Almost all formula-fed babies, at some time between the ages of 2 weeks and 4 months, will go for 2-4 days without a bowel movement. (Breast-fed babies may do this as well but it is much less common.)
Why does this happen?
Most of a baby's milk gets absorbed by his body, leaving very little waste product. Babies have an incredible growth spurt at this time in their lives, sometimes putting on as much as a pound in a week or two. All the calories, protein, fat, and other nutrients in the baby's milk provide the necessary nutrition to do this. The baby's intestines are designed to absorb as much of these nutrients as possible, and not much will be left over. Also, there is not much in infant formula that is "indigestible" (unlike an adult diet, which includes things like cellulose from salads, which are just expelled in the stool.)
If this happens to my baby, what should I do?
Nothing. It's normal and doesn't require any treatment.
When should I worry if my baby doesn't have any bowel movements?
A baby who isn't stooling because of something bad will have other symptoms, such as:
- forceful vomiting (not just spitting up)
- inconsolable crying
- decreased appetite
- decrease in wet diapers
- a hugely bloated, distended belly
So what counts as constipation in a baby?
Constipation in babies means hard stools - not infrequent stools. That is, a baby who has no bowel movements for 2-3 days and then has a soft stool does not have constipation. But a baby who has hard, pebble-like bowel movements - even he has several a day - is constipated.
What can I do if my baby is truly constipated?
Some helpful, safe remedies that soften the stool include:
- a teaspoon of dark Karo syrup in the bottle
- a tablespoon of the heavy syrup found in a can of peaches or pears
- an ounce of the "p" juices: prune, pear, peach, or pineapple
We do NOT recommend:
- honey in the bottle (this can cause botulism!)
- glycerin suppositories (these stimulate a bowel movement to occur, but don't make the stool any softer)
- putting other things in the baby's rectum, like soap or pencils
Could the iron in her formula be making her constipated?
No. (Iron only constipates children if it is taken in huge amounts - much more than is found in any formula.) Do not switch your baby to the low iron formulas. These formulas should only be used when babies are getting additional iron drops. (In fact, the formula labels say this.) Putting a baby on a low- iron formula can cause anemia, which is much worse than constipation.
What if these changes don't help?
If Karo syrup or fruit juice isn't helping, we should check the baby in the office to possibly recommend a different treatment.