How to relieve a constipated 6-month-old?
July 29, 2018 11:08 AM   Subscribe

Like it says on the tin. Details inside...

Our 6-month-old grand-daughter has been more-or-less constipated all her short life so-far. She tends to go a few days without a poop and, when she does finally poop, it's often hard nuggets (sometimes followed by a stream of not-hard once the hard ones are out.)

She and her mommy are visiting today and baby hasn't pooped since Tuesday (which is one of the longest non-poop periods she's gone). Baby is pretty obviously in discomfort, and mommy is concerned. The doctor has suggested prune and pear juices in the past, but those don't seem to be working as well this time. She's also been trying "bicycle legs," tummy massages, and a warm bath, but nothing has broken loose so far.

What has worked for you to help relieve a constipated baby? Mommy is definitely calling the doctor tomorrow, but, in the meantime, any suggestions will be greatly appreciated.

Pertinent details: Baby is on formula and it has a bit of oatmeal mixed-in (per the doctor several months ago) She's also taking solid food every other day or so at dinnertime. Baby is currently being treated for an ear infection with amoxicillin. She also has a bit of a cold and is somewhat congested.
posted by Thorzdad to Health & Fitness (21 answers total) 2 users marked this as a favorite
A friend with a baby with a similar problem applies glycerin suppositories if nothing else helps. (They're also pursuing a more permanent solution - suppositories aren't meant for long-term use.)
posted by I claim sanctuary at 11:13 AM on July 29, 2018 [1 favorite]

Obviously check with the doctor, but perhaps the baby is intolerant to gluten or has celiac disease or simply doesn't do well with oats. Could you switch to prunes and pears mixed with rice cereal? I'm not sure of guidelines where you are but, here, from 6 months, you can almost introduce any food now, I think. Canada has gone to a more culturally diverse approach to first foods. Obviously, you can't introduce multiple new foods at once and they have to be spaced out.

If it persists, maybe look at whether the formula is a problem. You might have to try a different brand.
posted by shockpoppet at 11:48 AM on July 29, 2018 [1 favorite]

Which formula? Thinking long term, Enfamil Reguline is a formula specifically designed to address infant constipation - I’m not sure about the actual clinical significance of its effectiveness, but I’ve heard from a few families that it helps. A gentle formula like Gentlease it Total Comfort could help as well, or an even more broken down one like Nutramigen, Alimentum, or Pregestimil. (The gentle formulas being a more affordable intervention, the latter more expensive) I would consider keeping the prune juice as a regular daily supplement rather than just as needed.

Probably not related, but if the oatmeal in the bottle isn’t for reflux or swallowing dysfunction, there’s not really another good reason to add cereal to the bottle. Oatmeal seems to be much less constipating than rice though, so I don’t suspect that’s a cause.

(I am a pediatric dietitian, I am not this baby’s dietitian, etc.)
posted by obfuscation at 11:49 AM on July 29, 2018 [4 favorites]

Oh, and if this keeps going on, you might want to get a blood test for celiac later, whenever you happen to be doing bloodwork.
posted by shockpoppet at 11:49 AM on July 29, 2018

Vitamin C.
posted by jbenben at 12:27 PM on July 29, 2018

Sometimes the insertion of a rectal thermometer can, uh, get things moving. My understanding is that babies aren’t really aware of the muscles and control needed to poop and the thermometer can get them to push a bit.
posted by gnutron at 12:51 PM on July 29, 2018

Cut the oatmeal! It won't help and is probably hurting.

Prune juices don't help much; pureed prunes are better. At the "hard rock" stage, though, she needs a suppository or a rectal thermometer with lubricant to help move things along.

She also needs a bottle of water per day. Not more than that, but at least that.

Going a week or so without pooping is totally normal! Timing, at this age, is not important. The texture absolutely is, though.
posted by Rock 'em Sock 'em at 1:14 PM on July 29, 2018 [1 favorite]

Yeah, glycerin suppositories helped our little one. We also put a very small amount of Miralax in her bottles. We should wean her off of it but that might help.
posted by kat518 at 1:47 PM on July 29, 2018

Our pediatrician puts his advice online.

At this age, his advice seems to boil down to: this is very unlikely to be an emergency. Babies often go ten days without pooping. Consider the possibility that the signs of "obvious discomfort" might be just general baby crankiness rather than something that has a medical explanation, or needs a medical intervention. But you might try 2 oz/day of prune juice, or, failing that, get a prescription for a laxative. Don't put anything in her butt in an attempt to get things moving manually without talking to your doctor. Make sure the solid food she is taking has minimal starch. Maybe cut out the oatmeal (but talk to the doctor first, since it was their recommendation).
posted by caek at 2:07 PM on July 29, 2018 [1 favorite]

Ask doctor about glycerin suppositories.
posted by gryphonlover at 2:31 PM on July 29, 2018

My doc recommended water if my son was constipated. I cannot advise on how much or how often, though. good luck!
posted by jj's.mama at 2:56 PM on July 29, 2018

My daughter's pediatrician recommended, along with more water and the addition of pureed prunes and apricots (six months is typically when kids start pureed foods, so this should help). The addition of cereal seems to have been concomitant with constipation, so there is that. She also gave her baby glycerine suppositories for when the baby really seems to be in discomfort. Keeping them in the fridge helped keep them formed.

