Pediatrician Questions Constipation

Newborn constipation, what can I do?

I have a two week old little girl who has up until now had at least 4 bowel movements per day. Over the last couple of days it has decreased, and as of the last two days she has not gone at all. She is predominantly breast fed with only 4 oz of formula(Enfamil Gentle Ease) just at night. She is gaining weight well- gained a pound in the last 8 days which means she is getting enough food.

What can I do to relieve her constipation, she is very gassy and uncomfortable is there anything I can give her or do to keep her regular that is safe for a newborn? If I giver her Mylicon to help with the gas, will that increase constipation?

24 Answers

Stimulate rectal area with little finger after putting gloves & some vaseline on little finger.
Typically a 2 week old breastfed infant has between 6-10 watery mustard color stools. However if you are feeding your infant 4 ounces of formula a day, the infant may become constipated and colicky. The formulas are harder to digest and supplementation of formula is not recommended by the American Academy of Pediatrics.
If the baby is eating well, no vomiting, just wait - sometimes even 3-5 days. Mylicon will not increase constipation.
Mylicon is safe to use for gas, but you need to discuss the change in pooping patterns with your Pediatrician.
Most of the time (especially in previously solely breastfed infants) once formula is introduced there can be a notable change in stooling frequency, Formula tends to slow the stooling frequency. You may want to eliminate the nighttime Formula and see if your baby goes back to more frequent stooling. That is safer than giving medications to help the pooping.
Continue breastfeeding, alone if possible. It is normal for baby, not to pass stools for 3 to 4 days. No intervention needed.
Use Mylecon drop and stop formula.
Assuring parents and the good history and exam are the key. What I can tell that we are not certain yet that the baby has constipation requiring intervention. However, some time I recommend Vaseline around the anal opening specially before the BM. and half of an infant glycerin suppository: once or twice in 12 hours is an option when the baby is struggling.
Mixing of formula and nursing sometimes cause this trouble. You can give her some times to adjust to new routine or may use 1:1 mixture of juice and water and give it over the day to help her stool daily. If that also does not help then consult your pediatrician for prescription of Lactulose.
Constipation is having hard stools that are difficult to pass. Constipation is not having less or no stools, especially if when the child does have a stool it is soft and easily passed.
It is normal for an infant of this age to have a decreased number or no stools for several days because they are going through a rapid growth phase where they are gaining weight.
They are only drinking fluids and not eating solid food so if the body needs it they are absorbing all the liquid food and there are no or very few stools. So what you are experiencing is normal.
They should still be urinating well.
You can still use Mylicon if the child is gassy.

Thank you for your question. The stooling pattern that you are describing is completely normal and expected in breast fed babies. In fact, as long as she stools every 7-10 days and the stool is soft in consistency, then she is not constipated. If her stools become firm or pellet-like, then you could add 1-2 ounces of prune juice to her diet once daily. Stools should be apple sauce consistency.

To relieve gas symptoms, be sure to frequently burp her during feeds. Also, you can bicycle her legs in order to help move the gas. Simethicone is the safest option to relieve gas, but there are no studies that prove it is actually effective.
First of all, so sorry for the delay in answering this question. There was a problem with seeing them in my inbox for some reason.

Your baby is settling into her regular stooling pattern now. While many breastfed infants seem to poop after every feed, it is also normal to have infrequent bowel movements, up to once every three days...even a week! As long as the stool is soft and not small, hard, and pebbly, she is not constipated.

To help your baby have more comfortable bowel movements and less gas, try massaging and stroking her tummy a few times a day, in a clockwise fashion. This helps to move gas bubbles in an outward fashion, and also helps to optimize intestinal motility. I'm a big fan of infant massage. You can do this with her regular lotion, or something like grapeseed or olive oil, which usually do not cause reactions on skin. Avoid any fragranced products. If she is grunting and straining to stool, apply some pressure to her feet to help her out so she has something to push against-- it is hard to expel stool on one's back.

Mylicon (chemical name simethicone) is safe for newborns, it just does not always work in every baby. It is not absorbed into the system, but stays in the intestines, and works by decreasing the surface tension of gas bubbles, essentially popping existing ones and preventing new ones from forming. It will not increase constipation.

If your baby is truly continuing to have constipation (hard pebbly stools), now that she is older, you can try some prune juice (1-2 oz) added to her formula. I prefer not to do this in babies less than 1 months old. Lactulose can also be added to formula, but should be discussed with your pediatrician.

Glycerin suppositories can be used occasionally when a baby has hard impacted stool, however, this should not be used routinely as it can alter the body's natural rhythms to expel stool. A dependence on rectal stimulation for stooling can develop.

If your baby had delayed passage of meconium at birth (should pass within first 48 hours of life) and is having ongoing, recurrent ,or chronic issues with constipation, consult your pediatrician to discuss whether or not something more serious might be going on, such as a condition called Hirschsprung Disease, in which the nerves are not developed properly in the colon, so that it fails to relax and expel stool properly. Also consult with your pediatrician if your baby has ribbon-like stools (very narrow in diameter), or is not growing or developing as she should. Seek urgent medical attention if your baby every has bloody stool, is vomiting, or has significant abdominal distention.

