What is constipation?
The infrequent passage of dry, hardened stools often accompanied by straining and pain.
What are the symptoms?
Some infants may normally pass stools several times a day, while others may normally pass stools only a few times a week. As well as infrequent, or irregular, bowel movements, a baby with constipation may also display the following signs and symptoms:
- Loss of appetite
- Lack of energy
- Being irritable, angry, or unhappy
- Foul smelling wind and stools
- Abdominal pain and discomfort
What causes it?
Constipation in babies and children is quite common, although not usually in exclusively breastfed babies. For example, not feeding enough and not giving enough fluids can cause constipation in babies and children.
Constipation in babies and young children can sometimes be a side effect of medicines such as:
- Sedating antihistamines
- Antiepileptics
- Opioids
How can it be treated?
Babies who have not yet been weaned
If a baby is constipated but has not yet started to eat solid foods, the first way to treat them is to give them extra water between their normal feeds.
Recommend that formula-fed babies should continue with their normal feeds, and feeds should not be diluted (the manufacturers instructions should always be followed).
Suggest that parents gently move their baby's legs in a bicycling motion, or carefully massage their baby’s abdomen (stomach) to help stimulate the bowels.
Babies who are eating solids
Advise parents to ensure they give their baby plenty of water, or diluted fruit juice. Suggest a diet rich in fruit and vegetables. The best fruits for babies with constipation are:
- Apples
- Apricots
- Grapes
- Peaches
- Pears
- Plums
- Prunes
- Raspberries
- Strawberries
If the baby is still constipated after a change in diet, parents should seek advice from their GP. They may have to be prescribed a laxative, usually an osmotic laxative followed, if necessary, by a stimulant laxative. Bulk-forming laxatives are not suitable for babies.
- Osmotic laxatives. For example, lactulose or polyethylene glycol. These work by retaining fluid in the large bowel by osmosis (so less fluid is absorbed into the bloodstream from the large bowel)
- Stimulant laxatives. For example, senna or docusate. These act on the muscle in the wall of the bowel to 'squeeze' harder than usual