If you’re like many parents, you’re all too familiar with your child’s poops — when they’re green, when they’re runny, and when they won’t come out.
Even little ones who have a healthy diet can come down with a case of baby or toddler constipation. Though your munchkin may not be able to tell you that her tummy aches or she can't poop, if she’s straining and passing hard stool balls, you might have a case of constipation on your hands. (Or, if it’s your potty-trained toddler who won’t go number two, she could instead be refusing to poop.)
The good news? Constipation is often easily treatable in babies and toddlers, and your little one can be regular again before you know it. Check out these guidelines when you’re on poop patrol, and be sure to consult with your pediatrician to confirm your suspicions.
What is baby constipation?
No secret here: Constipation happens when poop becomes hard, dry and difficult to pass. What you might not know? It's actually not all that common in newborns or babies. In fact, it's normal for breastfed babies over 1 month old to go days or even a week without a bowel movement. Formula-fed infants typically go a day or two in between poops too.
That said, your wee one might run into more problems in the bathroom department as she gets older and begins getting a larger portion of her calories from solid food.[1]
Signs of baby constipation
Straining or grunting alone doesn't usually mean your cutie is constipated, since even having a regular bowel movement requires a lot of effort for babies. (Pooping on your back isn't easy!)
Your little one might be constipated if:[2]
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- Her stools are hard or pellet-like, or they contain blood
- She's pooping less frequently than normal
- She cries or arches her pack while she's trying to poop
- She's very fussy
- She's spitting up more than usual
- She seems to strain for more than 10 minutes to have a bowel movement
What causes baby constipation?
Again, constipation isn't all that common in babies. But when it happens, it's much more likely to strike after an infant has started eating solids. After a strictly liquid diet, it can take her GI tract some time to get used to those new foods, which could lead to temporary problems pooping.
Babies under 1 month can also have constipation-like symptoms (read: pooping less than once a day) if they aren't eating enough. So if your newborn's poops have gotten less frequent, it's important to let the pediatrician know.
How to relieve baby constipation
There are plenty of ways to get your sweet pea's pipes working again. Depending on her age and what your pediatrician recommends, you can:[3]
- Give her apple or pear juice. Juice isn't recommended for the under-1 set, but in this case, the natural fruit sugars in the juice can help loosen up your sweetie's stool. Ask your pediatrician if they recommend giving a small amount of juice to your child to ease constipation. Start with ½ an ounce, and don't give juice to babies younger than 1 month.
- Serve high-fiber foods. Munchkin started munching on solids? Add some fiber-rich foods to the menu twice a day, such as prunes, peas, beans, apricots, peaches, pears, plums or spinach.
- Check her fluid intake. Babies over 6 months should sip 4 to 6 ounces of water per day, so make sure she's getting her fill.
- Get moving. Give your little mover and shaker plenty of opportunities throughout the day to, well, move! If she's not mobile yet, you can try bicycling her legs to get her gut going.
- Offer probiotic-rich foods. Make plain, whole-milk yogurt a mainstay for your older baby (just make sure to check with your pediatrician before introducing yogurt). The probiotic bacteria will help keep her gut healthy so things keep moving. As for probiotic supplements? The jury's still out, so check with the pediatrician first.
- Try some lubrication. Dabbing a little bit of petroleum jelly at your baby's anal opening can help things slide out a little easier. Slipping in a lubricated rectal thermometer can also stimulate the muscles that push out BMs.
- Hold off on the laxative unless it's recommended. Laxatives or constipation meds aren't typically recommended for babies, so don't use them unless you've been advised by the pediatrician to do so.
What is toddler constipation?
