I get asked a lot about what to do with a baby who is constipated.

First, it's important to check if your baby is really constipated or if they're just making a big fuss when they're having their bowels opened.

Babies make a lot of noise when pooing and often pull faces, go red in the face etc. Why? Well for a start off they have no social inhibitions! As adults, we've learned not to do such things. And their tummy wall is immature so they often strain to help the poo along!

So what is true constipation?

Well, the poo resembles rabbit droppings and is hard, round and dry. For pictures and more, I've written a previous blog on the different types of baby poo: What's normal for baby poo?

How often do they 'go' when not constipated?

It can be every nappy change or every day or every other day if formula fed. If they're breastfed they may poo once a week or occasionally once a fortnight.

So when should you get worried and do something about the constipation?

• If the baby is very upset and hasn't had their bowels opened for more than a few days if bottle/formula fed.
• If there is blood in the poo.

• If there is mucus

• If there is eczema and a family history of atopic disease - asthma, eczema and hay fever

• This may be related to cows milk protein allergy (CMPA).
• Here are links for recent research
  
  
  • http://www.drgreene.com/qa-articles/milk-constipation/
  • https://ijponline.biomedcentral.com/articles/10.1186/1824-7288-36-5
  • See also a link to my blog on the topic: Cows milk protein allergy and sleep
  • https://nurtureparenting.com.au/cows-milk-protein-allergy-and-intolerance/

It's usually a formula fed issue.

Sometimes if babies are started on solids too young it can also occur, especially if the main part of the diet is predominantly high in carbs - baby rice, excess dairy such as yoghurt and cheese, white bread and bananas.

If baby is on formula it may be worth trying an extensively hydrolysed infant formula e.g. Neonate or Elecare. May have to get on prescription from a paediatric gastroenterterologist.

What can you do about it?

• Increase fluids

• Add pureed pear to each pureed meal

• Increase fibre if on solids - lentils, chickpeas, pulses, beans, Weetbix, veggies and fruit especially pureed pears and prunes. Here are some of my blogs for ideas:
  
  

1. Breakfast ideas for the 6 month plus baby
2. Desserts that help babies and toddlers sleep
3. Moving on to solids the stress free way
   
   

• Offer diluted prune juice till settled, try 20mls each day. To make your own prune juice put 5-6 dried prunes in a saucepan just covered with cold tap water. Bring to the boil, simmer for 10 minutes and strain, using the strained liquid to give to baby.

• Avoid 'white foods' that constipate e.g. baby rice, yoghurt, cheese, dairy, pasta, processed foods, white bread

• Baby massage - massaging the baby's tummy in a clockwise direction.
  
  
• This massage technique features as one of a few in my video linked to here: https://www.youtube.com/watch?v=YtCxp5GpwB0.
  
  
• A more comprehensive massage demonstration is offered in my ebook with embedded video: Baby Massage: The Magic of Touch

• 'Bicycle' the legs - this technique demonstated in my video here: https://www.youtube.com/watch?v=YtCxp5GpwB0

• Tummy time or placing the baby across your knee can all help.

• Visit your doctor/GP or Child & Family Health Nurse if things do not resolveMay be worth trying a dairy free diet for two to four weeks.
  
  
• See my blog on the topic here: Cows milk protein allergy and baby sleep