprise you. The first time I saw that with my newborn, I was like, “Oh my gosh, what is this?” (It is normal, I was told, to have a speck here and there.)
However, when you've got a young toddler, a young baby, and there's a little bit of blood on the toilet paper stool after they've gone, it can often indicate that you have a constipated child. It's just tearing at those capillaries at the sides and popping them.
A hard stomach can be caused by constipation. If you push on their stomach and it's just rock hard, an infant massage can often resolve part of that. That's usually something caused by constipation - they’ve got a hard belly.
Constipation, believe it or not, can cause severe irritation in a baby. They could just not be themselves, just be irritable, and sometimes they won't sleep, etcetera.
On the same note, constipation can cause disruption in naps and sleep.
It can also cause toilet refusal - baby straight up won't use the toilet - and cause clinginess.
This is my daughter's last four months. She's 17 months now and she's been battling constipation for four months now because she had one hard poop that ruined it all, which is part of the reason why I'm doing this episode today. (But also, everybody's asking for all the options!)
She gets super clingy when she needs to poop and doesn't want to. There's a need here that's conflicting with another need.
I want to stay comfortable and safe in my body and I also don't feel safe, so I need you and I really need to poop but I don't want to.
Constipation can also, if it's serious, cause fever and changes in energy levels in your baby.
If you get a fever along with constipation, you should see a doctor or your pediatrician. Also, for any other thing that you feel iffy about, call them. Again, I'm not a medical doctor, this is just all my opinion.
Baby constipation remedies
Now for the solutions.
We can change their diet, we can add in those foods that can ease constipation. You can Google it, but I've got a few up here like water, yogurt, prunes and stuff like that.
We always add prune packs - the Just Prunes by Plum Organics is a really good one. Sometimes they outgrow those and they won't eat them, so you can mix that with yogurt.
Prunes (like the actual dried fruit) can be fed to your baby, the same way you do with raisins. Just chop them up and they often like those.
You can feed prune juice, which again, after a couple of times, they'll get smart - they'll be like, this doesn't taste good.
You can do apple juice or pear juice as my pediatrician recommended.
You can add more liquids to their diet and make sure they're absorbing the liquids if they've been sick recently. You may want to do something like Pedialyte.
Infant massage can often help. When you're looking at your baby, you go on the left side up to the right, down, and then over to the middle. You can look that up - I'm not a certified massage therapist so don't take my word for it. Do your own research.
Part of helping your baby relax is for you (mom, dad or caregiver) to chill out and relax yourself. There is typically no toilet fear or poop fear or any of that crazy stuff that three years of diapering would cause, if you’re ECing a 0-18 month baby. They haven't developed that same kind of, “I'm comfortable pooping in my diaper and now you're making me poop in a potty and I'm scared and I'm not going to do it.” This is different. This is withholding that is usually much more physical and much more related to the environment. So, you need to relax and they will relax.
Toddler suppositories - so, with our then-13 month old, I was told by the pharmacist that I could use these, and that I should just break it in half because they're made for ages two and up. Again, do your own research, make your own decision. I'm not responsible for you. We're all responsible for ourselves. Right? But this works for us, you guys.
We tried a baby enema first. I've had an enema and I personally thought it was the most terrifying thing I've ever done. My husband was like, I know she'll be fine. Our baby was miserable during the enema! So I wouldn't even try those. You break toddler suppositories in half, put the pointy part of it in, pop!, and then you wait about five minutes, then you get a poop. I just carry them around naked while that thing is in their butt and then when they start to get really squirmy, about five minutes later, I pop them on the potty and it produces a poop.
Oftentimes I'll also put them on the toilet seat reducer and I will walk away and once I give privacy. That's another cause of constipation, not giving your child privacy. Babies tend to want bathroom privacy starting at 6-8 months. That's why young toddlers hide behind a couch and do it in private. Babies are born really sensitive about this - it is not socially appropriate to poop in front of other people. So, when you're doing a solution like this - you have done the suppository, you've waited five minutes, they start to kick around and they need to go - set them on the potty, the toilet seat reducer as long as you feel safe doing that (they're not going to jump off), and say, “Oh, I just forgot something” and go grab your drink from the other room and come back. When you are gone, listen around the corner and you'll usually hear them start bearing down and pooping because they have privacy and they feel safe. After all, we are mammals.
That's what worked for us. That and the prune, apple, pear juice, actual prunes, and prune packs with yogurt. That all worked for us. When Twyla skips a day and then she's miserable again the next day and won't go poop, we are right on that suppository once again. Over the last few weeks (our pediatrician told us to use them for two weeks straight), after two weeks of doing that, we got her on a regular daily pooping pattern. We didn't need to use them again for another month, and then she was like, I'm going to wait again. Another day passed and on the third day there was no rising, and there was a suppository given. :)
Another solution: you can Google poop candy. If you mix coconut oil with peanut butter or chocolate and then freeze or refrigerate it, that coconut oil can really help a bowel movement to happen. I like to make homemade coconut cream ice cream with frozen bananas and frozen strawberries. You can Google that too, but that coconut oil is really good for lubing things up and combating constipation.
Magnesium powder - I've heard this from another mom. I haven't tried it but I did take Calm, a brand of magnesium powder, while I was pregnant for restless leg syndrome, to help me sleep, help me relax, and also to loosen my bowels. She's used it on her infant, but again, do your own research and see if you can do that.
Magnesium oil on the surface of the skin and on the belly is what another mom suggested on Instagram the other day, and a child sized dose of laxative. Consult with your pediatrician, but little doses of laxative could help as well, if you're facing this.
(Honestly, I usually don't just revert to my pediatrician for everything because I'm a pretty natural mama and I can handle stuff - I've had five kids. However, with Twyla I decided to ask her opinion, and the suppositories and the juices and everything were her first choice. Her second choice, if this doesn't work, was that we were going to give a child size dose of adult laxative.)
The other thing I really want you to do if you're working on a solution is keep a log (no pun intended). Write down on your calendar or on your phone: pooped, pooped, pooped - on which day they pooped, because you will lose track of what days that happened and you want to get on a regular rhythm.
Again, if you have a fever with this or changes in energy level and your child is not normal, you need to probably see a doctor right away.
But, that's everything I have about constipation.
Now I wanna hear from you! Please comment below:
Are you dealing with baby constipation? If so, what are you going to try from today's episode? If you've dealt with it before, what has worked for you and what hasn't?
I’ll look forward to seeing you in the comments below!
PS - here’s the video version of this episode in case you prefer to YouTube it. ;)