What Causes Constipation in Babies?
Table Of Contents
What causes constipation in babies is a major concern of all parents who come to seek my treatment for their constipated baby. However, in my experience, the causes are not always so straightforward. That is why I decided to write this blogpost. I hope that it helps parents understand what causes constipation in babies and how to avoid it in the future.
So, what causes constipation in babies? In brief, the causes can be
- Formula milk
- Introduction of solid foods
- Routine changes
- Medical conditions
- A breastfeeding mother’s addictions
- A breastfeeding mother’s diet (however, this is controversial)
Please note that, even with that list of possible causes, it is not always so easy to really know if a particular cause applies to your baby. So, in this blogpost, for each cause, I explain what you need to consider. Moreover, I will let you know what my own observations are when I treat my little patients. And, as usual, I will back my observations with scientific studies wherever I can.
Before we start, here is an important note!
I know that it is tempting for parents to look for answers to their questions online. However, please keep in mind that information online can only serve as an approximate guide.
If you are having any doubts about the well-being of your little one, please book a physical examination with a doctor who will be able to assess your baby’s individual case!
Can Formula Milk Cause Constipation In Babies?
The short answer is: “yes”!
Formula milk is known to produce firmer stools which could make a baby constipated. In fact, a study finds that constipation in formula-fed babies is 4.53 more likely than constipation in breastfed babies (1).
However, another reason why your baby may get constipated from formula milk could be related to the fact that these formulas are usually made from cow’s milk protein.
A group of scientists discovered that there is a link between constipation and cow’s milk consumption (2). In particular, they found that when they remove cow’s milk protein from the diet of children with chronic constipation, it significantly increases the number of their bowel movements and improves constipation.
Formula Milk And Food Allergy
One of the reasons why babies can get constipated from cow’s milk protein is an intolerance or even an allergy to cow’s milk. Note however, that in my experience, cow’s milk allergy in children normally causes diarrhea, and not constipation.
And indeed, there is a study which confirms that observation.
The scientists of that study investigated 280 infants who were diagnosed with cow’s milk allergy. Only 4.6% of them suffered from constipation, while most of them (61.1%) suffered from diarrhea (3).
So, if your baby is getting constipated from formula milk made from cow’s milk, a food allergy or food intolerance could be the reason. However, according to the study, a baby would most likely develop diarrhea in such a case, instead of constipation.
What About Formula From Goat’s Milk?
Many parents switch to goat’s milk as an alternative when their baby suffers from a cow’s milk allergy. Note however, that goat’s milk has no clear nutritional advantage over cow’s milk. And, most importantly, it is not less allergenic (4).
As a result, if your baby’s constipation is caused by a food allergy or intolerance to formula from cow’s milk, switching to formula from goat’s milk may not solve the problem.
Is Formula From Soymilk A Better Alternative?
Naturally, many parents switch to formula from soymilk, as another alternative to cow’s and goat’s milk.
The problem is that scientists do not recommend to feed infants soy products under the age of six months (5). The reason are nutritional risks.
This is particularly troublesome, since many parents want to switch to formula milk from soymilk during the first 6 months of the baby’s life. That’s because cow milk allergy is pre-dominant in infants exactly that age (i.e. 0 – 6 months of age) according to scientists (6)!
Extensively Hydrolized Formula
The only option that is left then, are extensively hydrolyzed formulas. Using such formulas may not be a guarantee that your baby won’t be constipated anymore. (Remember: formula milk always produces firmer stools and thus increases the risk of constipation in babies).
However, they can be a better alternative, if your baby’s constipation is caused by an allergy to cow’s milk and if neither goat’s milk nor soymilk are possible alternatives.
To sum up, formula milk could be the cause for your baby to be constipated. Either because of the fact that formula milk produces firmer stools in general. Or because your baby has developed a food allergy or intolerance to cow’s milk.
Constipation From Formula Milk: What Can You Do?
First of all, don’t make yourself crazy over trying alternative formulas! In my experience, if a baby gets constipated from cow’s milk, it will almost certainly get constipated from formula milk made from soy or goat’s milk too.
That’s unless the real underlying problem is a food intolerance or an allergy. However, as we have seen, this would normally cause diarrhea rather than constipation.