The thing that worked the best, though, was the addition of small amounts - like a teaspoon - of Miralax granules, which dissolve in liquids. The baby had these problems intermittently for several months, and gradually adding a little Miralax to his food a couple of times a day was extremely helpful. The doc suggested the amount be titrated to the child's digestive system, so if he didn't have a BM for a couple of days she'd start adding it, and back off when he got regular. Worked beautifully.
posted by citygirl at 3:20 PM on July 29, 2018

FWIW, one of my kids had "poorly coordinated intestinal peristalsis" until he was almost a year, his digestive system was immature and took an absurdly long time to get its shit together to, you know, shit on the regular. All our constipation and gas relief efforts were partly successful at best because his nervous system hadn't yet coordinated the peristalsis, which you can't control consciously so there's not a lot to be done. Mylicon (anti gas drops) helped with discomfort; things like prunes helped keep things soft. They also at one point gave us a medication that was basically sugar water to help things move along.

It sorted itself out in its own time as his digestion matured; until then, we could just try to limit discomfort by making sure stools were soft and gas was moving as well as possible.
posted by Eyebrows McGee at 3:58 PM on July 29, 2018

Long-term, you may also want to consider probiotic supplements, especially if baby didn't get bacteria from breastfeeding and has been on antibiotics. You can find something designed for babies at stores like Whole Foods.
posted by quince at 6:40 PM on July 29, 2018

I've been dealing with this recently with a two year old, and glycerin suppositories (when she was in a lot of discomfort) helped, along with doing everything I could to increase her liquid intake (juices, cordials, water in different sorts of cups and bottles, whatever I could tempt her with). Obviously your acceptable liquids will vary with a 6 month old.
posted by fever-trees at 9:09 PM on July 29, 2018 [1 favorite]

Inulin is a prebiotic fiber that feeds good gut bacteria and helps keep the intestines healthy. It comes as a powder and can be added to the formula. It’s best to start with very little (say, 1/16 or 1/8th tsp). It might cause a little bit of gas at first.

Also, n-thing the glycerin suppositories. My son was also perpetually constipated as a baby and I wish our pediatrician hadn’t scared me off the suppositories back then...I now know they’re pretty harmles (for an otherwise healthy baby). Make sure to use the baby size.
posted by CrazyLemonade at 9:33 PM on July 29, 2018

We just recently dealt with three weeks of really bad, painful constipation for our 8 month old.

What works for us: Miralax. 3/4 teaspoon every morning dissolved in some Pedialyte so he’ll drink it.

What didn’t work: milk of magnesia (caused stomach cramps), colace (same), stopping solids for weeks, prune juice (he wouldn’t drink it)

What helped partially but not enough without the Miralax: extra fluids including Pedialyte to tempt him, pear or prune purees, glycerin suppositories (got him to poop but didn’t make the poop any softer), probiotics (BioGaia and Culturelle daily)

Miralax is really effective. Our kid is so much happier now that he’s pooping soft stools regularly and not in tummy pain all the time. Highly recommended to talk to the pediatrician about Miralax. Good luck!

PS we’ve had a lot of ear infections and antibiotics tend to give our baby (and I think most babies) loose stools rather than hard ones. Doesn’t mean your granddaughter doesn’t react differently, but might be an indicator that her constipation is worse than “normal” at this age. Hope she feels better soon!
posted by bananacabana at 9:51 PM on July 29, 2018

Maybe it was a more extreme situation, but when my then-toddler had a lot of constipation from chemo we were well, she was) given glycerine suppositories and PEG, which were highly effective - the latter was a little weird as its the same compound I use tin my lab to preserve delicate wooden artifacts.
posted by Rumple at 10:36 PM on July 29, 2018 [1 favorite]

Also on board with glycerin suppositories. Helped my little on when she would get off her routine.
posted by PJMoore at 9:31 AM on July 30, 2018

So, doc put baby on Miralax for now. If that doesn't work, they'll do the suppositories next.

Thanks, all!
posted by Thorzdad at 2:31 PM on August 3, 2018

Well that's a relief all around. I see that Miralax is basically Polyethylene Glycol, which I did not know.
posted by Rumple at 4:36 PM on August 3, 2018

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