Effective Solutions for Infant Constipation: What Parents Need to Know

If a baby is experiencing constipation and nothing seems to help, it may be necessary to consult a pediatrician for further evaluation and guidance?

Hello, doctor.
My baby is currently 7 months old.
Since starting solid foods at 4 months, he has been experiencing constipation, which became more pronounced after 5 months.
He has been drinking Nestlé Nan H.A.
1 hydrolyzed formula and a small amount of breast milk since birth, but he only has a bowel movement every 3-4 days, and it's always loose.
After stopping breast milk, he has been on the hydrolyzed formula and has now gone over 2 months with bowel movements only every 7-8 days.
Each time, his stools are extremely hard, and there is even blood.
When we visited the clinic, the doctor only prescribed laxatives.
The first time he took one packet, he had a bowel movement, but the second time he needed 3 packets to go.
Relying on laxatives is not a solution, and I'm worried about him becoming dependent on them to have a bowel movement.
What should we do? The clinic doctor said it's okay because every baby has a different constitution.
Is that really the case? Should we switch formulas or stop solid foods? He drinks plenty of water, eats mostly fruits and vegetables for solids, and takes probiotics, but it seems ineffective.
Every time I see him struggle to have a bowel movement, he cries, and it breaks my heart.
I would appreciate your help.
Thank you.

Q Ma, 20~29 year old female. Ask Date: 2015/09/14

Dr. Xiao Kaiwen reply Pediatrics

It is recommended to first visit a pediatric gastroenterology department at a major hospital to rule out any congenital bowel function issues, such as Hirschsprung's disease.
If there are no congenital abnormalities, it is common for infants to experience temporary constipation due to immature muscle strength and coordination for bowel movements.
This typically improves as the child grows older.
In addition to the aforementioned physical methods, short-term use of stool softeners is acceptable.

Reply Date: 2015/09/14

More Info

Infant constipation is a common concern among parents, especially when introducing solid foods into a baby's diet. Your situation, where your 7-month-old has been experiencing constipation since around 5 months old, is understandably distressing, especially with the added complication of hard stools and bleeding. Here are some effective solutions and considerations for managing your baby's constipation.

Understanding Infant Constipation
Constipation in infants is typically defined as having fewer than three bowel movements per week, and when they do occur, the stools are often hard and difficult to pass. In your case, it seems that your baby is experiencing significant discomfort, which can be distressing for both the child and the parents.

Dietary Adjustments
1. Hydration: Ensure your baby is adequately hydrated. While you mentioned that your baby drinks a lot of water, it’s essential to ensure that the water intake is appropriate for their age. For infants, especially those on formula, hydration can sometimes be overlooked.
2. Formula Changes: Since your baby is on a hydrolyzed formula, it might be worth discussing with your pediatrician the possibility of switching to a different formula. Some babies respond better to different types of formula, and a standard formula might provide the necessary nutrients without causing constipation.

3. Fiber-Rich Foods: When introducing solid foods, focus on high-fiber options. Foods like pureed prunes, pears, peaches, and peas can help soften stools. Additionally, whole grain cereals can be beneficial.
4. Avoid Binding Foods: Some foods can contribute to constipation. For instance, bananas, rice, and applesauce are known to be binding. It might be helpful to limit these foods in your baby's diet.

5. Probiotics: While you mentioned that your baby is already taking probiotics, it’s essential to ensure that the strain is appropriate for infants. Probiotics can help in maintaining gut health and may alleviate constipation.

Behavioral Strategies
1. Regular Bowel Routine: Establishing a routine can help. Encourage your baby to sit on the potty or toilet at the same time each day, especially after meals, as this is when the bowel is most active.

2. Tummy Time and Movement: Encourage physical activity. Tummy time and gentle leg exercises (like cycling their legs) can help stimulate bowel movements.

3. Warm Baths: A warm bath can help relax your baby’s abdominal muscles and may encourage a bowel movement.

Medical Considerations
1. Medication: While you mentioned concerns about dependency on laxatives, it’s crucial to follow your pediatrician's advice. Sometimes, a short-term use of a mild laxative can help reset the bowel function. However, it’s essential to work closely with your healthcare provider to find the right balance.

2. Consult a Specialist: If the constipation persists despite dietary changes and behavioral strategies, consider consulting a pediatric gastroenterologist. They can provide more specialized care and investigate any underlying issues that may be contributing to your baby's constipation.

3. Monitor for Symptoms: Keep an eye on any additional symptoms such as vomiting, severe abdominal pain, or blood in the stool, as these may require immediate medical attention.

Emotional Support
It’s also important to consider the emotional aspect of this situation. Watching your baby struggle with constipation can be heartbreaking. Providing comfort and reassurance during these times is essential.

Conclusion
Managing infant constipation can be challenging, but with the right dietary adjustments, behavioral strategies, and medical support, you can help alleviate your baby's discomfort. Always consult with your pediatrician before making significant changes to your baby's diet or medication regimen. Remember, every baby is different, and what works for one may not work for another. Your proactive approach in seeking solutions is commendable, and with patience and persistence, you can help your baby find relief.

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