Constipation in babies is something that can often be seen as ‘normal’ – however, constipation should NEVER be seen as ‘normal’.
When your baby starts on solids you will see a difference in what their stool looks like – it will become gradually thicken and transition towards an adults stool – depending on the amount of milk feeds they have will determine the thickness of the stool.
However, babies should have a bowel movement daily (at the least every second day). Healthy and regular bowel movements are an amazing insight into how your baby’s digestive system is functioning, the integrity of their gut health and can also be a key into any possible food sensitivities.
There are a few key reasons that can contribute to constipation in babies (not exhaustive):
1. Their digestive system just isn’t ready for solids yet – a key reason I recommend starting solids once they have met the developmental signs of readiness, such as sitting up. This indicates their core muscles are strong enough to not only keep them upright, but also strong enough to move food through the intestines and back out again!
2. They are eating foods that can sometimes be constipating such as:
banana (specifically unripe)
rice (white/brown) and rice cereal
apples (cooked apples are the culprit, as cooking changes the pectin fibre which can contribute to constipation).
toast (and all white flour foods)
Dairy foods – particularly cheese
3. Too much food too soon! Remember to start solids slowly, to give their delicate digestive systems time to break their foods down!
4. Too much insoluble fibre foods (which provide bulk to the stool) – breastmilk isnt a high fibre food, so it can take the digestive system a while to learn how to process it!
5. Insufficient fluids! Keep up their milk and start sips of water when you start solids. Water should not replace breastmilk or formula, that needs to remain the priority until at least 12 months, but you can introduce some sips of water with meals.
6. A potential food sensitivity or intolerance through their diet or the breastfeeding mothers.
7. Altered gut microbiome – can be from antibiotics, type of birth, mothers gut health in pregnancy, stress, medications, environmental factors
8. Behavioural – for example they have experienced a painful bowel motion or have impacted hard stool that is hard to pass – so they learn to hold it in!
9. Formula type – specifically cows milk formula can be constipating for some babies.
10. Certain medications can be constipating (discuss this with your health care provider if you think this is the cause).
What does constipation look like for an infant on solids?
Some of the symptoms you may see include:
Infrequent bowel motions (less than 3 per week, aim for a bowel motion at least every second day)
Pain when passing a stool or excessive straining
Pellet (rabbit) poos
Abdominal distension and pain
Low appetite and early feelings of fullness (in combination with other symptoms)
Bright bleeding at the anus (fissures/tearing)
Foods to include that can help prevent or alleviate constipation include:
1. ‘P’ fruits such as prunes, plums, peaches, pears and also foods like nectarines and mangos
2. Offer sips of liquid with meals and throughout the day – such as bone broth and/or water. These shouldn’t replace milk feeds, just small sips.
3. Increase fermented foods, such as small amounts of sauerkraut brine, beetroot kvass, water or coconut kefir or cultured vegetables – or supplement with probiotics to increase the amount and diversity of gut flora. I would recommend having an individualised consultation with a practitioner (eg naturopath or nutritionist) to discuss probiotic strains and which/if they are beneficial for your baby.
4. Keep babies diet high in healthy fats.
My favourite ways to include healthy fats are:
2. Cooking in (if tolerated) butter/ghee/coconut/olive oil/lard/tallow
3. Ground flaxseeds or chia seeds (soaked)
4. Cod liver oil
5. Bone marrow
6. Eating fatty fish often (salmon, sardines, mackerel – fish is an allergen)
7. Grass fed beef strips
8. Nuts and seeds (if tolerated, nuts are an allergen)
9. Egg Yolk (if tolerated, egg is an allergen)
10. Coconut products – enrich foods with coconut cream
*Fats to stay away from are highly processed fats pumped with additives and unhealthy ingredients- such as vegetable oil, canola oil, processed meat, margarine, snack foods like chips, fried food etc.
There are plenty of recipes that incorporate these healthy fats in my book – Milk to Meals, as well as a great ‘Poo Poo Puree’ recipe that has had some amazing results!
If you believe your baby has constipation, and you have trialled changing what you can from this blog, then I would highly recommend booking an individualised consultation with us to help guide you and your baby through this journey – because constipation is NOT normal, and whilst medications (laxatives) can help to keep things moving, its important to address the root cause of the constipation!