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My baby is constipated

Constipation is when your baby’s poo becomes hard and becomes difficult to pass. They may go several days without passing poo, their poos may look like firm dry pellets that do not soak into their nappy and they may become very unsettled. Fortunately, constipation is usually easy to treat at home. Your baby is not constipated if their poo is soft, even if they have not had a dirty nappy for 1 or 2 days.

There's no 'normal' when it comes to how often babies poo. Breastfed babies rarely get constipated because breast milk contains a natural laxative. They tend to have yellow-colored seedy poos that are often quite soft. Newborn breastfed babies may poo after every feed. Older breastfed babies may go up to a week without pooing. Formula-fed babies tend to have bulkier poos and generally go several times a day; this reduces as they get older. You'll quickly get used to your baby's bowel movements, so you'll be able to tell what's normal for them.

If you are formula feeding, make sure you use the correct number of scoops of formula to water according to the packaging. Click here for more information about bottle feeding.

It is normal for babies to strain and look like they are trying to poo more often. This is not usually a sign of constipation but just them getting used to the feeling of poo/wind forming and moving through their bowel. This is called Infant dyschezia also known as grunting baby syndrome and is very common, normal and they will grow out of this with time and no treatment is required. 

  • Green vomit (like the color of spinach or green washing up liquid)
  • Is pale, mottled, and feels abnormally cold to touch
  • Has pauses in their breathing lasting more than 10 seconds, is grunting, or has blue lips
  • Is stiff or rigid or makes repeated, jerky movements of arms or legs that doesn't stop when you hold them (a fit or seizure)
  • Is extremely agitated (crying inconsolably despite distraction), confused, or very lethargic (difficult to wake)
  • Has a rash that does not disappear with pressure (the ‘ Glass Test’)
  • Is under 3 months of age with a temperature of 38° C / 100.4° F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

  • Your baby does not pass their first poo in the first 2 days of life
  • Not interested in feeding and/or looks dehydrated (dry mouth, sunken eyes, no tears, drowsy, no wet nappies in the last 8 hours or sunken fontanelle (soft spot on the head)
  • Vomits forcefully (shoots across the cot or the room) or ongoing vomiting with blood in the poo
  • A very swollen tummy
  • Seems to be in severe pain
  • Any abnormalities of their bottom (anus) - for example, if it is closed over
  • Blood in their poo
  • Weight loss (beyond 2 weeks of age)
  • Your baby is yellow in colour (jaundice)
  • Poos that are very pale in colour

     

You need to contact a doctor or nurse today.

Please ring your GP surgery (or call NHS 111 if your GP surgery is closed)

  • If none of the above features are present
  • Continues to feed well
  • Has plenty of wet nappies
  • Baby wakes up or cries regularly for feeds
  • Addition information is available about infant crying and how to cope.

Self care

 Continue providing your child’s care at home. If you are still concerned about your baby, speak to your health visitor or local pharmacist

 

What causes constipation in babies?

  • Not getting enough fluids.
    With formula fed babies this could be because their feed is too concentrated with not enough water.
    For breast fed babies, they may not be getting enough milk. Contact your midwife or health visitor for more help with feeding advice.
  • Having an illness.
    Common childhood illnesses such as a cold with high temperature, diarrhoea and vomiting  cause dehydrated which can lead to constipation.
  • Other undelying medical conditions. These will present with red or amber signs on the traffic lights above. 

Some babies seem to strain, grunt or go red in the face before passing a normal soft poo. This is call Infant dyschezia. It is also known as Grunting baby syndrome and is not due to constipation. It can happen because they haven’t yet learnt how to relax their pelvic floor while doing a poo. When they feel the urge to go, they often stretch out their legs, which tightens the pelvic floor muscles. Families often say they have to 'help the poo come out' by bending and holding their baby’s legs up. It usually gets better on its own by the time babies are a few months old and requires no treatment. Baby and toddler poo - what to expect - ERIC

What should you do?

Treating constipation

Here are some tips on helping relieve constipation at home:

  • Lie your baby down and gently move their legs like they're riding a bicycle – this can help get things moving.
  • If your baby is happy lying down, give them a gentle tummy massage  watch this video to see how to do this safely
  • A relaxing warm bath can help to get poo moving.
  • If your baby is bottle-fed, try giving them some extra water (cool boiled or sterile water) between some of their feeds
  • Breastfed babies do not need extra water but should be offered additional breastfeeds instead

It may take a few days to get things moving again, but if things do not improve, speak to your health visitor or GP Your doctor may occasionally prescribe something to soften your babies poo (a laxative), or want to double check that it's not being caused by any underlying medical conditions. 

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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