Constipation In Infants: What’s Normal, Home Care, And When To Call A Doctor

During your baby’s first year, their digestive system matures and begins to adapt to new foods, and occasional changes in bowel habits can be a normal part of this process. Occasional mild constipation in infants is not unusual but recognizing what’s normal and understanding how to support your little one’s digestion can help keep them comfortable and healthy.

In this article, parents will learn about normal stool patterns in breastfed, formula-fed, and solid-eating infants; how to identify constipation; and evidence-based strategies to manage and prevent it effectively.

What Is Constipation in Infants?

Constipation occurs when bowel movements become infrequent, hard, or difficult to pass. Behaviors like grunting or straining can be normal in newborns as they learn to coordinate their muscles (1), but true constipation involves additional symptoms like hard stools, discomfort, or bloating.

Symptoms of Constipation in Infants

Signs of constipation in babies may include:

Hard, pellet-like stools
Infrequent bowel movements: Fewer than three per week for formula-fed babies or more than 7 days without a bowel movement in exclusively breastfed babies, particularly if accompanied by discomfort.
Discomfort or crying: Persistent straining or pain during bowel movements.
Firm, bloated belly: Indicates stool buildup or gas.
Reduced appetite
Increased fussiness
Blood in stool: Small streaks may occur from straining.

Normal Stool Patterns in Infants

There is a wide range of what is considered normal for stool patterns in infants, and these patterns vary from baby to baby depending on how your baby is fed and their stage of development (2). Because there is so much variation, it’s easy for parents to worry or compare. Below are some general guidelines on what is typically considered “normal.” If you are ever unsure, your pediatrician is the best source for individualized guidance.

Normal Stool Patterns for Breastfed Babies

Frequency: Early on, frequent stools (3-4 times daily) are normal for breastfed newborns. By 4-6 weeks, some babies may start to go several days or even a week without a bowel movement (2,3). This is generally considered to be normal as breastmilk is easily digested and produces minimal waste.
Appearance: Stools are typically soft, yellow, and seedy. Occasional greenish stools can also be normal and may indicate faster digestion or a temporary imbalance between foremilk (lower fat) and hindmilk (higher fat). If green stools persist or are accompanied by other concerning symptoms like blood, mucous, or signs of discomfort, consult your pediatrician.

Normal Stool Patterns for Formula-Fed Babies

Frequency: Formula-fed babies typically have 1-2 bowel movements daily, though some may go every other day. This is normal as long as stools remain soft and the baby is comfortable (2,3).
Appearance: Stools are firmer than those of breastfed babies and may be tan, green, or brown in color. Consistency should remain soft, like peanut butter, rather than hard or pellet-like.

Normal Stool Patterns for Combination-Fed Babies

Frequency & Appearance: Stool patterns can vary but will reflect a mix of breastfed and formula-fed characteristics (4).

Normal Changes When Starting Solids

Introducing solids (around 4-6 months) naturally changes bowel patterns as your baby’s digestive system adjusts (5). Some normal changes you might notice include:

Frequency: Fewer bowel movements may occur initially – a decrease in frequency is normal, but constipation is not.
Texture: Stools naturally become thicker once solids are introduced, but they should remain soft.
Color: Foods like carrots, spinach, or blueberries may alter stool color (orange, green, or dark blue).

To learn more about starting solids, read these articles:

How to Support an Infant with Occasional Mild Constipation

Severe constipation requires medical care. If your baby is showing signs of mild constipation, here’s how to help at home:

1. Offer Plenty of Fluids

Breastfed Babies: Continue breastfeeding on demand to keep stools soft.
Formula-fed Babies: Ensure formula is prepared correctly. Babies over 6 months may benefit from small amounts of water (1-2 ounces per day).
Babies on Solids: Offer water or diluted chamomile tea with meals to aid digestion.

2. Introduce “P-Fruits” for Occasional Constipation

All fruits have fiber, but coincidentally, the p-fruits tend to have some of the highest amounts! If your baby is already eating solids, you can introduce the following fruits in puree form.

