Signs Of Constipation In Babies (0-24 Months)

The signs of constipation in babies are not always straightforward. That’s one of the reasons why so many parents seek my treatment for their supposedly constipated baby.

However, the problem is very often just a lack of information on what’s normal in terms of a baby’s bowel movements, rather than an actual problem of constipation. Because of that, I decided to write a blog post about the signs of constipation in babies. It is supposed to help parents evaluate, if their baby really is constipated or not.

In this blogpost, I will first go through “what’s normal” regarding the frequency of your baby’s bowel movements – given your baby’s age and nutrition (breastmilk, formula milk, solids or a combination). Afterwards, I will discuss typical signs of constipation in babies and show you what you need to look for in order to evaluate if your baby is really constipated or not.

Frequency Of Bowel Movements In Babies: What’s Normal?

As mentioned already, when parents come to me and tell me that their baby is constipated, the problem is very often a lack of information on what’s normal, rather than it is an actual problem of constipation.

Moreover, when they talk about constipation, they almost always exclusively refer to the frequency of their baby’s bowel movements. That is why, before we talk about the signs of constipation in babies, it is important that you understand what is a normal frequency of a baby’s bowel movements.

Note that the frequency of your baby’s bowel movements depends on both, your baby’s age and her diet (breastfed, formula-fed, solids or mixed feeds). So, let’s have a look at what we would normally expect given a baby’s age and what she eats:

Breastfed Babies (0 To 6 Weeks)

During their first couple of weeks, it is common for breastfed babies to have 3-6 bowel movements per day on average. But note that this number can even be as high as 10 per day and still be considered “normal”. Some babies poop after every feed. Some don’t.

But even if your baby has considerably less bowel movements, it does not necessarily give rise to worries. Though uncommon, newborns may not have bowel movements for days.

Some of them only pass stools once a week – and yet, they are still not constipated.

In fact, in my experience, exclusively breastfed babies are almost never constipated, even if they do not pass stools regularly. Sometimes, they are just able to absorb most of the nutritious breastmilk, leaving nothing else to pass.

With that said, please note that in rare cases, not passing stools regularly can be a sign that your little one is not feeding enough. In this case, the number of feeds per day should be increased.

However, as a general rule, as long as your baby is gaining weight and there are no other signs – apart from not passing stools – which give rise to your concerns, your baby is usually perfectly fine. But more on the signs and symptoms of baby constipation later.

Nevertheless, if you have any doubts, always consult your pediatrician and have the weight of your baby checked regularly!

Formula-Fed Babies (0 To 6 Weeks)

When it comes to formula fed babies, they usually have less bowel movements compared to their breastfed counterparts. We are talking about 2-5 per day during their first couple of weeks.

A pediatrician once told me that there is a simple reason why formula-fed babies usually have less bowel movements compared to breastfed babies. It’s because formula milk produces firmer stools, particularly if it is based on either cow milk or soymilk. And such stools are passed less frequently.

But there is also another reason: colostrum. Colostrum is the name of the first form of breastmilk right after delivery.

What’s interesting to know is that colostrum has a mild laxative effect on the baby. And obviously, this makes her poop more often initially, compared to her formula fed counterpart.

Note that, while 2-5 bowel movements per day is considered “normal” for formula-fed babies, the number can vary greatly from baby to baby. Some even pass more stools per day than breastfed babies. Others can go days without passing stools. And yet, they can be totally fine.

However, keep in mind that if your baby doesn’t pass stools regularly, it can be a sign that she is not feeding enough. If that’s the case, try to increase the number of feeds per day!

With that said, as a general rule, as long as your baby is gaining weight and there are no other signs – apart from not passing stools – which give rise to your concerns, your baby is usually perfectly fine. But more on the signs and symptoms of baby constipation later.

Nevertheless, if you have any doubts, always consult your pediatrician and have the weight of your baby checked regularly!

Breastfed Babies (About 6 Weeks To 6 Months)

As your baby is growing older, both, her digestive system and her gut flora become much more developed. As a result, your little one will be able to absorb more of the nutrients, leaving less to pass.

So, from about 6-8 weeks on, you most likely observe that the frequency of the bowel movements of your little one changes. For some babies, that change comes sooner, for others later.

Usually, this means that your baby will pass stools less frequently (about 1-4 times a day and less).

In fact, I have met many parents, whose breastfed babies could go days without passing stools, particularly once they were 2-3 months old. And still, they were not constipated at all.

