Infant Constipation and Formula Feeding: Solutions for Parents

Infant bowel movement issues?

Hello Doctor: My baby is currently almost three months old and weighs 5 kilograms.
He is on formula milk.
At first, we used Mead Johnson, but he experienced a lot of gas and cried every time he passed gas.
Then, the pharmacy recommended switching to Similac, but he became constipated.
The pharmacy then suggested Enfamil, and initially, he would only have a bowel movement every other day, but now it has been three days without a bowel movement.

1.
Should I switch formula again?
2.
Do you have any recommendations for formula that minimizes gas and promotes regular bowel movements?
3.
Someone told me to make the formula a bit thicker and then return to the normal consistency after he has a bowel movement.
Is that advisable?

Liang Bao Ma, 30~39 year old female. Ask Date: 2021/06/25

Dr. Xiao Kaiwen reply Pediatrics

1.
It is normal for infants to have bowel movements three times a day at one day old and once a day by three days old, as long as the stools are not hard, watery, or contain blood.

2.
Any infant formula that has passed inspection by the regulatory authorities can be used for babies.
Most formulas are similar (unless they are specialized medical formulas for specific health issues), so you can try to choose the formula that is suitable for your baby.

3.
Infant formulas have standard preparation methods, and it is not recommended to use concentrated formulas.
Physical methods to relieve constipation include clockwise abdominal massage, using a rectal thermometer or cotton swab with petroleum jelly for anal stimulation, or adding probiotics, among other methods.

Reply Date: 2021/06/25

More Info

Infant constipation and formula feeding can be a challenging issue for many parents. It’s important to understand that every baby is different, and what works for one may not work for another. Based on your situation, here are some insights and recommendations regarding your questions.

1. Should you switch formula again? If your baby is experiencing constipation with the current formula, it may be worth considering a switch, but it’s essential to do so cautiously. Frequent changes in formula can upset your baby's digestive system further. Instead, consider giving the current formula some time to see if your baby adjusts. If constipation persists, consult your pediatrician before making any changes. They can provide guidance on whether a different formula might be more suitable for your baby's needs.

2. Recommended formulas for gas and constipation: When looking for a formula that minimizes gas and promotes regular bowel movements, consider those that are specifically designed for sensitive tummies. Some formulas are labeled as "gentle" or "easy to digest," which may contain partially hydrolyzed proteins that can be easier for babies to digest. Brands like Similac Sensitive or Enfamil Gentlease are often recommended for babies who experience gas and discomfort. However, it’s crucial to consult with your pediatrician before switching to ensure it’s appropriate for your baby.

3. Adjusting formula concentration: The idea of making the formula a bit thicker to help with bowel movements is not generally recommended. Thicker formulas can lead to dehydration if not balanced correctly, and it may not necessarily resolve constipation. Instead, focus on ensuring your baby is adequately hydrated. If your baby is formula-fed, they should be getting enough fluids from the formula itself. If constipation continues, your pediatrician may suggest other methods, such as introducing small amounts of water or specific juices (like prune juice) once your baby is old enough.

4. Signs of constipation: Keep an eye on your baby’s bowel movements. If they are infrequent (less than once every three days) or if your baby is straining excessively to pass stool, these can be signs of constipation. Additionally, if your baby is showing signs of discomfort, such as crying during bowel movements or having a hard abdomen, it’s essential to seek medical advice.

5. Dietary adjustments: As your baby grows and begins to eat solids (around six months), you can introduce fiber-rich foods that can help with constipation. Foods like pureed prunes, pears, and peas can be beneficial. However, always introduce new foods gradually and consult with your pediatrician for personalized advice.

6. Monitoring and support: It’s vital to maintain regular check-ups with your pediatrician to monitor your baby’s growth and development. They can provide tailored advice based on your baby’s specific needs and help you navigate any feeding challenges.

In summary, while it can be tempting to switch formulas frequently in search of a solution, it’s best to consult with your pediatrician before making any changes. They can help identify the underlying issues contributing to constipation and recommend the best course of action. Remember, every baby is unique, and finding the right feeding strategy may take some time and patience.

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