Breastfeeding and infant constipation: Symptoms and causes

Constipation in breastfed babies is uncommon, but that doesn’t mean it doesn’t happen. 

Breast milk is generally considered more easily digested and therefore instances of constipation or diarrhea are rare. It is not uncommon for breastfed babies to go days without a bowel movement, and their poops often tend to be soft in comparison to those of formula-fed babies. Conversely, it is also not unusual for them to be passing a stool with every feed.

Understanding your baby’s bowel movements can be confusing at first, but once you notice a pattern, it will help you understand what is normal for your baby, and more importantly, what is not. 

What is constipation?

Constipation in babies is the same with us adults, it is infrequent bowel movements or stools that are hard, often rock-like and painful to pass.

What causes constipation in babies?

The most common cause of constipation in babies is a lack of fluid in their diet. It is rare (but as mentioned not impossible) for exclusively-breastfed babies to be constipated, but becomes more common as formula and/or solids are introduced into their diet from around 4-6 months.

Other causes of constipation can be illness, stress or nappy rash (due to baby trying to hold off doing a poo to avoid pain or discomfort).

If your baby is under six weeks and they are constipated you should speak with your doctor or healthcare provider to rule out any underlying issues.

Does the mother’s diet affect constipation through breastfeeding?

Whilst it is known that certain foods and beverages (and flavours) pass through the breastmilk to the baby, typically the mother’s diet should not have a direct effect on constipation. Generally if you are eating a healthy balanced diet, including plenty of fluids yourself, this should be sufficient to ensure the baby is getting what it needs.     

Symptoms of constipation in babies

Generally you will know your baby is constipated by the frequency and consistency of their stool. If their bowel movements are infrequent and/or hard, often like rocks or pebbles then chances are they are constipated.

Babies may show some, all or none of the following symptoms:

1. Straining, crying or going red in the face when attempting to do a bowel movement
2. Extra irritable or grizzly
3. Lack of energy
4. Hard or firm stomach
5. Refusing to feed
6. Hard or bloody stools
7. Weight Loss or reduced weight gain

How to relieve constipation in breastfed babies

Usually it is possible, and recommended to treat constipation at home, however if your baby is under 6 weeks and exclusively breastfed it is recommended you speak to your doctor or caregiver. 

Things you can do to help your baby’s constipation:

• Up their fluids – try offering extra breastfeeds, or if they are over six months you can offer some cooled, boiled water.
• Check their diet – if they are on solids make sure they are getting enough fresh fruits and vegetables and wholegrains that are high in fiber. 
• Exercise – make sure your baby is getting enough age-appropriate exercise and physical activity. Small babies may just need tummy time and time on a mat to kick their legs about, and as they grow and become more mobile they will need more opportunities to be physically active.
• Massage – baby massage can be a great way to help get your little one’s bowels moving. Try laying them on their back and:
  • Using you finger tips to gently massage their stomach
  • Hold their legs and pushing their knees into their belly and out again
  • Holding their legs and doing bicycle moves

• Warm baths – the warm water can help relax the muscles to get the digestive tract moving. It can also help relax the baby emotionally from any stress or discomfort the constipation is causing them.