Instead, try to find natural treatments and remedies to help your baby with constipation!
In my experience, in most cases, it is really just the baby’s digestive system which needs a “boost”. So, rather than trying different formulas, the goal should be to strengthen the baby’s digestive system. After all, it is supposed to be able to cope with formula milk.
With that said, if you have any doubts about the well-being of your baby, always consult your pediatrician! Even more so, if you suspect that the underlying problem is a food intolerance or an allergy!
Can Dehydration Cause Constipation In Babies?
Dehydration is another major reason which can cause constipation in babies!
Note that as long as your baby is not yet on solids, she is supposed to receive all the required fluids through either breastmilk or formula milk. And because of that, you should normally not have reason to worry about dehydration.
However, there are circumstances which can have an impact on the fluid balance in your baby. Here are some examples:
- Hot weather conditions:
Like grown-ups, babies require more fluids during hot weather conditions. If your baby’s main source of nutrition is milk, you may consider increasing the number of feeds to keep your baby hydrated. If your baby is on solids, make sure she receives enough water to keep her hydrated!
- Baby is not feeding enough:
If your baby is not feeding enough (breastmilk or formula milk), she is at risk of not getting enough fluids to properly hydrate her.
- Sickness (see later in blog post)
I know that it seems counterintuitive that diarrhea is supposed to cause constipation in babies. However, many parents of constipated babies have told me that their baby suffered from constipation right after a period of diarrhea.
The most helpful explanation for this phenomenon comes from a pediatrician from Germany. Years ago, she told me that the problem with diarrhea is that it draws fluids from your baby’s little body. So naturally, your baby dehydrates. As a result, it is not uncommon for babies to get constipated after a period of diarrhea.
- Medications (see later in blog post)
- Introduction of solid foods (see later in blog post)
Can Introducing Solid Foods Cause Constipation In Babies?
The number 1 reason for babies to suffer from constipation is the introduction of solid foods. In fact, a study finds that constipation is prevalent much more in babies at the age of 6 to 24 months (38.8%), compared to babies in their first semester of life (15.1%) (1).
There are several reasons why a baby may develop constipation at that stage:
First of all, the still immature digestive system of your baby is not yet used to solid foods. Because of that, her digestive system has a hard time dealing with it.
Moreover, solid foods will ultimately lead to firmer stools, as you know from your own stools.
Furthermore, as you gradually increase the amount of solid food, naturally, your baby will drink less milk (breastmilk or formula milk). As a result, she will receive less fluids from milk.
If your baby does not compensate the reduced amount of fluids by other means, she could dehydrate. And as we have seen, dehydration can be a cause of constipation.
That is why you may want to serve water to your baby’s meals as soon as you start with solid foods. It is supposed to support her digestive system and to keep your baby hydrated.
A Note On Feeding Your Baby Water
Whenever you serve your baby water in addition to solid foods, please keep in mind that too much water can have adverse effects on your baby too!
Pediatrician James P. Keating, retired medical director of the St. Louis Children’s Hospital Diagnostic Center, urges parents to limit the amount of water intake of their baby. That is, as long as your baby is younger than 1 year old and particularly if it is younger than 9 months old (7).
According to Keating, too much water can dilute your baby’s normal sodium levels. This can be fatal for the baby’s health (7).
For more information on hydration and how much water to add to solids, please read my blogpost: Home Remedies For Baby Constipation (Guide 0-24 Months)
Can Routine Changes Cause Constipation In Babies?
Routine changes may not be the number one cause of constipation in babies. However, I have been observing it many times in my little patients. That’s why I include it into this list.
So, what is a routine?
A routine is a procedure which your baby has learned. For example, having a bath at 5:30pm, feeding at 6pm and then going to bed at 6:30pm etc.
If your child has internalized that routine, changes to that routine can mess around with her bowel movements.
For example: let’s say your baby has learned the routine mentioned above. But for some reason, you want to change that routine and feed your baby first before giving her a bath. That routine change can have an impact on your baby’s bowel movements and ultimately cause constipation.
However, routine changes are not always intentional. For example, let’s say you are travelling or have an urgent appointment or any other obligation which prevents you from applying your daily routine. Again, such incidents could cause constipation in your baby.
