How do you tell if your little one’s bowel patterns are normal, and if she is pooping enough? EVELINE GAN finds out what you should know about constipation in babies and toddlers.
How do you tell if your little one’s bowel patterns are normal, and if she is pooping enough? EVELINE GAN finds out what you should know about constipation in babies and toddlers.
1. A poopy diaper just once a week?
That’s normal for some breastfed babies.
In the first month, your newborn may have three to six bowel movements every day, but this can change as she grows.
From six weeks, some breastfed babies poop every day, while others may go up to a week without a bowel movement, shares Dr Christelle Tan, a specialist in paediatrics at Raffles Specialists at Raffles Holland V. This is normal as breast milk is so well-digested.
Formula-fed babies tend to have more regular bowel movements. Expect one to two poopy diapers daily after they turn two months old.
Beyond the first year, most toddlers generally do a Number 2 once or twice daily, although going once every other day is also normal for some kids, Dr Tan says.
That said, don’t be overly fixated on the numbers. Like adults, every child’s bowel pattern is different. As long as your baby is gaining weight well and her stools are not hard and dry, there is no need to worry, says Dr Eugene Han, a paediatrician at Thomson Paediatric Centre.
2. Now she is truly all backed up.
Having a bowel movement can be hard work, and it isn’t uncommon to see your baby straining until she’s red in the face. So, how can you tell when she is constipated? The American Academy of Pediatrics (AAP) lists the following telltale signs. Your baby:
+ is excessively fussy.
+ spits up more than usual.
+ has dramatically more or fewer bowel movements than before.
+ has unusually hard stools.
+ strains for more than 10 minutes without success.
3. She may be so constipated, it leads to watery stools.
Sometimes, severe constipation may cause your child to soil herself when the stools overflow and leak around the backed-up hard stools, Dr Tan says. Don’t confuse this type of liquid stool with diarrhoea – it’s not.
Your child may also complain of tummy pain and start vomiting, she adds. In some cases, she may have trouble urinating when the stools build up in the colon and block her urinary tract.
See a doctor if your baby is not gaining weight or feeding well, or is distressed from the pain of passing hard stools, Dr Han advises.
4. The culprit might be follow-on formula.
Some babies are more sensitive to the change to follow-on formula, which is usually given after the age of six months. It usually has higher casein to whey content compared to Stage One infant milk formula and breast milk, Dr Tan says.
Both casein and whey are milk proteins. Although casein takes longer to digest and helps growing babies feel fuller, it can lead to constipation, she explains.
“Not all babies are ready to switch to follow-on formula at six months. If constipation occurs, get your baby back to her previous diet and try again at a later time,” Dr Tan advises.
5. Grandma blames it on ’’heaty‘‘ food and she may be right.
What your toddler eats determines what her poop looks like. While the concept of “heatiness” doesn’t exist in Western medicine, foods commonly thought to be “heaty” like milk and dairy products, chips and other deep-fried food tend to be high in fat and low in fibre. This can lead to constipation in babies or toddlers, says Dr Tan.
When weaning Baby, offer a variety of food. Be sure to supplement low-fibre food like bread, rice cereal, pasta and crackers with high-fibre choices such as fruit and vegetables (beans, peas and lentils are great high-fibre choices), Dr Tan advises. Fibre softens the stools by drawing water into them, making them less hard and dry, and easier to pass.
6. Not getting enough liquid can make her poop hard and dry.
By the time your kid turns one, she should be taking about one litre of fluids every day, Dr Tan says. This can be in the form of milk, water and juices.
If your baby has constipation, try giving about 60ml to 90ml of water after a solid feed to get things back on track, Dr Tan says.
But remember not to replace her regular milk feeds with water. Don’t dilute expressed breast or formula milk with water if your baby is constipated, particularly if she is under six months old. This may result in inadequate nutrition and a serious complication, known as water intoxication, that can lead to brain damage, Dr Han explains.
7. Hold that over-the-counter remedy; see a doctor instead.
Constipation is a long-term problem, so treatment shouldn’t just be a short- term fix with medication, Dr Han says. You need to adjust your child’s lifestyle, such as making sure she is drinking enough, as well as increasing her fruit and vegetable intake.
If your little one is persistently constipated, always see a doctor instead of resorting to over-the-counter enemas or laxatives, which can be dangerous to babies and children when not used properly, warns the AAP. A doctor will prescribe the right medication and offer tips on good bowel habits.
If not treated, constipation may worsen. The longer the stools stay backed up, the drier and firmer they become, making them harder to pass out.
Toddlers with chronic constipation can develop anal fissures (tears in the anus) and haemorrhoids (swollen veins in the anus) due to over-straining when passing hard stools, Dr Tan explains.
This can be painful and your child may become fearful of pooping. She may prefer to withhold her stools – even when she needs to go – and this will worsen the condition.
Finally, here’s why you should make that trip to the doctor’s office: In some rare cases, persistent constipation may signal a dangerous medical problem, Dr Tan says.
