Constipation chronic in infants

Overview

Chronic constipation in infants means the baby has hard, dry, or infrequent bowel movements (poo) that lasts for more than a few weeks. It is not a disease but a symptom of something not working quite right in the baby's digestive system.

Yes, constipation in infants is common. About 5 to 30 out of every 100 infants experience it at some point.

It affects infants from birth to about 12 months old, but can continue as they grow into toddlerhood.

Symptoms

Common symptoms

• Poo less often than normal – for example, fewer than 3 times a week in a formula-fed baby.
• Poo that is hard, dry, or like small pellets.
• Straining or crying when trying to poo.
• Bloated tummy or feeling uncomfortable.
• Lack of appetite or refusing to feed.

Symptoms in children

• Holding in poo on purpose to avoid pain.
• Soiling (leaking small amounts of poo into underwear) because of a backup in the bowel.
• Stomach ache that comes and goes.

Symptoms in older adults

• Chronic constipation does not affect older adults in the same way. For information on adults, see the separate article on chronic constipation.

Causes

Main causes

• Diet: Too little fluid (especially if formula is not mixed correctly) or not enough fibre after starting solids.
• Withholding: The baby holds in poo because it hurts, creating a cycle that makes constipation worse.
• Change in routine: Starting solids, traveling, or illness can disrupt normal pooing.
• Medical conditions: Rarely, conditions like an underactive thyroid (hypothyroidism) or a blocked bowel (Hirschsprung’s disease).

Risk factors

• Family history of constipation.
• Feeding only formula that is not mixed according to instructions.
• Starting solid foods too early or too late.
• Using certain medicines, such as iron supplements.
• Being born prematurely.

When to see a doctor

See a doctor urgently if:

• If the baby has any of the emergency symptoms above (severe pain, vomiting, blood in poo).
• If the baby is less than 6 weeks old and has not pooed in 24 hours.

Book a routine appointment if:

• If home care does not help within 2 weeks.
• If the baby seems to be in pain every time they poo.
• If you are worried about your baby’s feeding or weight gain.

Diagnosis

The doctor will ask you about your baby’s pooing pattern, feeding, and any other symptoms. They will also gently feel your baby’s tummy and examine the bottom area (anus).

Tests that may be done

• The doctor may do a rectal examination (a gentle finger check inside the anus) to see if there is a blockage.
• In rare cases, an X-ray of the tummy or a scan may be done.
• Blood tests are only used if a medical condition (like thyroid problems) is suspected.

What to expect at your appointment

The visit usually takes about 15–20 minutes. The doctor will explain what they found and suggest a plan – often starting with diet changes and gentle treatments.

Treatment

Treatment focuses on helping your baby pass soft poo regularly, without pain. It starts with simple home changes and only uses medicine if needed. Always follow the doctor’s advice for any treatment.

Self-care at home

• Give extra fluids: Offer small amounts of cool boiled water between feeds (if over 6 months and recommended by your doctor).
• For formula-fed babies: Check the instructions and make sure you are mixing the powder and water exactly right.
• If your baby has started solids: Add foods that help soften poo, like pureed prunes, pears, peaches, peas, or broccoli.
• Gentle tummy massage: Use your fingertips to make circular motions around the baby’s belly button.
• Bicycle legs: Gently move your baby’s legs as if they are pedalling a bicycle, while they lie on their back.

Medical treatments

If self-care does not work, the doctor may recommend a laxative (medicine to soften poo or help the bowel move). These are usually given as a syrup or powder added to feed. They are generally safe for infants when used under medical guidance. The doctor will tell you exactly how much to give and for how long. Do not give any laxative without talking to a doctor.

When is surgery considered?

Surgery is very rarely needed for chronic constipation in infants. It is only considered if there is an underlying problem that blocks the bowel, such as Hirschsprung’s disease.

Living with this condition

Keep a simple diary of your baby’s poo (how often and how hard). This helps you and the doctor see if treatments are working. Be patient – it may take weeks or months to get into a good routine.

Lifestyle tips

• Stick to a regular feeding schedule and offer extra fluids as recommended.
• Encourage movement: Tummy time and gentle leg movements help the bowel work.
• Limit foods that can worsen constipation, such as rice cereal or bananas, until the baby is better.

Diet and exercise

For babies on solids, offer high-fibre purees like pears, prunes, and vegetables. For older babies, small pieces of soft fruit and cooked vegetables are good. Always give plenty of water alongside meals. Tummy time and moving the legs also stimulate the bowel.

Mental health and emotional wellbeing

Caring for a baby with chronic constipation can be stressful. You may feel worried or frustrated. It is normal to have these feelings. Talk to your health visitor, doctor, or a trusted friend – you do not have to do this alone.

Prevention

It is not always possible to prevent chronic constipation, but you can reduce the risk. Ensure correct formula mixing, offer a balanced diet when starting solids, and encourage plenty of fluids. Early treatment for occasional constipation may stop it from becoming chronic.

Complications

If left untreated

• Anal fissures: small tears in the skin around the anus, which can bleed and cause pain.
• Fecal impaction: a large, hard mass of poo that gets stuck and cannot pass easily.
• Poor weight gain, because the baby may eat less due to discomfort.
• Pain and distress that can affect bonding and feeding routines.

Long-term outlook

The outlook for babies with chronic constipation is very good. With the right care and support, most babies eventually have normal, comfortable poo. Treatment may take a few weeks to months, but nearly all babies improve fully and lead healthy lives.

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