As a parent, ‘poo’ is no longer a ‘dirty’ word, but becomes something that you look at and think about daily. Your baby’s poo will tell you a lot about the health of your little one, so it’s important to know what’s normal. 

When should you be concerned?

Just like adults, infants have some differences in their poo from child to child, and you’ll also notice differences in their poo as they age.  In the first few weeks, you’ll find that most infants open their bowels a couple of times each day.  After the first month, it’s normal for them not to poo every day. 

Constipation in infants is defined as defecating less than three times per week or hard, dry poo that looks like rabbit droppings, usually accompanied by a foul smell.  Often they’ll have a hard belly full of gas as well.  Even if your baby is straining, and going red in the face, as long as the poo is soft, they are not constipated.  Baby’s poo comes in a range of colours from brown to green to orange to yellow.  As long as it’s the right consistency and frequency, you usually have no cause for concern.

Constipation in breastfed infants

Constipation in breastfed infants is rare. If your baby is constipated, she may not be getting enough milk, so you may need to feed her more often. 

If this doesn’t resolve the problem, I’d recommend speaking to a healthcare professional as it could be some type of allergy.  The healthcare professional will test your baby for different allergies or intolerances, and you may need to cut these foods out of your diet and replace them with alternatives until you have finished breastfeeding.  It’s important to note that if you do think your baby has an allergy or intolerance it is recommended that they be seen by a healthcare professional rather than you excluding foods from your baby’s diet, as elimination of certain foods could result in nutritional deficiencies.

Constipation in formula fed infants

Formula fed infants often have harder poos than breastfed infants. If your formula-fed baby is constipated, first check that you are making up the formula exactly as per the instructions on the pack. If your baby isn’t getting enough water, this could be causing her hard bowels.  If that doesn’t work, you may like to consider changing her formula. A few key factors to consider include:

Oligosaccharides – oligosaccharides are a type of carbohydrate that have been shown to be beneficial for increasing the frequency and texture of infant’s bowel motions.  Oligosaccharides also have a natural prebiotic effect, which means that good bacteria in the gut feed off them to grow.  This helps to improve your baby’s gut microbiome which helps to reduce constipation.

Beta-palmitate (SN-2 Palmitate) – Your baby needs a lot of nutrition to grow and develop, so breastmilk and formula contain fats for energy.  One of the most common fats found in both breastmilk and infant formula is palmitic acid.  Although standard palmitic acid usually does the job, studies show that a slightly different version of palmitic acid, called beta-palmitic acid or beta-palmitate or SN-2 Palmitate  can often make infants bowels softer and more frequent.  It’s kind of like using a different brand of shampoo.  Both wash your hair, but one just leaves your hair feeling a little bit softer.  Although, it’s interesting to note that one study found that baby’s who were given infant formula with the SN-2 palmitate had fewer cries per day, and cried for shorter periods of time; probably because they had less digestive discomfort, so that might be something to consider when you’re choosing which brand to buy too.

Probiotics – some infant formulas already have probiotics added, alternatively you can purchase specialty probiotics for your baby. Probiotics are live, good bacteria that are given to help improve your baby’s gut microbiome, and can sometimes be a help for constipation and digestive issues.

Iron – iron is an important ingredient in most infant formulas because iron deficiency is one of the most common nutritional deficiencies for babies.  However, iron is also well known for causing constipation and other digestive issues.  If your formula-fed baby is struggling with constipation, it might be worth looking for a formula with less iron in it.

Constipation in partially fed infants

Once your baby starts solids, you’ll probably notice some changes to her bowel motions again. That’s normal!  Some babies poo more regularly when they start solids, some less.  But, here’s a few things to keep in mind:

Fluids – when your baby starts solids, the fibre in their food can absorb some of the fluid, so they may need a little more fluid than usual.  Your baby won’t be able to tell you when he’s thirsty, so it’s important that you provide him with plenty of fluid.  You can use either water in a sippy cup, breast milk or formula, but stay away from juice and sugary drinks until after your little one is at least two years of age.

Fibre – encourage fibre-rich vegetables and fruits as some of your little one’s first foods, as these are great for his digestive system.  Apples and pears contain types of fibre that are particularly good for your bubba’s bowels as they draw water into it, so you might like to include these regularly if he’s having problems.  Sultanas are also great, and I’ve never met a little one who doesn’t love sultanas – and trying to pick them up is great for their developmental skills.

Other issues to consider

It is important to note that constipation can also be a symptom of more serious underlying causes so if symptoms persist it is best to see a healthcare professional. More serious conditions associated with constipation can include:

Hirschsprungs disease – this is a disorder of the abdomen that occurs when all, or part of the large bowel has no nerves and therefore cannot function.

Behavioural issues – some baby’s can develop an aversion to defecating as they expect it to painful; particularly if they’ve had a tear inside their bottom from a hard poo.  If this happens, it’s best to get advice from a healthcare professional.

Weather – that’s right, just like us, babies need more fluid in hotter weather.  If they’re not getting enough fluid, it can increase their risk of constipation.

Medications – some medications can cause constipation, so if you are concerned about your little one’s poo, and he’s on medication, it might be worth raising this with your treating doctor.

Also, please note that it’s advised not to give medicines to your baby for constipation unless prescribed a healthcare professional.

So, if you’re still concerned about your baby’s poo, make an appointment to see one of our expert dietitians.