Constipation in Babies and Toddlers

Constipation in babies and toddlers is often misunderstood as “normal.” While changes in bowel movements are common as little ones transition to solids, constipation should never be ignored. Healthy and regular bowel movements are a window into your child’s digestive health, gut integrity and even potential food sensitivities.

If your baby is experiencing constipation, this blog provides a starting point. For more in depth or tailored guidance, our Constipation Masterclass and online clinic can help you uncover the root causes and create a personalised plan.

What Does Constipation Look Like?

Signs of constipation in babies and toddlers can vary, but common symptoms include:

• Infrequent bowel movements (less than 3 per week)*
• Pain or excessive straining when passing stools
• Hard, pellet-like stools
• Abdominal pain or distension
• Foul-smelling gas
• Blood in the stool or bright bleeding at the anus (indicating fissures or tearing)
• Reduced appetite or early fullness
• Soiling (“stains” in nappy rather than whole stool) 

If you’re seeing these symptoms, it’s important to take action. Constipation isn’t just uncomfortable—it can lead to behavioural issues like withholding stool if a painful experience occurs, which can in turn worsen the problem.

* For exclusively breastfed infants, passing bowel motions once/ week can be within a normal range, but we would expect them to be soft and easy to pass. After solids are introduced, we would typically expect the frequency of bowel motions to increase for these infants.

Common Causes of Constipation

Constipation in babies and toddlers can arise for a variety of reasons, including, but not limited to:

1. Starting solids before readiness: A baby’s digestive system might not be mature enough for solids. Waiting until developmental signs of readiness – like sitting up unsupported – can help.
2. Constipating foods: Some foods, like bananas (especially unripe), rice, cooked apples, white bread, and dairy, can contribute to harder stools in some children.
3. Insufficient fluids: Keep up their milk feeds and start sips of water when you start solids. Water should not replace breastmilk or formula as the main source of hydration/ fluids as milk feeds should remain the priority until at least 12 months, but you can introduce some sips of water with meals.
4. Excessive insoluble fibre: While fibre is important, too much too soon can increase the bulk of the stool and potentially contribute to constipation. 
5. Potential food sensitivities or intolerances: These can cause digestive upset including diarrhoea or constipation and should be evaluated with a healthcare practitioner – our team of dietitians, nutritionists and naturopaths in our online clinic can help.
6. Altered gut microbiome: Factors like antibiotic use, birth method and maternal gut health during pregnancy may impact the balance of gut flora. Even starting solids will alter the microbiome and this might contribute to constipation in some children. 
7. Formula type or introduction of/ increase in formula 
8. Certain medications: Some medications and supplements can be constipating (discuss this with your health care provider if you think this is the cause).
9. In some rare situations, constipation can be due to underlying medical conditions – such as hypothyroidism and sometimes coeliac disease. If constipation is severe, not responding to treatment or associated with other concerning symptoms, seek medical care.

Supporting Healthy Digestion

Preventing and managing constipation starts with a diet rich in whole foods, healthy fats, and gut-supportive ingredients.

Foods That May Help Prevent or Alleviate Constipation:

• ‘P’ Fruits: Prunes, pears, peaches, plums – and nectarines, and mangoes.
• Fermented foods: Small amounts of sauerkraut brine, beetroot kvass, or coconut kefir can boost gut flora. Consult one of our experienced practitioners for probiotic recommendations specific to your baby’s needs.
• Healthy fats: These are essential for gut motility and overall health.

Healthy fat sources to include:

• Avocado
• Butter, ghee, or coconut oil (for cooking)
• Ground flaxseeds or chia seeds (soaked)
• Fatty fish (like salmon, mackerel, sardines – note: fish is an allergen)
• Grass-fed meats and bone marrow
• Coconut cream or coconut-based products

Avoid highly processed oils (like vegetable or canola) and fried or packaged foods. For more recipes incorporating these healthy fats, see our book Milk to Meals, which also features the highly effective “Poo Poo Purée” recipe.

Recipes that can help

When to Seek Support

If you’ve tried dietary changes and your baby’s constipation persists, it’s important to address the root cause rather than relying solely on laxatives. Medications like stool softeners can be helpful to start as an interim part of management because they provide short-term relief and prevent issues such as fissures and stool-withholding, but they don’t resolve the underlying cause.

Our Constipation Masterclass offers practical, research-backed strategies to understand and manage constipation in babies and toddlers. For individualised support, our online clinic connects you with our experienced practitioners who can provide tailored advice and solutions.

It’s also important to seek medical attention if constipation is severe (e.g. associated with a fissure), or if there are associated symptoms such as severe bloating, vomiting, rectal bleeding, abdominal pain or associated weight loss.

Take the Next Step

Constipation can feel overwhelming, but with the right support, you can help your little one get back to comfortable, regular bowel movements. By focusing on dietary adjustments, gut health and individualised care, you’ll address the issue at its root rather than just treating the symptoms.

For personalised advice, book a consultation with our expert team or explore our Constipation Masterclass for comprehensive insights into managing and preventing constipation.