On a positive note, periods of constipation in babies which are caused by routine changes usually do not last very long.
Can Medical Conditions Cause Constipation In Babies?
Medical conditions are one of the main reasons which can make a baby constipated. Such conditions can be something as simple as a runny nose. However, constipation in babies can also be caused by more severe diseases.
So, let’s have a look at some examples of medical conditions:
First of all, note that when a baby is sick, the fluid balance in her body can get messed up. A runny nose, for instance, draws fluids from the little body. This can eventually lead to dry stools.
To make things worse, babies usually eat less when they are unwell. As a result, they receive even less fluids from breastmilk or bottle feeds.
Therefore, always make sure that your baby receives enough fluids when she is sick!
With that said, please stay away from fruit juices – even diluted fruit juice – as they contain lots of sugar! Instead focus on hydration through either breastfeeding or formula feeds, and / or water.
I often observe that babies who first suffer from diarrhea eventually suffer from constipation. A German pediatrician once told me that there can be two reasons for this phenomenon:
First, diarrhea can mess up the gut flora (i.e. healthy gut bacteria). Therefore, the ability of the digestive system to properly digest foods can be jeopardized. It will take some time for the digestive tract to recover.
Second, as mentioned already, diarrhea draws fluids from the body. It dries out the body which, on the long run, can cause dry stools and therefore constipation.
“Severe” Underlying Diseases
In minor cases, constipation can be caused by more severe underlying diseases. Examples are the Hirschsprung disease or celiac disease.
If you have had such cases in your family history, it is important that you get in touch with a pediatrician, particularly if constipation is an ongoing problem in your baby!
However, keep in mind, that unfortunately, some diseases cannot be diagnosed before your baby has reached a certain age. Celiac disease is just one example.
Can Medications Cause Constipation In Babies?
Medications are another major cause of constipation in babies. Very often, when I replace certain medications in babies by natural treatments, the baby’s constipation problem almost immediately disappears.
However, please keep in mind that replacing medications by natural treatments must only be done under the supervision of and in collaboration with the treating physician!
Here are some examples of medications which can cause constipation:
Medications For Constipation
Sadly enough, it seems to me that some medications which are meant to fight constipation, are actually causing exactly that. I have found that this is particularly true for laxatives. However, this is really just my own observation and I have not found any scientific studies to prove it.
Laxatives usually work very well on the short run. However, in my experience, on the long run (i.e., if taken too often), they seem to aggravate the symptoms.
This can quickly become a vicious circle, as parents naturally feed their babies even more laxatives.
It is therefore advisable to look for natural remedies for baby constipation.
You can read more in my blogpost: “Home Remedies For Baby Constipation (Guide 0-24 Months)”
Another major contributor to constipation in babies, are antibiotics. They almost certainly cause constipation, so don’t be surprised, if it happens to your little one as well!
Antibiotics can damage the gut flora. It will take some time to recover and to restore the balance of the digestive system.
Unfortunately, there is really nothing that you can do to prevent constipation when your baby receives antibiotics. And frankly, in some situations (f.e. bacteria or infections), antibiotics are really the only way to treat certain conditions in babies.
Luckily, there are things that you can do to relieve constipation naturally.
Read more about what you can do in my blog post: Home Remedies For Baby Constipation (Guide 0-24 Months)
Can A Mother’s Addictions Cause Constipation In Babies?
When people come to me with a constipated baby, I always start by asking them questions. It’s just an initial consultation in the hopes to identify the actual cause of the problem.
If a mother is breastfeeding, I also ask if she has some sort of addiction. And by addiction, really what I mean is, if she is a smoker or consuming lots of caffeine.
[For simplicity, I’ll keep it to caffeine and nicotine in this blogpost. I do not want to go down that rabbit hole and talk about the abuse of drugs and alcohol. Every breastfeeding mother should know that drugs and alcohol will have adverse effects on their baby.]
So back to smoking and caffeine:
Many women with constipated babies admit that they are either smokers or that they drink lots of drinks containing caffeine.
Note that, by “lots”, I mean at least 3 cups of coffee per day, or 3 glasses of coke or a mix etc.