So therefore, the fact that your baby does not pass stools regularly is not necessarily a reason to be worried. Just make sure your baby is gaining weight and that there are no other signs – apart from not passing stools – which give rise to your concerns.

But more on the signs and symptoms of baby constipation later.

Nevertheless, if you have any doubts, always consult your pediatrician and have the weight of your baby checked regularly!

Formula-Fed Babies (About 6 Weeks To 6 Months)

Parents of formula fed babies most likely observe similar changes from about week 6-8 onwards as parents from their breastfed counterparts.

Formula-fed babies usually have already less bowel movements during the first couple of weeks of their life (on average 2-4 per day), compared to breastfed babies.

But now, after some 6-8 weeks, this number will most likely go even further down (often to 1-3 daily or even less).

The reason is simple. Your baby’s digestive system has developed, and it has become more capable of absorbing the nutrients of the formula milk.

Still, while 1-3 bowel movements are to be expected at that age for formula fed babies, the actual number can vary. Having both, more or less bowel movements per day can be totally normal. In fact, some babies can go days without passing stools.

Just make sure your baby is gaining weight and that there are no other signs – apart from not passing stools – which give rise to your concerns. But more on the signs and symptoms of baby constipation later.

Nevertheless, if you have any doubts, always consult your pediatrician and have the weight of your baby checked regularly!

Babies Receiving Mixed Feeds (About 6 Weeks To 6 Months)

While I clearly recommend breastfeeding your baby at least for the first 6 months (actually for even longer: up to 1 year of age), sometimes, there are good reasons to introduce formula milk earlier.

In my experience, many breastfeeding mothers start introducing formula milk at the age between 6 weeks and 6 months while they keep breastfeeding their baby.

Their intention is to make sure the baby gets used to both, formula milk and bottle feeds. This is supposed to make the transition to bottle feeds and formula milk smoother once they stop breastfeeding.

If you start with mixed feeds, it normally means that the number of bowel movements is decreasing, compared to the number of bowel movements when you exclusively breastfeed your baby. And that’s because formula milk produces firmer stools, which are usually passed less frequently.

In fact, many worried mothers told me that the bowel movements of their baby slowed down considerably once they had introduced formula milk. However, this is not necessarily a reason to be worried.

As long as your baby is gaining weight and there are no other signs – apart from not passing stools – which give rise to your concerns, your baby is usually perfectly fine.

But more on the signs and symptoms of baby constipation later.

Nevertheless, if you have any doubts, always consult your pediatrician and have the weight of your baby checked regularly!

Babies After Introducing Solids (About 6 Months To 24 Months)

Once you start introducing solid foods, i.e. once your baby is about 6 months old, you are going to see big changes to the bowel movements and stools of your baby. Your baby will now usually pass stools less frequently compared to babies whose diet is not yet based on solids.

The reasons for this phenomenon are quite simple. First of all, the digestive system of your baby is not used to solids. It is a big change and it needs time to adjust.

That is also, why you will find parts of the food in your baby’s stools initially. For example, you can often find teeny-tiny black pellets in your baby’s diapers after you feed her banana.

Moreover, keep in mind that solid foods will cause your baby’s stools to be much firmer. As a result, your baby might pass stools less frequently.

So, if you see the frequency of her bowel movements go down after you have introduced solids it is not necessarily a sign that your baby is constipated.

With that said, the probability of a baby to be constipated once you have introduced solid foods is much higher compared to babies which are being exclusively fed with either breastmilk or formula milk. In fact, the majority of the babies that I treat for constipation are on solids.

Moreover, in my experience, almost every baby goes through phases of constipation once you introduce solid foods.

So What Frequency Of Sools Is Normal At That Age (6-24 Months)?

Well, it’s difficult to say, because it depends on the ratio between breastfeeding/formula-feeding and solids.

If your baby is purely on solids, she is supposed to have at least one bowel movement per day. However, if you keep breastfeeding or bottle feeding her while feeding her solids too, the number of bowel movements will often be higher.

As a general rule, the fact that your baby does not pass stools regularly is not necessarily a reason to worry. As long as your baby is gaining weight and there are no other signs – apart from not passing stools – which give rise to your concerns, your baby is usually perfectly fine.

But more on the signs of constipation in babies later.

Nevertheless, if you have any doubts, always consult your pediatrician and have the weight of your baby checked regularly!

