Newborn Grunting: Grunting Baby Syndrome

Does your baby grunt loudly, turn red, and strain while trying to poop? It can be alarming to watch your little one struggle.

Although it looks exactly like constipation, if the diaper reveals soft poop, there is a good chance your baby is dealing with Grunting Baby Syndrome (GBS). Doctors often call this “infant dyschezia.”

While the name sounds silly, the frustration is real. Your baby is trying to learn a new skill, and it is harder than it looks.

Let’s break down what GBS is, why it happens, and how you can help your baby find relief.

What Is Grunting Baby Syndrome?

At first glance, Grunting Baby Syndrome looks like constipation. However, the biggest clue lies inside the baby’s diaper. If the stool is soft or runny, those noises are likely caused by a coordination error, not hard poop ⁽¹⁾.

In the medical world, this is known as infant dyschezia. It is not an illness; it is a learning curve.

Think about it like rubbing your stomach and patting your head at the same time. It takes coordination. For a baby to poop, two things must happen simultaneously:

1. They must flex their stomach muscles to push.
2. They must relax their pelvic floor (anus) to let it out.

Babies are not born knowing how to do this. They instinctually grunt to create pressure in their abdomen ⁽²⁾. Unfortunately, they often squeeze their anal sphincter shut at the same time.

Essentially, they are pushing against a closed door. They grunt, strain, and push until their body finally figures out how to relax the pelvic floor. Once that happens, the poop comes out easily, and the pain stops.

Common Symptoms of GBS

If you suspect your newborn is struggling with infant dyschezia, look for these specific behaviors during a bowel movement:

• Screaming or crying: This is often due to frustration rather than physical pain from the stool itself.
• Straining: You will see visible effort.
• Discoloration: The face may turn bright red or purple.
• Abdominal tension: Their belly may feel hard as they squeeze their muscles.
• Duration: This struggle can last 10 to 20 minutes before they succeed.
• Relief: As soon as they poop, the baby returns to a happy, calm state immediately.

How Can I Help My Baby With GBS?

The hardest part of Grunting Baby Syndrome is watching it happen. Naturally, you want to fix it.

However, GBS usually resolves on its own by the time a baby is 3 or 4 months old. They simply need time to learn how their body works.

Avoid Rectal Stimulation
Some older advice suggests using a rectal thermometer or a cotton swab with Vaseline to stimulate the anus. While this triggers a poop and offers instant relief, doctors generally advise against it for GBS.

If you stimulate their bottom every time they struggle, your baby may begin to rely on that sensation to poop. This can actually delay them from learning how to relax those muscles on their own.

When It Is Not GBS

Not every grunt is related to pooping. Grunting can also be a symptom of constipation, reflux, or serious respiratory issues.

If your baby is grunting with every breath (respiratory distress) or if the grunting does not lead to a bowel movement, check for these other conditions.

1. Constipation

While constipation causes straining, the result is different. You can tell the difference by looking at the stool consistency.

Signs your baby is constipated include:

• Hard stools: The poop comes out as hard, dry pellets (pebble-like).
• Blood: You might see small streaks of bright red blood from anal fissures caused by hard stool.
• Frequency: While breastfed babies can go days without pooping, a sudden decrease in frequency accompanied by discomfort suggests constipation.

Constipation is often linked to formula ingredients or the introduction of solids ⁽³⁾. If you see hard pellets, contact your pediatrician. They may suggest dietary changes or small amounts of juice.

2. Acid Reflux (GERD)

Gastroesophageal reflux (GER) happens when the muscle ring between the esophagus and stomach is weak, allowing acid and milk to travel back up ⁽⁴⁾. This causes discomfort that can lead to grunting.

Symptoms of reflux include:

• Spitting up frequently.
• Arching the back during or after feeding.
• Irritability and colic-like crying.
• Refusal to eat or pulling away from the breast/bottle.

Keeping your baby upright after feedings usually helps. If the grunting is persistent and interferes with weight gain, your doctor may prescribe medication.

3. Respiratory Distress

This is the most critical distinction to make. If your baby is grunting rhythmically with every breath, it is a sign their lungs are struggling to stay open ⁽⁵⁾.

Call 911 or go to the ER immediately if you see:

• Continuous grunting: A noise at the end of every exhale.
• Nasal flaring: The nostrils widen with each breath.
• Retractions: The skin sucks in between the ribs, under the ribcage, or at the base of the throat.
• Cyanosis: A blue or gray tint to the lips, tongue, or skin.
• Lethargy: The baby is limp or hard to wake up.

Respiratory grunting can indicate pneumonia, asthma, or heart failure. Do not wait for a bowel movement; seek help instantly.

4. Rare Medical Conditions

In rare cases, grunting can signal a systemic infection or neurological issue.

• Sepsis: This is a severe response to infection. Look for fever (over 100.4°F in newborns), low temperature, rapid breathing, and pale or blotchy skin.
• Meningitis: An infection around the brain. Symptoms include a bulging soft spot (fontanelle), stiff neck, sensitivity to light, and extreme irritability.

Grunting Baby Syndrome FAQs

How Long Does Grunting Last in Newborns?

GBS typically starts in the first few weeks of life and resolves itself by the time the baby is 3 to 4 months old. By this age, they have usually mastered the coordination between their abdominal muscles and pelvic floor.

Why Is Baby Grunting Worse at Night?

Digestion keeps working while your baby sleeps. When lying flat on their back at night, babies lose the assistance of gravity to help move gas and stool, which can lead to increased grunting and squirming in the early morning hours.

Does Grunting Mean Autism?

No. Grunting related to bowel movements (GBS) is a developmental phase related to muscle coordination. It is not an early sign of autism.

When Should I Worry About Baby Grunting?

You should seek medical attention if the grunting occurs with every breath (respiratory distress), if the baby has a fever, if they are vomiting green fluid, or if they appear lethargic and unresponsive.

Is Grunting Baby Syndrome Painful for the Baby?

It looks painful because the baby turns red and cries, but doctors believe the discomfort comes from the frustration and effort of pushing, not actual pain. Once they pass the stool, they are instantly relieved.

The Bottom Line

It is stressful to hear your newborn making noises that sound like they are in pain. However, if the result is a diaper full of soft poop, you can usually take a deep breath. Grunting Baby Syndrome is a normal, temporary part of growing up.

(Who knew learning to poop was such a complicated skill?)

While it is tempting to intervene, giving your baby time to figure it out is usually the best gift you can give them.

That said, always trust your gut. If your baby seems sick, is grunting with every breath, or isn’t gaining weight, contact your pediatrician immediately to rule out other causes.