If you flip through most breastfeeding books, you probably won’t find a section on constipation. This is because true constipation in a fully breastfed baby is very rare. In fact, most experts agree that if a breastfed baby is constipated, there is something medically wrong.
Breast milk is a natural laxative; however, a breastfed baby may become constipated due to the introduction of food or formula. The formula in particular causes constipation. If you recently started giving your baby formula, this may be the reason for constipation. The best single remedy is simply more breast milk.
Reasons for constipation in a breastfed baby:
1. Illness requiring medical attention (call your doctor!)
2. Consumption of formula
3. Initial solids
Signs/definition:
1. The American Academy of Family Physicians defines constipation as a delay or difficulty in having a bowel movement (pooping) for more than two weeks. In a newborn (less than 6 weeks), the AAFP recommends that parents contact their doctor if their baby has had fewer than five bowel movements per week over a two-week period.
2. Hard stools like pebbles
3. Excessive effort and crying in the bread. Some exertion, grunting and discomfort is normal. Babies are learning how their bodies work. Grunting, straining, and agitation that cause a loose bowel movement are not constipation and do not need treatment.
Remedy/Treatment for babies under 6 months:
1. If you have been exclusively breastfeeding, call your doctor immediately. This could be a sign of a more serious problem and your baby should be evaluated by your healthcare professional. Constipation along with weakness, a weak cry, and reduced feeding may indicate botulism. Although very rare, this is a life-threatening disorder and requires immediate medical attention.
2. If you were giving formula as a supplement, but primarily breastfeeding, stop giving formula and exclusively breastfeed. Cow’s milk protein is very irritating to the baby’s stomach and intestines. Providing only breast milk will help soothe that irritation.
3. If you have been formula feeding, start breastfeeding (if your baby is less than 2 weeks old) or get help from an International Board Certified Lactation Consultant (IBCLC) to resume breastfeeding. Even if you have never breastfed before, you will most likely be able to produce milk. If breastfeeding is simply not an option for you, use donor breast milk. You can contact a milk bank (this could be expensive) or you can ask a trusted friend or family member for some of their milk.
Some health care providers advise against using unprocessed breast milk, as you could expose your baby to drugs or disease through donated milk. However, if you trust this person and your baby is healthy, then most likely you have nothing to worry about. This could be a great use for frozen breast milk from friends who aren’t sure what to do with their surplus. While you can try an alternative formula, they are not derived from human milk, therefore the problem may not resolve or may even worsen.
Babies older than 6 months:
1. More breast milk! If you are weaning, increase the number of feedings per day again until the problem is resolved. Reduce the amount of food or formula you are giving. Consult a registered dietitian to discuss solid foods that are less constipating for your baby.
2. Time. Constipation will usually go away without the help of special foods or medicines. Although there are over-the-counter constipation treatments, talk to your health care provider before using them. Repeated hints of constipation may be a sign of a more serious problem.
3. If you are sure it is constipation and you have the approval of your health care provider, the American Academy of Family Physicians states that “Parents may give infants 1 ounce of juice containing sorbitol (such as prune, pear, or apple) to treat constipation. This should only be given to babies older than 6 months.
4. Some health care providers recommend giving corn syrup for constipation. This is not necessary as the other treatment options mentioned will generally work better. However, if you choose to give your baby corn syrup, put 1 teaspoon in a 2 oz. of water. Do not put the syrup directly into the formula or expressed breast milk. Corn syrup works by drawing water into the intestines and stimulating the intestine to move stool. It’s easy to overindulge in corn syrup and cause diarrhea and an electrolyte imbalance. Both problems can be harmful to your baby.
References:
http://www.aap.org/publiced/BR_Medicine_OTC.htm
http://www.aafp.org/afp/20060301/849.html
