M.Ed., RD, LDN, CLC, RYT-200
Andie is a Registered Dietitian, Certified Lactation Consultant, and Certified Personal Trainer who thinks of nutrition counseling as equal parts science and sensitivity. She specializes in lactation, sports nutrition, exercise fitness, and weight loss programs.
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Read time: 7 minutes
Constipation in children is defined as having fewer than two bowel movements per week and/or difficulty passing stools that are small, hard and dry.1 But every child is different. Pay attention to whatever seems regular for your little one, because any deviation from your baby’s “normal” can be unpleasant.
Inadequate hydration is the likely constipation culprit, along with eating a diet low in fiber.
It is important for babies and toddlers to drink enough fluids to keep their bodies properly hydrated and bowels moving regularly.2 And when increasing the amount of fiber in your child’s diet, it is important to keep increasing the amount of water to help process the added fiber.
How much fluid does your family need? Read more here: Hydration to Prevent Constipation for the Family
Healthy babies under 6 months are unlikely to experience constipation because they receive adequate hydration and nutrients from breastmilk or formula or a combination.
Remember that it’s very common for your baby to grunt, strain, and turn red while passing stool since their abdominal muscles are still weak so they must work harder to have a bowel movement. As they become older and their muscles get stronger, they’ll be able to pass stool much easier!
Reasons babies under 6 months may become constipated:
Contrary to popular belief, recent studies have found that formulas with iron do not necessarily cause more constipation than formulas without iron.5, 6
What are the signs of infant constipation?7
Will starting solids cause constipation?
Firmer, less regular bowel movements are common once your little one starts solid foods (likely around 6 months). This is because the digestive track needs time to adapt to digesting. Think about it this way: solid foods ‘in’ equals more solid poops ‘out’! Note that some straining during bowel movements is normal, as babies still have weak abdominal muscles.
Once in toddlerhood, constipation can occur if your child holds in his stools. The longer the stool stays in the colon, the harder it becomes since the body continues to absorb fluids from it. As more stool gets backed up, the colon stretches, making it more difficult for the colon to then push the stool out.
Some children delay passing stool because they don’t want to stop playing, others feel embarrassment or stress about using the bathroom, while sometimes stool-withholding stems from fear of a painful bowel movement.1
What are the signs of toddler constipation?1
Although constipation is more common in toddlers than babies, most cases aren’t serious and generally last a short amount of time. Even though most cases aren’t dangerous, it is important not to ignore symptoms or leave constipation untreated because it can lead to more serious health problems (such as fecal impaction, anal fissures, and rectal prolapse).
When preparing formula, add water first and then the powder to ensure baby is getting enough fluids. If constipation is consistent even with correct preparation of formula, speak with the pediatrician about additional signs that your little one may not be tolerating the formula well.
Even though research indicates that iron in formula may not cause constipation, all babies are different. If you feel this is the cause, call the pediatrician before switching to a low -iron formula, as iron is important for growth and development.
While a baby having an allergy and intolerance to the foods you eat is not common, it’s also not unheard of. If you are breastfeeding and are concerned about your baby reacting to foods you are eating, contact the pediatrician for more information.
You can also reach out to our team of registered dietitians and lactation consultants for free to discuss how to alter your diet if that is what your pediatrician recommends. They’re here to help on our live chat from Monday – Friday 8am-8pm (EST), and Saturday – Sunday 8am-4pm (EST). Chat them here.
Learn more: Constipation in Breastfed Children
If needed, a small amount of 100% prune, apple, or pear juice may be added to formula or breastmilk as long as baby is older than 4 weeks. The general recommendation is to give 1 oz per day for every month of life up to 4 months. For example, a 3 month old would be allowed to have 3 oz per day.7
Be sure to discuss with your doctor before providing your baby with juice. Note that juice is not recommended for infants younger than 1 year old at any other time.
If these dietary changes do not work, or if you are at all concerned, call the pediatrician.
Keeping your child well hydrated will help prevent and alleviate constipation. Choose water as the main source of hydration and limit drinks such as fruit juices (and no juice under the age of 1). And remember that in addition to fluids, fresh fruits and vegetables can also contribute to proper hydration.
The recommended amount of fiber for toddlers (children 1-3 years old) is about 19 grams of fiber per day.8 For babies 6 months and up, simply aim to introduce veggies and fruit, in the texture your little one can handle, multiple times per day.
Include lots of vegetables, fruits, beans, and whole grains in your child’s diet to help meet this goal.
Examples of foods with fiber include apples and pears (keep the skin on for added fiber), berries, prunes, sweet potatoes, peas, broccoli, beans, oatmeal and whole grain bread or pasta. You can’t go wrong with vegetables and fruits so offer a variety daily. The goal is one fruit or veggie at each meal and snack.
For reference, half a cup of cooked beans has about 6-9 grams of fiber, 1 small apple with skin has about 3 grams of fiber and half a cup of broccoli or greens has about 3 grams of fiber.
Check the nutrition facts panel on whole grains to determine the amount of fiber they provide.
Learn more about how much fiber is needed and where to get it: Why Fiber Matters for Babies, Tots, and Mama, and Including More Whole Grains In Your Daily Diet
Examples of foods that are either low in or don’t have any fiber include cheese, chips, ice cream, white breads and refined grains (such as white rice), and many processed foods. Try swapping out low fiber foods for those high in fiber.
Probiotics, or healthy gut bacteria, may also be helpful in relieving constipation.9, 10, 11 Try adding yogurt or other foods with added probiotics to your little one’s daily eating pattern.
Breastmilk contains both probiotics and prebiotics, which have been shown to be beneficial for gut health in people of all ages. Research on formulas with prebiotics shown that they may lead to better stool consistency and frequency in infants.12 So if your baby struggles with constipation and all other dietary changes have not helped, choosing a formula with prebiotics may be beneficial.
Learn more about probiotics here: Probiotics 101
The “I love you” massage for babies and toddlers can be helpful in reducing constipation, abdominal pain, bloating, and gas.
Read Baby massage: Benefits and techniques for all the details.
When potty training, ask your child frequently if he needs to use the bathroom and visit the bathroom regularly even if your child does not ask to go. Help your child feel comfortable using the bathroom in places other than your own home.
If your child is experiencing persistent constipation for 2 weeks or constipation accompanied by fever, vomiting, blood in stool, swollen abdomen or weight loss you should contact your child’s pediatrician.
Do not use treatments such as mineral oil, stimulant laxatives, or enemas without consulting your child’s pediatrician.
We know parenting often means sleepless nights, stressful days, and countless questions and confusion, and we want to support you in your feeding journey and beyond. Our Happy Baby Experts are a team of lactation consultants and registered dietitians certified in infant and maternal nutrition – and they’re all moms, too, which means they’ve been there and seen that. They’re here to help on our free, live chat platform Monday – Friday 8am-8pm (EST), and Saturday – Sunday 8am-4pm (EST). Chat Now!
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For more on this topic, check out the following articles:
Hydration to prevent constipation for the family
Why fiber matters for babies, tots, and mama
Include more whole grains in your daily diet
Baby massage benefits and techniques