Baby's Bowel Movements: When to Worry and What to Expect

Baby bowel movements

Hello doctor, my baby is currently 1 month and 13 days old and is exclusively breastfed.
However, he hasn't had a bowel movement for five days.
He usually consumes 120 ml of milk, but for some reason, he hasn't been finishing it these past few days.
There have been a few instances where he vomited milk halfway through feeding, which came out from both his mouth and nose.
He is passing gas.
Is this normal?

Yu, 20~29 year old female. Ask Date: 2017/11/13

Dr. Zhong Ruixian reply Pediatrics

Hello! Based on your question, there are several possible causes:
1.
Fecal Impaction: If the stools in the colon are hard or abundant, it can affect the baby's feeding.
Check if the baby has abdominal distension or if there are hard stools at the anus.
Breastfed infants typically have multiple bowel movements in the early stages, which may decrease to every few days later on.
2.
Milk Allergy: This is a less common cause.
If you have not consumed seafood recently, you can rule this out.
3.
Gastroesophageal Reflux: Most infants improve as they grow older.
4.
Pyloric Stenosis: This condition requires further observation and medical evaluation.
It is still recommended to seek further medical advice! Thank you for your question! Wishing you good health!
Zhong Ruixian

Reply Date: 2017/11/13

More Info

When it comes to understanding a baby's bowel movements and overall gastrointestinal health, there are several important factors to consider, especially for a one-month-old exclusively breastfed infant. It’s common for new parents to have concerns about their baby's bowel habits, especially when there are changes in frequency or consistency.

Firstly, it is important to note that breastfed babies can have a wide range of normal when it comes to bowel movements. In the first few weeks of life, a breastfed baby typically has several bowel movements a day. However, as they grow, it is not uncommon for breastfed infants to go several days without a bowel movement. This is because breast milk is highly digestible, and many babies may absorb most of the nutrients, resulting in less waste. In your case, a five-day interval without a bowel movement can be normal, especially if your baby is otherwise feeding well, gaining weight, and appears comfortable.

Regarding the vomiting you mentioned, it’s not unusual for infants to spit up or vomit after feeding. This can happen for a variety of reasons, including overfeeding, swallowing air while feeding, or simply the immaturity of their digestive system. If your baby is vomiting forcefully (projectile vomiting) or seems to be in distress, it would be advisable to consult a pediatrician. The fact that your baby is passing gas is a good sign, as it indicates that the digestive system is functioning.

If your baby is not finishing their usual milk intake, it could be due to a variety of factors, including minor illness, teething, or simply a temporary decrease in appetite. Babies can also go through phases where they are more or less interested in feeding. If your baby is alert, active, and gaining weight appropriately, these fluctuations are often not a cause for concern.

However, if you notice any of the following signs, it would be prudent to seek medical advice:
1. Persistent Vomiting: If the vomiting continues or worsens, especially if it is projectile or accompanied by bile (greenish color), it may indicate a more serious issue.

2. Signs of Dehydration: Look for signs such as a dry mouth, fewer wet diapers (less than six in 24 hours), or lethargy.

3. Abdominal Distension: If your baby's abdomen appears swollen or hard, this could indicate a problem.

4. Changes in Behavior: If your baby is unusually fussy, inconsolable, or shows signs of pain, it’s important to consult a healthcare provider.

5. Blood in Stool or Vomit: Any presence of blood should be evaluated immediately.

In summary, while a five-day interval without a bowel movement can be normal for a breastfed baby, the combination of vomiting and decreased feeding warrants careful observation. If you have any concerns about your baby's health or behavior, it is always best to consult with a pediatrician who can provide personalized advice and reassurance based on a thorough examination. Regular check-ups are also essential to monitor your baby's growth and development, ensuring they are healthy and thriving.

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