Choosing Formula Milk: Addressing Baby's Constipation Issues

Choosing formula milk when the baby is constipated?

The baby is almost 4 months old.
Before April 11, the baby was exclusively breastfed, drinking 4-5 times a day (average intake of 600 ml), and having 1-2 bowel movements daily, which were soft, mushy, and yellow.
From April 11 to April 18, the baby continued to drink 4-5 times a day, but had formula milk before bedtime (average intake of 700 ml), and had a bowel movement only once in 7 days, which was also soft, mushy, and yellow with a large volume.
From April 19 to April 24, the baby drank 4-5 times a day with all formula milk (average intake of 700 ml) and did not have a bowel movement for 5 days.
Is this normal?
Now that the baby is almost 4 months old, can they drink water, and if so, how much? The baby has not yet been introduced to solid foods; could this be related to the formula milk? Currently, the baby is drinking Aptamil 1; should we consider switching to a different formula?
Is it necessary to use partially hydrolyzed formula, or is regular formula sufficient? Do you have any recommendations for formula brands? (e.g., Enfamil, Snow Brand, Meiji, New Angel...)

Xun, 30~39 year old female. Ask Date: 2020/04/24

Dr. Xiao Kaiwen reply Pediatrics

Infants under six months old should not drink too much water.
After four months, babies can start trying small amounts of a variety of solid foods, which will change their stool patterns.
It is normal for infants to have bowel movements two to three times a day or once every two to three days.
More importantly, the consistency of the stool should be soft; if it appears hard and pellet-like, it may indicate constipation.
As for formula milk, any reputable brand that has been approved by the government for infant consumption is acceptable.
However, individual infants may have varying tolerances to different formulas, so trying other brands is also an option.

Reply Date: 2020/04/24

More Info

When it comes to choosing the right formula milk for your baby, especially when dealing with issues like constipation, it's essential to consider several factors. Your baby is approaching four months, and you've transitioned from breast milk to formula, which can sometimes lead to changes in bowel movements.
Firstly, it's important to understand that formula milk is different from breast milk in composition. While breast milk is easily digestible and contains natural laxatives, formula can sometimes lead to constipation, especially if the baby is not getting enough fluids. The fact that your baby has gone several days without a bowel movement is concerning and may indicate that the formula is not agreeing with their digestive system.

In your case, since you mentioned that your baby has been on a formula diet for about a week and is experiencing constipation, it might be worth considering a few adjustments:
1. Hydration: At around four months, babies can start to have small amounts of water. While breast milk and formula provide hydration, introducing a little water can help with constipation. A few ounces a day, especially if your baby is constipated, can be beneficial. However, be cautious not to overdo it, as too much water can interfere with their nutrient intake.

2. Formula Type: You mentioned using "啟賦1" (Enfamil A+), which is a standard formula. If your baby continues to have constipation, you might want to consider switching to a formula designed for sensitive stomachs or one that is partially hydrolyzed. These formulas are often easier to digest and can help alleviate constipation. Brands like Similac Sensitive or Nutramigen are examples of formulas that may be easier on the digestive system.

3. Introducing Solids: Although you haven't started solids yet, many pediatricians recommend introducing small amounts of pureed fruits or vegetables (like prunes or pears) around this age to help with digestion and prevent constipation. However, consult with your pediatrician before starting solids to ensure it's appropriate for your baby.

4. Monitoring Bowel Movements: It's crucial to keep track of your baby's bowel movements. If they continue to go several days without a bowel movement, or if they seem to be in discomfort, it's essential to consult your pediatrician. They may recommend a different formula or other interventions.

5. Consulting a Pediatrician: Since you are considering switching formulas, it's best to discuss this with your pediatrician. They can provide personalized recommendations based on your baby's specific needs and health status.

In summary, while formula milk can be a suitable substitute for breast milk, it can lead to constipation in some babies. Ensuring adequate hydration, considering a different formula, and possibly introducing solids can help. Always consult with your pediatrician before making significant changes to your baby's diet to ensure their health and well-being.

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