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Dr. Bill and Martha Answer:
What can I do for my baby when he's constipated?

Question:
What can I do for my 9-month-old son who is breastfed still and is constipated? He no longer eats baby food with apples, bananas or pears which drastically limits his menu. He is eating peaches, barley cereal, all veggies and sometimes prunes (with pears in them). I have started grinding up canned apricots but they seem to make him gassy.

Answer:
While it is unusual for breastfed babies to become constipated, it does happen. Remember constipation refers to the compactness of the stools and the difficulty passing them, not the frequently of bowel movements. An occasional infant will normally have a bowel movement only once every two or three days without pain. If he draws his legs up and is obviously straining and having difficulty passing a stool, he is constipated. First, try high-fiber cereals such as barley, buckwheat, millet, oats, rye and whole wheat. Avoid white rice cereals, since rice is low in fiber. Second, remember the three Bs of fiber: bran, beans and berries. Also remember the three As of fiber: apricots, avocados and apples. For an infant 9-12 months old, remember the four Ps of fiber-rich foods: pears, plums, prunes and peaches. Sweet potatoes are also a tasty source of fiber.

One of the most common causes of constipation in infants is not enough fluids. In addition to breastfeeding, give your infant at least 8 ounces of extra water a day and/or nectar such as pear, prune or apricot. Not drinking enough fluids, primarily water, is one of the most subtle and easily treatable causes of constipation. In fact, if you give your infant extra fiber-rich foods without the extra water the fiber becomes constipating instead of working as a laxative. Fiber needs water to do its intestinal sweeping job. More fluids in your baby’s diet puts more fluids in his bowels, lessening constipation.

Your straining baby may appreciate a little outside help with a well-timed glycerin suppository. Often times, babies get a tiny tear in their rectum, called a rectal fissure, that is painful and causes a few drops of blood during passage of a hard stool. This heals easily with glycerin suppositories daily for a week. Available without prescription at your pharmacy, these look like tiny little rocket ships. If your baby is straining, insert one as far into the rectum as you can and hold baby’s buttocks together for a few minutes to dissolve the glycerin. You can use these for three or four days in a row. A healthy and natural laxative is flax oil; a teaspoon a day mixed with his cereal should help clear his little bowels. As your baby grows, so will his rectum, and this uncomfortable stage of stool retention will soon pass.