Constipation refers to infrequent and “hard to pass” bowel movements. When it comes to constipation, doctors worry more about the consistency of the stools than their frequency.

In general, if the poop is soft, the child seems content, and the belly isn’t firm, then doctors are happy. 

However, if the poop looks like pellets or little marbles, then your little one might be constipated.

Insider Info: I’ve had patients who didn’t poop for a week and were fine. To be on the safe side, though, doctors usually want to be called if:

• A baby goes more than 1 day without a bowel movement during the first month of life. This can be normal after Day 4 but is worth a call to the doctor. 

• The baby hasn’t pooped for 5+ days after 1 month of age. 
  
  Caveat: Your baby’s pediatrician might want to know about this earlier (like on Day 3), so ask what his/her protocol is. 

• The poop looks like goat pellets and the baby is straining to get them out

Double Take: If your baby turns red and grunts while pooping but produces normal stool, then he/she is probably fine.

Why? Because babies tend to be super dramatic when they poop or pass gas. That’s because they’re not socialized yet, and they don’t know that grunting and straining in public are faux pas.

On the other hand, if your baby turns red and grunts but doesn’t produce any gas or poop OR the poop that he/she produces is hard and pellet-like, then he/she might be constipated.

If your child becomes super fussy, starts vomiting, or develops a firm and bloated belly, call the doctor regardless of how long it’s been since the last poop.

Tips for the Baby That Hasn’t Pooped in a While:

If Your Kiddo is Taking His/Her Sweet Time to Poop, His/Her Doctor Will Probably Recommend One or More of the Following Tricks:

• Tummy Massages and Exercises.

• Rectal Stimulation. This can be done at home or at the doctor’s office. 
  
  At Home: The doctor will instruct you to insert the tip of a lubricated thermometer into your baby’s bum (as if you’re taking a rectal temperature) to get things moving. 
  
  In the Office: When doctors do rectal stimulation in the office, they either use the thermometer technique or do a “digital rectal exam” (in which they insert the tip of a gloved pinkie into the baby’s rectum).   

• Watching and Waiting. If your child seems comfortable and is eating normally, you may be on “poop watch” for a while.

• Adding Prune Juice to a Bottle of Breast Milk or Formula: This trick is usually recommended for babies over 4 months of age, but some doctors will tell parents to do it before 4 months. A common ratio is 1 ounce of prune juice for every 4 ounces of breast milk or formula.

• Giving MiraLAX a Whirl.
  
  What’s That? MiraLAX is a stool softener that you mix with water (or another liquid). It’s usually reserved for babies over 6 months of age.

• Offering Your Baby Pureed High-Fiber Foods (After 4-6 Months). Foods high in fiber include prunes, apricots, apples, and plums.

• Giving Your Little One a Suppository. If your baby remains constipated, the doctor may recommend a glycerin suppository (a medication that goes up the bum) to make your child poop. Make sure to get the thumbs up from the doctor before giving one.

The Bottom Line

Constipation is a common problem in babies and toddlers. Most cases of constipation are mild and resolve with one or more of the minor interventions listed above (such as adding prune juice to the milk or offering high-fiber foods when the child is old enough to take solid foods). If your child hasn’t pooped in a while OR seems bothered by the constipation, call the doctor to discuss next steps.