When it’s been days since you last had to change your baby’s dirty diaper, you might begin to worry. Although, if you’re honest, you may also be a little thankful to have avoided any public blowouts and poop-stained clothing.
We’ve all been there, wondering what’s normal, worrying that our baby is uncomfortable, questioning the cause of their possible constipation and how it will affect them.
Knowing when you need to take action can prevent much worry and empower you to make the best choices for your baby. So we asked the experts and wrote this article to discuss how long breastfed and formula-fed babies can go without pooping. We’ll also outline the signs, causes, and treatment of constipation and let you know when you should consult your pediatrician.
How Often Should My Baby Poop?
There is a wide range of normal for exclusively breastfed babies. Your baby might poop after every single feeding or go days — or even a week or two — without a single poop (after six weeks of age).
During the first 24 hours of life, your baby’s poop will be a black, tarry substance called meconium. Breastfed babies should have at least three bowel movements, the size of a U.S. quarter, within their first 24 hours. As colostrum changes to mature milk, your baby’s stools turn from black to greenish and then yellow, seedy, and loose (1).
Colostrum is a natural laxative, so exclusively breastfed babies will poop a lot more often during the early days.
Breastmilk is perfect for the human body and easily absorbed, so very little “waste” needs to be excreted from your baby’s body. They use all those good nutrients from your milk to grow, leaving you with fewer poopy diapers to handle.
Formula Fed Babies
Baby formula is more difficult to digest than breastmilk. So it is typical for formula-fed babies to have fewer bowel movements than a breastfed baby during the first few months of life. Your formula-fed newborn should be pooping around three to five times a day.
After the first six weeks, babies receiving formula typically have one bowel movement every day or every other day.
What Causes Infant Constipation?
There are a few possible reasons why your newborn may be constipated:
- Powdered formula: Formula often causes your baby’s stools to be firm and bulky, especially if you have the wrong ratio of powder to water.
- Dietary changes from breastmilk to formula: A simple change from breastmilk to formula can disrupt your baby’s digestive system and regularity.
- Allergy/food intolerance: Your baby might be allergic or intolerant to the milk protein in your breastmilk or formula.
- Lack of fluid/dehydration: When dehydrated, babies’ bodies absorb all the fluids they ingest, creating hard, dry stools.
- Physical abnormalities: Physical abnormalities, such as rectum position, tightness around the anus, or an obstruction in the bowel system could be the culprit of your newborn’s constipation.
- Illness or medical condition: Although rare, underlying medical conditions, such as hypothyroidism, botulism, or Hirschsprung’s disease (a condition caused during fetal development, affecting the function of the large intestine and making stools difficult to pass), could be the reason your baby is backed up (2).
Signs of Infant Constipation
As mentioned above, the frequency of bowel movements can be all over the map and still be considered normal, so this is not always a good indicator of constipation in infants. Here are eight other signs your baby may be constipated (3).
- Crying in pain when stool passes.
- Grunting when trying to poop.
- More spit-up than usual.
- Fussiness due to stomach pain.
- Poop that is hard and comes out like rabbit droppings.
- Constant straining coupled with a firm belly.
- Baby eating less.
Relieving Baby’s Constipation
If your baby seems unusually fussy, hasn’t pooped in a while, has a firm abdomen, and has no appetite, they may be constipated and need extra help to relieve themselves. Here are some ways to get your baby’s bowels moving:
- Bicycle legs: Place your baby on their back and move their legs in a circular motion, mimicking the motion of pedaling on a bicycle. This should relieve some belly pressure and get things moving.
- Warm water bath or warm washcloth on baby’s belly: This will relax and help them release some of the bowel tension.
- Try a different formula: Your baby may be reacting to ingredients in their formula. Try a different brand or a different kind of formula, such as a sensitive stomach, low-lactose, or even soy.
- Change your diet: If you are breastfeeding, your baby could be reacting to something in your diet. Try eliminating dairy from your diet to see if that helps.
- Tummy massage: With your baby on their back, place your hands on their tummy right by the navel and gently massage in a clockwise circular motion. You may use some baby lotion or oil, such as coconut oil, while you massage for about three to five minutes.
If the tips above do not relieve your baby’s constipation, talk with your baby’s doctor about trying the following:
- Take a rectal temperature.
- Give your baby some prune, apple, or pear juice.
- Use a glycerin rectal suppository.
When Should I Worry?
Be sure to visit your baby’s doctor as soon as possible if none of the previous tips work or if you notice any of the following:
- Bloody or black stool.
- Mucus in the stool.
- White/clay-colored stool.
- Persistent crying.
- Baby refuses to eat.
- Signs of dehydration.
- Baby is losing weight.
- Bowel movements look like rabbit droppings.
- Yellow or green spit-up or vomit.
The Poop Scoop
If your baby seems in pain, has hard, pellet-like poops, or is constantly straining without results, they may need help to get things moving. Try warm baths, tummy massages, bicycling their legs, or even giving them a bit of prune juice for some relief.
Call your baby’s doctor if nothing is working, if you notice blood in the stool, if you see signs of dehydration, or if your baby has green/yellow vomit or spit-up.
However, if your baby is having fewer bowel movements but seems happy and healthy, relax and enjoy the lack of poopy diapers.