Constipation in infants

Constipation in infants: When to be alarmed?

Constipation in infants after starting complementary feeding is one of the most common problems that parents bring to a pediatrician. While for a newborn on breast‑feeding the absence of stool for several days can be normal, for a child who is already eating solid foods this is often a sign that the digestive system needs help. It is important to understand that the main criterion for constipation is not frequency, but the consistency of the stools and the child's well‑being.

How to recognize constipation in an infant?

Unlike the soft, porridge‑like stool of breast‑fed infants, the stool of a child receiving complementary foods becomes more formed. The following signs indicate constipation:

• Hard, dry stool in the form of separate "balls" or a large, dense mass.
• Pain and straining during defecation. The child strains heavily, turns red, cries.
• Reduced frequency of bowel movements significantly below the child’s individual norm.
• Specks of blood on the surface of the stool, resulting from micro‑tears of the anal opening.
• Decreased appetite, irritability, abdominal pain.

Causes of constipation after starting complementary feeding

Introducing solid foods is a serious challenge for an immature digestive system. Main causes of constipation at this stage:

• Insufficient fiber intake. If the base of the complementary diet consists of instant cereals and banana puree, it can "tighten" the stool.
• Insufficient fluid intake. With the start of complementary feeding the child should be offered water. Lack of fluids makes stool masses harder. More details in the blog "When and how to offer water to an infant?".
• "The big three" constipating foods: rice, bananas, cooked apples.
• Cow’s milk protein allergy. Sometimes constipation can be one of the manifestations of food allergy.

To correct the condition it is important to review the child’s diet, enriching it with vegetables and fruits that have a laxative effect (prunes, apricots, broccoli) and ensure adequate fluid intake. Read about general feeding principles in the article "Introducing complementary feeding".