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."
In general, if your baby passes soft stool and seems healthy in every other way, these grunting and kicking behaviors are just a part of the learning process. On the other hand, if your baby has any red flags, such as hard stool, fever, blood in the stool, failure to gain weight, or failure to pass the first meconium bowel movement by 24 hours after birth, a doctor's visit is in order.
So what about my four-month-old son? It did not appear that he was having any difficulty, but he certainly was having less than one dirty diaper per day. This brings up one key exception to the above average number of stools per day: a baby who receives only breastmilk. "It's very common for an exclusively breastfed baby to go several days without a bowel movement," explains Dr. Baker. "When they do have a bowel movement, it will usually be large and very soft." No one knows exactly why breastfed babies may go up to a week without having a bowel movement, but it probably has to do with the fact that human milk is very easily absorbed, and there may not be much left to come out as stool.