Caffeine And Nicotine Enter The Breastmilk
Here is the problem with both, caffeine and nicotine:
So far, no scientist has ever investigated, if there is a link between those substances and constipation in babies. However, some studies did show that both substances enter the breastmilk and take relatively long to disappear.
They revealed that nicotine can be found in the breastmilk up to 3 hours after just one cigarette. Caffeine, on the other hand, can be found even up to 24 hours after having just one cup of espresso (8).
While many studies show that your baby will be fine if you consume caffeine in moderation (9, 10), it is the accumulation of several cups of coffee or several glasses of coke per day which could elicit possible side effects (like hypertension) in the infant according to scientists (8).
With nicotine, the situation is worse.
Studies show that the daily consumption of cigarettes by a breastfeeding mother can pose serious risks to the infant’s health.
Examples are decreased lung growth, increased rates of respiratory tract infections and childhood asthma (8).
So, what’s my point here?
While we do not yet have scientific proof that either caffeine or nicotine can cause your baby to be constipated, it does not mean that such a link does not exist. It just has not been researched yet.
Keep in mind that both nicotine and caffeine can lead to dehydration in grown-ups. Dehydration on the other hand is a known cause of constipation.
Is it then unreasonable to assume that those substances can cause the same problem in babies when they enter the bodies through breastmilk?
It is something to think about…
Can A Breastfeeding Mother’s Diet Cause Constipation In Babies?
A Mother’s diet while breastfeeding is a highly controversial topic.
Very often, the mothers of my little patients are concerned that they themselves are the very cause for their baby to be constipated. In other words, they believe it’s their diet.
The foods which they particularly worry about are onions, spicy foods, chocolate and bananas.
Over time, I understood where that guilt was coming from! There is just so much wrong and also contradicting information out there.
Some people tell you that you don’t need to take care of your diet at all when you are breastfeeding. Others tell you, that you have to be super careful with certain foods.
So, what are you really supposed to do?
Here Is What You Need To Know
First of all, it is true: a mother’s diet does have an impact on her breastmilk. But the impact is different from what most people assume.
A mother’s diet has an impact on the kinds and number of nutrients that enter her breastmilk. By nutrients, I mean micronutrients like vitamins, fatty acids etc. They are super important, because they have an impact on the development of the baby.
Here is an example:
A study from 2019 found evidence that there is a positive link between carotenoids in the breastmilk and infant motor development (i.e. crawling, standing, walking etc.) (11). It was also found that carotenoid levels in breastmilk are determined by the mother’s diet (12). As a result, a breastfeeding mother’s diet should be rich in carotenoids.
So, Can A Breastfeeding Mother’s Diet Cause Baby Constipation Then?
While a breastfeeding mother’s diet does have an impact on the micronutrients contained in her breastmilk, it normally does not cause gastrointestinal problems in the baby.
That’s unless we are talking about substances like caffeine, nicotine etc. (see above).
So, if a mother becomes constipated or gassy from eating chocolate, it does not seem possible for her to pass on that constipation or gassiness to her baby when she is breastfeeding. And that is, after all, the main concern of most mothers.
It’s also the number 1 reason, why they leave away certain foods in the first place.
In fact, a study from 2017 which included 145 breastfeeding mothers which restricted themselves from eating certain foods, concludes that “most mothers restricted certain foods unnecessarily” (13).
Moreover, when reviewing previous studies about the same topic, the scientists “identified no foods that mothers should absolutely avoid during breastfeeding” (13).
This Is Science. But What’s It Like In Reality?
If the scientific conclusion above seems counterintuitive to you, let me give you an example based on my observation:
Many mothers of breastfed babies believe that they need to avoid spicy foods when they are breastfeeding. And to be perfectly honest with you, being a mother myself, my own instinct would have told me the exact same!
However, in some cultures, spicy foods are just part of a normal diet. For example, I am based in London, UK. Lots of people from India live here. Their diet it known to be really spicy (in fact, I have witnessed it myself multiple times).
Does this mean that their breastfed babies have more gastrointestinal problems than babies from other cultures?
So, in general, according to science, a breastfeeding mother’s diet does not seem to cause constipation in babies. As a result, according to scientists, it seems pointless to avoid certain foods while breastfeeding if your concern is constipation in your baby.
