Ask The Doctor: Constipation ... Health Article

Claire McCarthy, M.D., is a senior medical editor for Harvard Health Publications. She is an instructor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and co-director of the pediatrics department at Martha Eliot Health Center, a neighborhood health service of Children's Hospital. The author of two books, "Learning How the Heart Beats" and "Everyone's Children", Dr. McCarthy was a regular columnist for "Sesame Street Parents Magazine" from 1995 to 1998 and is currently a contributing editor for "Parenting Magazine".

Question:

What's the best way to relieve constipation in babies?

Answer:

First, is your baby truly constipated? Many parents think their babies are constipated because they strain to poop, or because they don't poop every day. If the stool comes out soft, it doesn't matter if your baby strains to poop or doesn't do it every day. Some babies poop every few days, and this is fine. If the stool is hard, especially if it comes out as little balls, your baby is constipated.

The best way to relieve constipation depends on the age and diet of the baby. One of the many benefits of breastfeeding is that it helps prevent constipation; breastfeed you baby as much as possible. If you are exclusively breastfeeding and your baby is constipated, talk with your doctor; there may be something in your diet that is the culprit.

If your baby is taking formula, there are a few things you can try. Giving a bottle of water daily (2 to 4 ounces) can be helpful. So can adding Karo syrup (1 to 2 tsp) to a bottle or two each day (or mixing it with the water). For older babies (4 to 6 months), 2 to 4 ounces of apple juice a day can help. Prune juice works even better (so smaller amounts usually do the trick) but has a stronger taste.

When babies are old enough to take solids, rice cereal and bananas, two common first foods, can be constipating (as can some of the other iron-fortified cereals). Usually the effect of those foods can be offset by giving vegetables and other fruits.

Some caveats: Simply not getting enough to drink can cause constipation, so make sure your baby is taking enough breast milk or formula. Your baby is likely getting enough breast milk or formula if he or she:

• Appears satisfied

• Seems to be vigorous

• Is gaining weight, and

• Is wetting diapers every four hours or so.

If the baby's not, or if you aren't sure, call your doctor.

You should also call your doctor if:

• The constipation has been present since birth.

• Your baby is very irritable.

• Your baby's belly seems larger than usual.

• Your baby has vomiting or blood in the stool.

• You have any other concerns at all.