My baby is constipated

Constipation is when your baby’s poo becomes hard and becomes difficult to pass. They may go several days without having a poo, their poos may look like firm dry pellets that do not soak into their nappy and they may become very unsettled. Fortunately, constipation is usually easy to treat at home. Your baby is not constipated if their poo is soft, even if they have not had a dirty nappy for 1 or 2 days.

There's no 'normal' when it comes to how often babies poo. Breastfed babies rarely get constipated because breast milk contains a natural laxative. They tend to have yellow-coloured seedy poos that are often quite soft. Newborn breastfed babies may poo after every feed. Older breastfed babies may go up to a week without pooing. Formula-fed babies tend to have bulkier poos and generally go several times a day; this reduces as they get older. You'll quickly get used to your baby's bowel movements, so you'll be able to tell what's normal for them.

If you are formula feeding, make sure you use the correct number of scoops of formula to water according to the packaging. 

It is normal for babies to strain and look like they are trying to poo more often. This is not usually a sign of constipation but just them getting used to the feeling of poo/wind forming and moving through their bowel.

What causes constipation in babies?

There are a variety of reasons why your baby could be constipated, including a lack of fluids (dehydration). There are various reasons why your baby may not be getting enough fluids – it could be down to illness. Lack of fluids can make your baby's poo harder and more difficult to push out.

When should you worry?

If your baby has any of the following:

  • Dark green vomit 
  • Breathing very fast, too breathless to talk, eat or drink 
  • Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
  • Breathing that stops or pauses
  • Is pale, blue, mottled or feels unusually cold to touch
  • Difficult to wake up or very sleepy
  • Weak, high-pitched cry or can’t be settled
  • Has a fit (seizure)
  • Has a rash that does not go away with pressure (the 'Glass Test')
  • Has a temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red or amber features

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

 

If your baby has any of the following:

  • Your baby does not pass their first poo in the first 2 days of life
  • A very swollen tummy
  • Their bottom (anus) looks abnormal
  • Not gaining weight
  • Poos that are very pale in colour
  • Blood in poo
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Dry skin, lips or tongue
  • Not had a wee or wet nappy in last 8 hours
  • Poor feeding (less than half of their usual amount)
  • Irritable (Unable to settle them with cuddles, toys or feeding)
  • Getting worse and you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features

If your baby has any of the following:

  • Weight loss (beyond 2 weeks of age)
  • Poos that are very pale in colour

     

You need to make a routine appointment to see a healthcare professional – contact your GP practice

If your child:I

  • If none of the above features are present
  • Continues to feed well
  • Has plenty of wet nappies
  • Baby wakes up or cries regularly for feeds
  • Additional information is available about infant crying and how to cope – click here.
  • Additional information is available to young families for coping with crying of well babies – click here.

Self care

Continue providing your child’s care at home. If you are still concerned about your baby, speak to your health visitor or local pharmacist

 

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What should you do?

Treating constipation

Here are some tips on helping relieve constipation at home:

  • Lie your baby down and gently move their legs like they're riding a bicycle – this can help get things moving. If your baby is happy lying down, give them a gentle tummy massage
  • If your baby is bottle-fed, try giving them some extra water (cool boiled or sterile water) between some of their feeds
  • Breastfed babies do not need extra water but should be offered additional breastfeeds instead

It may take a few days to get things moving again, but if things do not improve, speak to your health visitor or GP surgery.

Where should you seek help?

Self Care

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Local Pharmacist

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health Visitors

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School Nurses

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GP (General Practitioner)

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

NHS 111

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

Accident and Emergency

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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