Constipation in Babies and Little Kids: What You Need to Know

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Having fewer diapers to change seems like it should be a good thing, but it is cause for concern when it means your baby is constipated.

When my son was a newborn, it seemed like he had a dirty diaper after every feeding. I went through 12 diapers a day and a box of wipes every few days. Then, when he was four months old, it just . . . stopped. One day went by, then two, then three. By day four without any action, I was panicked. What could be the problem? After all, he wasn't eating anything but breastmilk! Could he be constipated?

I'm not alone in my new parent worry. According to Dr. Susan Baker, MD, PhD, a pediatric gastroenterologist (a doctor who specializes in disorders of the digestive system) at Women and Children's Hospital of Buffalo, up to 40 percent of referrals to her office by primary care physicians concern constipation in infants and young children. Reassuringly to us parents out there, Dr. Baker says that "most of the time, there's not a darn thing wrong!"

What is constipation? A normal stooling pattern for infants and toddlers changes according to age. On average, newborn babies have four bowel movements per day during the first week of life, which falls to an average of 1.7 per day at age two years. By the time a child is four years old, the average number of bowel movements per day is 1.2, and this stays the same throughout childhood. Because not all children fall within the average, doctors define constipation as a difficulty or delay in having a bowel movement that is present for two or more weeks.

Constipation in Infants

Recognizing true difficulty in having a bowel movement is a tricky situation for parents of babies. It frightens parents when they see their baby grunt, cry, turn beet red, and kick her legs before passing what turns out to be a soft stool. "This is normal," says Dr. Baker. "Babies don't have the benefit of gravity, and they are learning which muscles to use to make a bowel movement. It's very hard sometimes to help parents understand that this behavior is very, very normal."