Signs Of Constipation In Babies: When Is A Baby Constipated?

As you can see, almost anything can be normal when it comes to the frequency of your baby’s bowel movements. It is really hard to tell from the frequency alone, if your baby is constipated. Therefore, we need to look at other signs and symptoms of baby constipation.

In order for you to know, if your baby is constipated, you need to ask yourself the following 6 questions:

1 What Is The Consistency Of Your Baby’s Stools?

Exclusively Breastfed Babies

Note that the consistency of a healthy exclusively breastfed baby is very soft, “creamy” and it is not awfully smelly. I like to refer to it as “Dijon mustard” when I talk to parents, not only because of its consistency, but also because of the color.

If the consistency of your baby’s stool deviates from that and turns into something thicker, like the consistency of peanut-butter, only firmer, then your baby may be constipated if she is also showing other signs of constipation (so please, read on!).

If on the other hand, you observe dry pellet-like stools, then it is a clear sign of constipation.

With that said, it is very rare that this happens in exclusively breastfed babies. So far, I have hardly had any such cases.

Formula-Fed Babies

The consistency of baby stools from formula-milk is slightly different from stools of exclusively breastfed babies. And that is because formula-milk, particularly from cow or soymilk, tends to produce firmer stools.

Because of that, I like to refer to such stools as “peanut butter” when I talk to parents, while color-wise, that baby poop is still more like Dijon mustard.

Hint: baby stools from formula milk are also smellier compared to stools from breastfed babies, although not as bad as from babies who eat solid foods.

If the consistency of your baby’s stools deviates from what I describe here and turns into something thicker, like dry pellet-like stools, then it is usually a sign of constipation if your baby is also showing other signs of constipation (so please, read on!).

Babies On A Solid Food Diet

Once you introduce solid foods, your baby’s stools will almost instantly change. Although the consistency will still be on the soft side (a paste-like consistency), the stools will become firmer (sometimes even firmer than peanut butter).

When you feed her solids, please keep in mind that the consistency of her stools will depend on the kind of foods that you feed her. Some foods produce firmer stools than others.

Another defining factor is if milk is still her main source of nutrients (no matter, if it is breastmilk or formula milk).

Obviously, the more milk you feed her in addition to solids, the softer the stools and the brighter (Dijon mustard like) the color. The more solids you feed her, the firmer and browner the stools.

So What Is The Consistency Of Stools Of Babies On Solids Supposed To Be Like?

As long as milk is still the main source of nutrition, consider a peanut-butter like consistency as “normal”! 

If the consistency is getting firmer than that, it can be a sign of constipation IF there are also other signs (see below). However, if the stools of such babies become pellet-like, it is usually a clear sign of constipation.

As you decrease the number of breastfeeds/formula feeds, and replace them by solid foods, the consistency of the stools of your toddler will become even firmer.

At this stage, we would normally talk about constipation, if your baby has hard/firm stools. They would not look like a smooth, creamy paste anymore.

The consistency of such stools can almost be like modeling clay (like “Play-Doh” if you are based in the US or Canada; or like “Plasticine” if you are based in the UK, Australia or New Zealand).

Alternatively, many parents of constipated babies have described their baby’s stools as “rabbit-like”. In other words, such stools would look dry and crumbly.

So, the consistency of your baby’s stools can give you the first hint if constipation is a problem or not. However, there are 5 more questions that you need to ask yourself:

2 How Is Your Baby Behaving?

When a baby is constipated, you can often tell from her behavior that something is wrong. So when parents come to me with their (supposedly) constipated babies, I ask them: how is your baby behaving?

What you are looking for are signs that indicate that your baby finds it painful to pass stools.

With that said, please note that just because your baby is straining does not mean that she is constipated.

In fact, a straining baby during bowel movements is nothing unusual. Passing stools is a challenge for every baby, simply because her abdominal muscles are not yet very strong.

So instead, watch out for the following signs:

Fussiness

Constipated babies are almost always VERY fussy when it comes to passing stools. So, fussiness during or before bowel movements can be a sign of constipation.

Avoidance

Next, check for signs of “avoidance”. If your baby can walk already, then you might observe her tiptoeing or somehow straightening her little body or arching her back. What your little one is trying to do is avoiding to poop, out of fear from the painful experience.