Prunes, pears, and peaches: These fruits are natural stool softeners, rich in fiber and sorbitol, which can help maintain healthy bowel movements (6).
Papaya: Papaya naturally contains digestive enzymes like papain, which supports digestion and can gently alleviate occasional constipation (7). It is not always easy to find at all grocery stores, but if you manage to find a papaya, I find that it tends to be really effective.

3. Add a Small Amount of Coconut Oil to Purees

Adding 1/2 teaspoon of coconut oil to your baby’s puree once a day may help soften stools and ease bowel movements. Coconut oil is easy to digest and nutritious, making it a gentle addition to your baby’s diet, when used in moderation.

4. Consider Chiropractic Care

Anecdotally, many parents swear by chiropractic adjustments to help maintain regularity in infants.

Finding a chiropractor: Look for a practitioner experienced in working with infants and highly recommended by other parents. Social media groups are excellent for local recommendations.
What to expect: Infant adjustments are very gentle and often involve light pressure—far different from adjustments for adults.

5. Try Gentle Movement for Occasional Constipation

Gentle movement can help get things moving in tiny bellies.

Bicycle Legs: Move your baby’s legs in a cycling motion to encourage bowel activity.
Tummy Time: Encourages abdominal engagement and improves digestion
Tummy Massage: Rub your baby’s belly in a clockwise motion to help move stool along.
Warm Baths: Warm baths can help relax abdominal muscles, and they pair beautifully with gentle massage and movement.

For detailed instructions on how to perform infant abdominal massage for occasional constipation, read this article: Abdominal Massage For Infant Colic & Constipation Relief In Toddlers And Kids

6. Consider Herbal Remedies

Herbal remedies can offer gentle digestive support (8). When it comes to herbal supplements for babies, look for infant-safe, 3rd-party tested remedies, and be sure to carefully follow dosage guidelines. Some favorite digestion-supporting herbs for babies include:

Licorice Root: This herb can soothe the digestive tract (9).
Marshmallow Root: Marshmallow root has mucilaginous properties, meaning it creates a soothing, gel-like substance (10) that can help lubricate the digestive tract and make stools easier to pass.
Fennel Seed: A popular choice for soothing occasional digestive discomfort in babies, such as gas and colic (11,12). Relaxed muscles in the gastrointestinal tract may help ease mild bloating and promote smoother digestion.

7. Incorporate Probiotics

Probiotics are beneficial bacteria that support a happy gut microbiome and set the scene for healthy digestion. While not a quick fix for constipation, regularly incorporating probiotics into your baby’s diet can promote overall digestive health and regular bowel movements over time (13,14).

To learn more about probiotics, read this article: The Vast Health Benefits of Probiotics

When to Call the Doctor For Constipation in Infants

It’s normal to worry. Parents, always trust your gut, and reach out to your doctor if your baby does not improve with home care, or shows any of the following signs:

Blood in stool or excessive straining.
Bloated belly, vomiting, or refusal to eat.
Breastfed Babies: No bowel movement for over 7 days, especially with discomfort or bloating.
Formula-Fed Babies: No bowel movement for 3-4 days, or persistent hard stools.
Combination-Fed Babies: No bowel movement for 5-6 days with signs of discomfort.

To learn more about constipation in infants and kids, read these articles:

Summary

Occasional mild changes in bowel patterns are normal in infants as their digestive systems develop, but recognizing the signs of constipation—such as hard stools, infrequent bowel movements, or discomfort—is key to supporting your baby’s digestive health. Home care for occasional mild constipation in infants can include offering adequate fluids, introducing fiber-rich “P-fruits” like prunes, utilizing probiotics and infant safe herbal care, incorporating gentle movement and tummy massages, and considering chiropractic care. Always consult a pediatrician if symptoms persist, worsen, or include blood, vomiting, or a bloated belly.