Once your little one has officially transitioned to toddlerhood after her first birthday and is solidly on solid foods, her poop patterns will look a lot like yours. It's normal for tots to have between three bowel movements a day and three bowel movements a week. If the poops are coming less often or they're hard, dry or painful, she's likely constipated.[4]
Signs of toddler constipation
A constipated toddler isn't usually a happy camper. You'll know your little one is having trouble going if:
- She poops fewer than three times per week
- Her poop is hard and dry
- She complains that it hurts when she tries to poop
- She can't poop after trying for more than 10 minutes
- She complains that her tummy hurts, even when she's not trying to poop
- She has blood in her stool or on the toilet paper
What causes toddler constipation?
Toddler constipation can happen for many of the same reasons as it does in grown-ups. Not getting enough high-fiber foods (like fruits, veggies, beans or whole grains), not drinking enough water, and spending too much time sitting can all make stools harder and more difficult to pass. Stress from new situations, travel or changes in routine can also be culprits.
Being a cow's milk guzzler or a cheese connoisseur can also factor in. If you notice your toddler's poops are hard and pale, she may need to cut back on the dairy.
Behavior can play a part at this age, too. If you're trying to potty train but your toddler is resistant or afraid of pooping in the toilet, she might try to control the situation by holding it in, a habit called stool withholding. She may also try to avoid going if it hurts to poop (which can happen with a GI bug or diaper rash).[5]
How to relieve toddler constipation
Many of the same strategies you might have used for curbing your own constipation may work for your toddler. You can:[6]
- Offer high-fiber foods. Fiber makes stool softer and bulkier, so it's easier to pass. Find ways to incorporate more fiber-rich foods into your tot's diet, including fruits, veggies, whole grains and beans. If she tends to balk at anything that's not white or cheesy, get creative: Add berries or leafy greens into a smoothie or try whole wheat noodles for her usual pasta-with-butter combo.
- Beware of binders. Dairy, refined grains (like white rice or pasta), processed snacks (like crackers or chips), and some fruit like bananas, apples and carrots can worsen constipation. Your doctor may recommend limiting these foods until your tot's stools are back to normal.
- Check her fluid intake. Your toddler should drink around 4 cups of water a day, so make sure she's getting her fill. You can also ask the doctor about offering small amounts of prune or pear juice.
- Make time for active play. Moving gets your toddler’s GI tract moving too. Head to the playground for some running and jumping, have a living room dance party, or hit up a toddler yoga class.
- Consider pausing potty training. If the potty situation is turning into a power struggle, think about taking a break for a few weeks.
- Offer probiotic-rich foods. As with babies, plain, whole milk yogurt is a healthy choice for tots.
- Try some lubrication. Dabbing a little bit of petroleum jelly on your toddler's bottom can help things slide out a little easier.
- Ask the doctor about OTC meds. Stool softeners (like docusate sodium); osmotic laxatives (like magnesium hydroxide, magnesium citrate, or Polyethylene glycol 3350 3350); or stimulant laxatives (like Senokot) are safe for children, according to the American Academy of Pediatrics (AAP). They can be helpful if lifestyle changes haven't improved your child’s symptoms, but always check with the pediatrician first to confirm that a stool softener or laxative is the best option for your little one.
When to call the doctor
An occasional case of constipation isn't usually cause for concern, especially for older babies or toddlers. However, you should reach out to the pediatrician if:
- Your newborn (under 1 month old) has fewer than one bowel movement a day.
- Your formula-fed baby seems uncomfortable and fussy, and she hasn't pooped in three days (if there's a change in her bowel habits).
- Your breastfed baby has gone longer than usual without a bowel movement and you're concerned.
- Your older baby or toddler hasn’t had a bowel movement for four or five days.
- Your baby or toddler's constipation is accompanied by abdominal pain or vomiting, there's blood in her stool, or at-home measures aren't working.
- Your toddler seems to be withholding her poops on purpose.
Constipation isn't fun for you or your child. Luckily, you can usually get things moving again at home. So bump up the fiber and fluids, make sure your little one has plenty of time for physical activity, and try to be patient. Before long, your cutie's constipation will clear up — and she'll be feeling a lot more comfortable.
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