Instead, focus on how to strengthen the baby’s digestive system so that she is less likely to develop constipation. You can read more about helping a baby’s digestive system in my blogpost “Home Remedies For Baby Constipation (Guide 0-24 Months)”.
It can be a great challenge to identify what causes constipation in babies.
And – being a mother myself – I understand that not knowing the cause is highly unsatisfactory. You naturally want to identify the reason.
After all, you want to help your baby avoid constipation in the future.
However, keep in mind that your baby’s digestive system is only just developing! It is a journey, which will often be accompanied by gastrointestinal issues, of which baby constipation is just one example.
Luckily, there are natural ways to help a baby with constipation. If you like to know more, read my blogpost “Home Remedies For Baby Constipation (Guide 0-24 Months)” in which I summarize the numerous ways to help a baby with constipation naturally!
(1) Aguirre AN, Vítolo MR, Puccini RF, de Morais MB (2002): Constipation in infants: influence of type of feeding and dietary fiber intake. In: Jornal de Pediatria. May-Jun; 78 (3): 202-8.
(2) Elesa T. Crowley, et al. (2013): Does Milk Cause Constipation? A Crossover Dietary Trial. In: Nutrients. 2013 Jan; 5 (1): 253–266.
(3) Yang QH, et al. (2019): Clinical features of cow’s milk protein allergy in infants presenting mainly with gastrointestinal symptoms: an analysis of 280 cases. In: Zhongguo Dang Dai Er Ke Za Zhi. 2019 Mar; 21 (3): 271-276.
(4) Turck D. (2013): Cow’s milk and goat’s milk. In: World Review of Nutrition and Dietetics. 2013; 108: 56-62.
(5) Fiocchi A., et al. (2010): World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines. Pediatric Allergy and Immunology. 2010, 21 (Supp. 2l): 1–25.
(6) Yang QH, et al. (2019): Clinical features of cow’s milk protein allergy in infants presenting mainly with gastrointestinal symptoms: an analysis of 280 cases. 2019 Mar; 21 (3):271-276.
(7) James P. Keating, MD: Water Intoxication in Infants. (Accessed on 04/19/2019: https://www.stlouischildrens.org/health-resources/pulse/water-intoxication-infants).
(8) Calvaresi V. (2016): Transfer of Nicotine, Cotinine and Caffeine Into Breast Milk in a Smoker Mother Consuming Caffeinated Drinks. In: Journal of Analytical Toxicology. 2016 Jul; 40 (6): 473-7.
(9) Berlin CM Jr, et al. (1984): Disposition of dietary caffeine in milk, saliva, and plasma of lactating women. In: Pediatrics. 1984 Jan; 73 (1): 59-63.
(10) Nehlig A., Debry G. (1994): Consequences on the newborn of chronic maternal consumption of coffee during gestation and lactation: a review. In: The Journal of the American College of Nutrition. 1994 Feb; 13 (1): 6-21.
(11) Zielinska MA. (2019: Association between Breastmilk LC PUFA, Carotenoids and Psychomotor Development of Exclusively Breastfed Infants. In: International Journal of Environmental Research and Public Health. 2019 Mar 30; 16 (7).
(12) Monika A., et al. (2019): Carotenoid Content in Breastmilk in the 3rd and 6th Month of Lactation and Its Associations with Maternal Dietary Intake and Anthropometric Characteristics. In: Nutrients. 2019 Jan, 11 (1): 193.
(13) Goun Jeong, MD (2017): Maternal food restrictions during breastfeeding. In: Korean Journal of Pediatrics. 2017, Mar; 60 (3): 70–76.
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!
ABOUT THE AUTHOR
Nathalie is a pregnancy and birth Consultant and a TCM Therapist with almost 20 years of experience in Traditional Chinese Medicine (TCM), acupuncture, reflexology, Shonishin baby massage techniques, Western and Eastern massage techniques (including TUINA), as well as herbal medicine and nutrition.
She has worked in hospitals across London and was Head of the Maternity Acupuncture Clinic at the Whittington hospital in London. Today, Nathalie runs her own practice in London and helps pregnant women with pregnancy- and birth-related issues. She also specializes in alternative treatments for babies and children.
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