References:

Kramer EA, den Hertog-Kuijl JH, van den Broek LM, van Leengoed E, Bulk AM, Kneepkens CM, Benninga MA. Defecation patterns in infants: a prospective cohort study. Arch Dis Child. 2015 Jun;100(6):533-6. doi: 10.1136/archdischild-2014-307448. Epub 2014 Dec 24. PMID: 25539766.
Sood, MR. (2023). Patient education: Constipation in infants and children (Beyond the Basics). Uptodate.com. https://www.uptodate.com/contents/constipation-in-infants-and-children-beyond-the-basics/print
Moretti E, Rakza T, Mestdagh B, Labreuche J, Turck D. The bowel movement characteristics of exclusively breastfed and exclusively formula fed infants differ during the first three months of life. Acta Paediatr. 2019 May;108(5):877-881. doi: 10.1111/apa.14620. Epub 2018 Nov 7. PMID: 30402945.
Çamurdan AD, Beyazova U, Özkan S, Tunç VT. Defecation patterns of the infants mainly breastfed from birth till the 12th month: Prospective cohort study. Turk J Gastroenterol. 2014 Dec;25 Suppl 1:1-5. doi: 10.5152/tjg.2014.5218. PMID: 25910285.
Homann CM, Rossel CAJ, Dizzell S, Bervoets L, Simioni J, Li J, Gunn E, Surette MG, de Souza RJ, Mommers M, Hutton EK, Morrison KM, Penders J, van Best N, Stearns JC. Infants’ First Solid Foods: Impact on Gut Microbiota Development in Two Intercontinental Cohorts. Nutrients. 2021 Jul 30;13(8):2639. doi: 10.3390/nu13082639. PMID: 34444798; PMCID: PMC8400337.
Stacewicz-Sapuntzakis M, Bowen PE, Hussain EA, Damayanti-Wood BI, Farnsworth NR. Chemical composition and potential health effects of prunes: a functional food? Crit Rev Food Sci Nutr. 2001 May;41(4):251-86. doi: 10.1080/20014091091814. PMID: 11401245.
Annaházi A, Schröder A, Schemann M. Region-specific effects of the cysteine protease papain on gastric motility. Neurogastroenterol Motil. 2021 Jul;33(7):e14105. doi: 10.1111/nmo.14105. Epub 2021 Mar 12. PMID: 33710722.
Kim YS, Kim JW, Ha NY, Kim J, Ryu HS. Herbal Therapies in Functional Gastrointestinal Disorders: A Narrative Review and Clinical Implication. Front Psychiatry. 2020 Jul 10;11:601. doi: 10.3389/fpsyt.2020.00601. PMID: 32754057; PMCID: PMC7365888.
NCCIH. (2020). Licorice Root. Nccih.nih.gov. https://www.nccih.nih.gov/health/licorice-root
Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006–. Marshmallow. 2024 May 15. PMID: 30000899.
Das B, Rabalais J, Kozan P, Lu T, Durali N, Okamoto K, McGeough MD, Lee BJ, Barrett KE, Marchelletta R, Sivagnanam M. The effect of a fennel seed extract on the STAT signaling and intestinal barrier function. PLoS One. 2022 Jul 8;17(7):e0271045. doi: 10.1371/journal.pone.0271045. PMID: 35802574; PMCID: PMC9269469.
Alexandrovich I, Rakovitskaya O, Kolmo E, Sidorova T, Shushunov S. The effect of fennel (Foeniculum Vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Altern Ther Health Med. 2003 Jul-Aug;9(4):58-61. PMID: 12868253.
Wallace C, Sinopoulou V, Gordon M, Akobeng AK, Llanos-Chea A, Hungria G, Febo-Rodriguez L, Fifi A, Fernandez Valdes L, Langshaw A, Saps M. Probiotics for treatment of chronic constipation in children. Cochrane Database Syst Rev. 2022 Mar 29;3(3):CD014257. doi: 10.1002/14651858.CD014257.pub2. PMID: 35349168; PMCID: PMC8962960.
Huang R, Hu J. Positive Effect of Probiotics on Constipation in Children: A Systematic Review and Meta-Analysis of Six Randomized Controlled Trials. Front Cell Infect Microbiol. 2017 Apr 28;7:153. doi: 10.3389/fcimb.2017.00153. PMID: 28503492; PMCID: PMC5408016.

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