Constipation in breastfed infants - Symptoms, Causes and Treatment of bowel movements

Posted by Master, Doctor Mai Vien Phuong - Department of Examination & Internal Medicine - Vinmec Central Park International General Hospital

Breast milk is easy to digest for babies. Therefore, it is rare for an exclusively breastfed baby to have a constipated bowel movement. But that doesn't mean it can't happen. Every baby has a different bowel movement - even babies who are exclusively breastfed. Read on to learn more about constipation in babies, including the symptoms, causes, and treatment of bowel movements.

How can you tell if your child has a constipated bowel movement? It should be noted that the frequency of bowel movements is not always an accurate indicator of constipation. Don't see your child grumbling or straining during bowel movements.
Many babies look like they're pushing when they have a bowel movement. That could be because babies use their abdominal muscles to help pass stools. Babies spend a lot of time lying on their backs, and without gravity helping them, they may have to work a little more to have a bowel movement.
Signs of constipation in breastfed babies are:
Hard, round abdomen Hard pebble-like stools Crying during bowel movements Reluctance to eat Hard, bloody stools (possibly caused by hard stools tearing some anal tissues when go outside)

For the most part, breastfed babies don't have constipated bowel movements until they are introduced to solid foods, around the time they are 6 months old. Some foods that can cause constipation include:
Cereal rice. Rice is cohesive, which means it draws water in the intestines, making it difficult for stool to pass. Consider switching to oatmeal or barley cereal if your baby shows signs of constipation. Dairy cows. This is usually introduced at about a year. Banana. May cause constipation in infants. You can try giving your baby pureed foods with a little water or 100% fruit juice mixed in. Low fiber diet. White pasta and bread are low fiber foods. Without enough fiber, it may be more difficult for your baby to have bowel movements. Other things that can cause constipation include:
Not giving your child enough fluids. Always try to breastfeed your baby before introducing solids. Liquids will make it easier for your baby to have bowel movements. Emphasize. Traveling, being hot, moving – all can stress the baby and cause constipation. Diseases. Viral and bacterial infections in the stomach can cause vomiting and diarrhea, leading to dehydration and constipation. Even something like a common cold can reduce your child's appetite and, due to a stuffy nose, make it difficult for him to have bowel movements while feeding. Less fluid means more chances of constipation. Health status. A medical problem, such as an abnormality in the digestive tract, can cause constipation, although this is rare.

The normal amount of stool for a baby varies with the age and, yes, the baby's diet. Here is a sample bowel movement for a breastfed infant from Seattle Children's Hospital:

Here are some tips to prevent and treat constipation:
Add more fiber to the diet if your child is starting to eat solid foods, Switch from rice cereal to barley, which has more more fiber. When you start eating fruits and vegetables, try high-fiber ones like prunes and pureed peas. Exercise your child by moving your child's legs back and forth as if they were riding a bicycle. Also, lay them on their stomach with some toys and encourage them to squirm and stretch their arms. Activity can encourage bowel movements. Baby belly massage. With your hand just below the navel, gently massage the baby's belly in a circular motion for about a minute. Can a nursing mother's diet affect constipation in her baby?
Can a nursing mother's diet cause - or relieve - constipation in her baby? The short answer is probably no.
According to a 2017 study of 145 women in the Korean Journal of Pediatrics, there is no food that a nursing mother needs to avoid unless her baby has a clear negative reaction to it.
Gas and fiber are not passed from mother to child. So do acids from acidic foods like citrus and tomatoes. A nursing mother can have as much food as she wants in moderation.
According to La Leche League International, how much you eat or drink will cause your milk not to come up - it's your baby's ability to suckle that helps the milk come in. Also, breast milk is made from what's in your blood, not your digestive tract.
However, it is important to eat a nutritionally complete and balanced diet when you are breastfeeding, for your own health and well-being, rather than that of your baby.

Don't hesitate to call your doctor if:
Simple remedies for constipation are not working Your baby seems to be in trouble Your baby is not having a bowel movement Your baby has a fever Your child is vomiting you have a hard and swollen belly

The doctor will examine your child and may even order special tests, like an X-ray of the abdomen to check for intestinal blockages. You can ask your doctor about using suppositories and which ones are safe, although these are generally not recommended or necessary.
Never give a baby laxatives or suppositories without checking with a healthcare provider first.
Conclusion
Most breastfed babies are not constipated until they start eating solid foods. Even then, that's not a sure thing. Simple dietary and lifestyle changes often work. But if constipation persists, see your child's doctor for medical advice.
Vinmec International General Hospital is one of the leading hospitals in the country for examination, diagnosis and treatment of digestive diseases, especially in infants and young children. With modern equipment, sterile space, minimizing the impact as well as the risk of disease spread. Along with that is the dedication from the doctors with professional experience with pediatric patients, making the examination no longer a concern of the parents.
To visit with experienced pediatricians at Vinmec. Please make an appointment at the website to be served.

References
Breastfeeding questions. (2019). seattlechildrens.org/conditions/a-z/breast-feeding-questions/ Constipation. (n.d.). llli.org/breastfeeding-info/constipation/ Constipation. (2016). oregon.gov/oha/PH/HEALTHYPEOPLEFAMILIES/WIC/Documents/cip-constipation-eng.pdf Constipation: Infant. (2014). childrens.org/conditions/constipation-infant Feeding the new mother. (2018). llli.org/feeding-the-new-mother/ Hoecker JL. (2017). Infant and toddler health: What are the signs of infant constipation? And what's the best way to treat it? mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/infant-constipation/faq-20058519 How long can a baby go without pooping? (2015). childrensmd.org/browse-by-age-group/newborn-infants/long-can-baby-go-without-pooping/