Even younger babies (i.e. babies which are not yet able to walk or stand) can instinctually behave in a similar way. They would arch their backs, rock back and forth or move their bodies from one side to the other. They want to avoid the painful experience, making constipation worse eventually, of course.

Straining “Without Success”

Next, check if your baby is straining more than usually and if it leads to any success (i.e. the passing of stools). Again, straining itself is not the issue here. But if your little one is straining for a long time, say 2-3 minutes and longer, without successfully passing stools, it is often a sign of constipation.

Painful Experience

Finally, check if there are signs that your baby finds passing stools particularly painful. Is she crying? Is she grunting? Is she even screaming? Does she have painful cramps during her bowel movements? If so, constipation is most likely the reason!

3 How Does Her Tummy Feel?

Another important question to ask is: “how does your baby’s tummy feel like”? Obviously, your baby’s tummy is supposed to be soft. With constipation however, that tummy can feel hard, firm or swollen. That’s often because of the excess gas, which your baby is unable to pass if she is constipated.

Place one of your hands on your baby’s tummy while your baby is lying and apply gentle pressure! Does it feel hard or bloated? If so, it can be a sign that she is constipated.

4 Does Your Baby Have Appetite?

Almost all parents who come to me with constipated babies report that their baby does not seem hungry. In other words, their baby refuses to eat.

However, the underlying problem is usually not lack of hunger! The actual problem is that with constipation, your baby refuses to eat because of the discomfort that adding more food causes her.

Moreover, with constipation, your baby can have the feeling that she is full much more quickly. In other words, her overall appetite is already lower when she is constipated.

Therefore, it can be a sign of constipation if she refuses to eat or does not eat that much.

With that said, please note that poor appetite can also be a sign of other health-related problems! So, poor appetite alone is never enough evidence to say that your baby is constipated.

If you are having any doubts or concerns, always ask your pediatrician!

5 Is There Any Rectal Bleeding?

Sometimes, parents have reported that they found traces of blood in their baby’s stools. These can come from small tears around the baby’s anus when she passes dry and hard stools.

While so far, I have only had cases of rectal bleeding caused by constipation, please be very aware that there could be other reasons for this phenomenon.

That is why I always send those parents straight to a pediatrician. It is important to rule out other important reasons before starting a treatment to help the baby with constipation.

So, if you observe rectal bleeding or discover blood in your baby’s stools, don’t wait! Go see a doctor and check, if there are other reasons – next to constipation – that could have caused her bleeding!

6 Did The Frequency Of Bowel Movements Change?

If you have read this blog post from the beginning, you already know what’s normal in terms of the frequency of passing stools.

We have seen that the frequency of your baby’s bowel movements alone is not enough to assess if your baby is constipated or not. However, knowing the frequency of your baby’s bowel movements along with knowing other signs of constipation, as we have discussed them above, can help get the “big picture”.

So instead of asking yourself, how many bowel movements does my baby have per day, ask yourself this: Did the frequency of your baby’s bowel movements change recently? Does she pass stools less often compared to what she used to do?

Here is an example: if your baby usually passes stools twice a day, but has not passed stools for three days, her tummy feels really hard and she keeps straining without success, the “big picture” tells you that your baby is constipated.

How To Evaluate If Your Baby Is Constipated

Make a note of all your answers! If you have answered at least 2 questions in favor of constipation, your baby is most likely constipated! But don’t worry! There are natural ways of relieving constipation and they are suitable for babies of all ages!

So, now that you know if your baby is constipated or not, let’s have a look at natural treatments and remedies for baby constipation!

Summary And Conclusion

In this blogpost, we went through “what’s normal” in terms of the frequency of a baby’s bowel movements. We have seen that almost anything can be normal, as long as your baby’s main nutrition is still milk (no matter if breastmilk or formula milk).

So, the fact that your baby does not pass stools regularly at a younger age, does not necessarily mean that she is constipated.

Because of that, in order to assess if your baby is constipated or not, we also need to look at other signs:

1 The consistency of your baby’s stools

2 The behavior of your baby

3 How your baby’s tummy feels

4 Your baby’s appetite

5 Rectal bleeding

6 A change of frequency in your baby’s bowel movements

If you observe at least 2 signs of constipation, chances are that your baby is constipated. In such a case you could try home remedies for baby constipation.

Medical Disclaimer: The information on this page is not intended to diagnose, prevent, mitigate, treat or cure any disease! It is not personal medical advice. We recommend that you ask a doctor whenver you are looking for medical advice!