In older babies, constipation generally occurs when the muscles at the end of the large intestine tighten, preventing the stool from leaving the body. The longer the stool stays inside, the firmer and drier it becomes, making it even more difficult to pass without pain. Then, because the bowel movement is painful, your baby might try to hold it in, making the problem even worse.
Become familiar with your child’s normal bowel patterns. Make note of the usual size and consistency of the stools. This will help you and your doctor determine whether constipation is present and how severe it is.
Signs of constipation include:
- Stools that are either large, hard and compact, or small and pellet-like.
- Bowel movements that are painful and associated with excessive straining, grunting and pain.
- Blood on the outside of the stools, often associated with a small tear on the outside of the rectum. This tear can cause pain and withholding, which worsens the constipation.
- Soiling (liquid waste leakage) between bowel movements.
Constipation among older babies is rarely a cause for serious medical concern. You should call your pediatrician, however, if your baby has gone more than three days without a bowel movement, is experiencing severe pain, or has experienced steady pain for more than two hours.
The most common causes of constipation include a low fiber diet or a recent change in the diet. Often, the introduction of solid foods or new foods can cause a baby to be constipated. Also, diets chronically low in fiber, excessive amounts of yogurt, cheese and milk, and foods such as bananas, applesauce, cereals, breads, pasta and white potatoes can all worsen or cause constipation. It is important at a young age to establish healthy eating habits, including lots of fruits, vegetables, and high fiber foods. You can also increase your baby’s daily water intake to help relieve constipation. Also, try introducing high-fiber vegetables and fruits in juice or pureed forms, especially pears, prunes, peaches, apricots, plums, raisins, peas, beans, and broccoli, as well as whole-grain cereals like barley or oatmeal instead of rice.
In order to prevent constipation, it is important to recognize the symptoms early. Otherwise, your baby will have painful stools and will begin withholding, only making the constipation worse. Once your child is ready to be toilet trained, be sure that it is not forced, or this can only worsen constipation. It is helpful to have a regular toilet schedule for older children, such as visiting the potty after every meal until the problem is resolved.
Reviewed by Dr. Sara Connolly, December 2018
- In older babies, constipation normally occurs when there is a change in diet.
- If your child has strained bowel movements that are painful and a cause for grunting, it may be constipation.
- The longer the stool stays inside, the firmer and drier it becomes, making it even more difficult to pass without pain.
- It is important at a young age to establish healthy eating habits, including lots of fruits, vegetables, and high fiber foods.