I hope she is better now!
You can give 1/4 of a colace glycerin suppository rectally daily if needed.
If you have any concerns you should first see your pediatrician. Assuming everything is normal, you don't have to do much at this point. Some babes stool multiple times per day and some only go every 2-3 days. As long as your baby is happy, eating and growing and having soft stools there is not much else that you need to do. You can check out a whole handout on this topic on my website at
More likely, it is due to adding formula to her feedings. If your breast feeding is already established, there is no need to supplement with formula. You can also pump and put in a bottle. If her gas and constipation is bad, you could use babylax suppository to help relieve it.
Hi there!

I hope you will be relieved to know there is nothing wrong with your baby and she sounds very healthy. It is normal for an infant to have changes in their bowel patterns and gassiness is common. Gas drops are safe to use according to package instructions. Massaging a baby's abdomen in a clockwise direction can also be of some help.

Constipation in this age group does not mean skipping days of poopy diapers, unless poop becomes firm or difficult to pass. Gas and discomfort can be increased in babies who are breast fed if mother eats raw cruciferous veggies (broccoli, kale, etc.) and sometimes caffeine or chocolate.

Hope this is helpful. Congratulations on your new addition!

Dr. E
Your baby's constipation can be totally normal. Very frequently and around two weeks of age predominantly breast fed babies can have fewer bowel movements per day. In fact, breast fed babies can have a bowel movement after each feeding or once a week and that can be totally normal and no need for intervention. However, if the baby is gassy, bloated or acting fussy you can do a few things about it. In my opinion the most important intervention would be watching your diet. What you are eating your baby is eating as well, so avoiding gas-forming food is a good idea such as beans, broccoli, Brussels sprouts and so forth. Another big one is dairy products especially milk and ice cream. We frequently encounter milk protein allergies in newborns and eliminating dairy completely can be helpful.

To answer your question about gas drops. They are safe and effective, but they can increase constipation. Gripe water is also good for gas. Tummy massage and warm bath is another way to relief gas and fussiness.

I would not use any medication for constipation for a two-week newborn.

If the issue continues I would consider rectal stimulation for quick relief using a Q-tip with QY or Vaseline (you can also use rectal thermometer with lubricant). We do not recommend the regular use of rectal stimulation!

We do not give water as it can overload the kidney.
If all of the above don't please contact your pediatrician to rule out other organic issues.
At this age constipation is not a matter of frequency but of consistency. Some babies have frequent bowel movement, some other ever every 3-4 days. As long as they are soft, it is considered appropriate.

Occasionally, your diet may be affecting her, so try to have a balanced diet, avoiding gassy foods and minimizing dairy products in your part. You should be drinking plenty of fluid and continue to take your prenatal vitamins. If she is fussy, it may be related with your diet. You seem to be using the right formula.

It is OK to use Mylicon drops (0.3 ml - 1/2 dropper) every 6 hours around the clock. Use them regularly to maximize effect. Mylicon shouldn't increase constipation. If your problem continues it would be advised to consult with your pediatrician.

Hope this answer helps you.
I practice Emergency Medicine and Urgent Care. A newly born baby with constipation and passing a lot of gas is most likely related to feeding and food given. Ideally only breast feeding frequent burping should be the routine. Pay attention to abdomen, rectal area, and stools.
I think this baby has no problem . She is breast fed and can have many BM or none at all daily.

However this gassy issue can probably improve with burping the baby for a while as some babies may take a longer time.

It is reassuring that she is gaining weight well.
It is reassuring that she has been eliminating stool frequently and normally for 2 weeks; the plumbing is all intact. Now with this reduced pattern, it may still be normal, yet you are concerned about a sudden change. First, I would make sure that you are well hydrated and then I would take her rectal temperature to stimulate the anal sphincters to relax, then apply massage with oils to the abdomen in an upside down U pattern to assist with colon and stool movement. Bicycle her legs back and forth. You can also put a teaspoon of flax seed oil into the bottle of formula once daily to soften the stool. A sprinkle of probiotic of lactobacilli into bottle once daily may also help normalize elimination.
Congratulations on your baby. Your question is a very common one. It is hard to see your baby uncomfortable and that is very understandable. However, you did not mention in your comment the consistency of her stools. Constipation is defined as infrequent, hard and painful stools.
She didn't have a BM for 2 days, but when she does go, it is soft, seedy, mushy, liquidy, pasty or small balls? Most breast fed babies have frequent stooling, but some have one or one every a few days. That does not make them abnormal as long as what is being passed is soft. The babies due cry in order to increase the pressure in the abdomen to push the stools out. It doesn't necessarily mean it is painful. Every child have a different bio-rhythm in terms of how often they defecate, so do not worry if she takes a couple of days to go. You do not need to give her any medication at he present time, but you can give her Mylicon for gassiness. Mylicon does not make her more constipated. It is not absorbed in the body and is very safe. I hope this helps.
Breast fed infants may not move their bowels for up to 5 days. Breast milk is very well digested so there is not much waste. The gas could be caused by the formula or something in your diet. Anything that causes you gas could cause gas in the baby. Adding Karo corn syrup, up to 1 teaspoon per ounce of formula, is a safe way to relieve constipation. You may also try 1/2 to 1 oz of prune, pear,or plum juice 1-2 times daily.

Hope this helps,

Dr J
Your baby is definitely gaining good weight . You might want to cut down dairy products in your diet. You might also consider trying Alimentum or Nutramigen as the supplemental milk formula if you really need to supplement. Hopefully the constipation and the gassinees can get better without mylicon drops, Hope this advice will help.
Yes the short answer is stay only on breast milk only. No need for formula (Constipation cause) . No Medications.