Infant constipation: How is it treated?

Is it normal for babies to be constipated? My 2-month-old son hasn't had a bowel movement for three days.

- Catherine / No state given

Mayo Clinic pediatrician Jay Hoecker, M.D., and colleagues answer select questions from readers.

Answer

An infant who has not had a bowel movement in three days most likely is constipated. In general, infants pass about four stools a day. Breast-fed infants have more bowel movements than formula-fed infants do. This frequency gradually declines to about two a day by the time the child is 2 years old. Constipation in infants often begins with the transition from breast milk to formula, or from strained foods to table foods.

Treatment of infant constipation varies by age:

For infants 2 months or younger, call your baby's doctor for advice on treatment.
For infants older than 2 months, give them 2 to 4 ounces of water twice a day in addition to their usual fluid intake. If constipation doesn't improve, give them 2 to 4 ounces of fruit juice — such as grape, pear, apple, cherry or prune — twice a day.
For infants older than 4 months who are already eating solid foods, give them baby food that's high in fiber — such as peas, beans, apricots, prunes, peaches, pears, plums or spinach — twice a day until constipation improves.

Another helpful tip: Apply a small amount of water-based lubricant to your child's anus to ease passage of hard stools. However, never give mineral oil, stimulant laxatives or enemas to an infant.

Rarely, infant constipation is due to an underlying condition, such as Hirschsprung's disease or hypothyroidism. If constipation persists or is accompanied by vomiting or noticeable irritability, call your baby's doctor.