Breast-fed infants defecate frequently, but formula-fed babies might go three or four days between bowel movements. Also, most babies strain when they go, because they are lying down and cannot use gravity to ease the process. More reliable signs of infant constipation include hard or pebble-like stool, drops of blood in the stool or diaper and pain or crying during bowel movements. Consult your child's pediatrician to rule out more serious problems and gain treatment advice. Usually the doctor will recommend dietary changes.
The Merck Manual Home Health Handbook notes that most infant constipation results from dehydration, inadequate dietary fiber intake or a feeding pattern change. Less commonly, constipation might indicate a medical problem, such as Hirschsprung's disease, cystic fibrosis or hypothyroidism. Some medications can cause constipation in babies, including anticholinergic drugs, opioids and antihistamines. Addressing the medical issue might alleviate the constipation; otherwise, your child's doctor will recommend treatment specifically for constipation.
A dehydrated baby needs to increase her fluid intake. Depending on your baby's age and food mastery, her doctor might advise offering your baby water or juice in addition to formula. If you switched formulas or are introducing solid foods or cow's milk for the first time, the pediatrician might suggest going back to the original formula. Note that babies younger than 6 months should still be gaining most of their fluids from formula or breast milk.
If your baby is eating solid foods in addition to formula, the doctor might recommend dietary changes to increase her fiber intake. High-fiber, strained baby foods include apricots, peaches, pears, prunes, spinach, beans, peas, plums and some cereals. Your child's doctor also might suggest sprinkling bran on top of baby cereal or offering barley cereal instead of rice cereal. He also could recommend avoiding strained bananas, a fruit that sometimes worsens constipation. If dietary changes do not solve the problem or if your baby displays other symptoms -- such as vomiting, fever, irritability, lack of appetite, lethargy or bloody stool -- call the doctor.
Do not give your baby natural or artificial laxatives, mineral oil, suppositories or enemas without the pediatrician's approval and explicit instructions. To help a baby pass hard stools with less pain and damage, consider gently applying a water-based lubricant to her anus. Frequent, warm baths sometimes help, as well -- but never leave a baby alone in the tub. If dietary changes do not resolve the constipation, your child's doctor might recommend that you insert a glycerin suppository in your baby's rectum to help her have a bowel movement. Alternatively, the doctor might suggest giving precise amounts of corn syrup, lactulose or malt extract to soften your baby's stool and ease bowel movements. However, do not offer any of these to your baby unless the doctor specifically recommends it. Follow the doctor's treatment instructions precisely.