Case of “He Won’t Go”
A 4-week old baby is brought to clinic by his mother who says the baby hasn’t had a “poop” in over 24 hours. The baby is otherwise healthy. He was a full-term baby with an unremarkable birth history. He is exclusively breastfed and is eating well. There has been no fever, vomiting, rashes, or cold symptoms. When he does “go”, his stool is soft and the color of mustard. Mom is concerned that he is constipated and wonders what she should give him.
It can be perfectly normal for a baby to go two days or even longer between bowel movements…especially if he’s breastfed. Breast milk is highly nutritious and is efficiently absorbed by the gut, so there is often little left to move along through the GI tract. Therefore, the stools become infrequent. Some formula-fed babies also have infrequent stools, but that does not necessarily mean that they are constipated. It’s not so much the length between bowel movements that defines constipation, but the consistency of the stool and whether it causes pain or difficulty to pass. A baby who has soft stools that pass with ease only once a week is probably not constipated. However, a baby who has hard stools that cause discomfort probably is.
If you’re concerned, you should always call your pediatrician. But remember, if your baby is feeding well and passing soft stools, he’s probably just fine.
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