Helping parents understand if their baby is constipated
Infant Constipation is a topic that parents often discuss with healthcare professionals, ranging from questions about what their baby’s stool looks like, to whether their baby is constipated. Sometimes parents may think their child is constipated based on the number of times the baby poos in a day, however, the frequency of stools on its own may not be enough to define constipation and a better understanding is required.
What is constipation?
Constipation is defined as a decrease in the frequency of bowel movements, characterized by the passing of hard stools which may be largely associated with straining and pain.1
- Baby struggling to poo
- Fewer than three complete poos per week*
- Being irritable and unhappy
- Loss of appetite
- Poos that are larger than usual
- Dry, hard, lumpy or pellet-like poos
- Foul smelling wind and poo
- Their tummy might feel firm
There is no standard for the number of times a baby is supposed to pass stools in a day, the frequency of stools can be affected by diet, liquid intake, age, behaviour and illness.
Breastfed babies may sometimes go for several days without having a poo, or even a week (this is more common in babies aged 6 weeks or older)2. Formula fed babies tend to poo either at least once a day or every other day. Some babies may even go longer between poos without being constipated.
As long as their stools are soft, they have plenty of wet nappies and are not distressed, the baby is not constipated3.
To help healthcare professionals understand the stools parents describe, it is helpful for parents to offer a clear account of stool frequency and consistency. This can be done more accurately with the use of the Bristol stool chart4, a reference guide illustrating different types of stools.
Click below to download a copy of this Bristol stool chart4.
For more information about the causes of constipation and treatment, read our other article on Infant Constipation.
*Does not apply to exclusively breastfed babies after 6 weeks of age.
National Institute for Health and Care Excellence (NICE). Clinical knowledge summary (CKS): Constipation in children. Available at https://cks.nice.org.uk/topics/constipation/#!topicsummary (Accessed Feb 2021)
Start4life, Breastfeeding challenge, Available at https://www.nhs.uk/start4life/baby/breastfeeding/breastfeeding-challenges/constipation/ (Accessed Feb 2021)
NICE CG99 (2010). Constipation in children and young people: diagnosis and management. Available at https://www.nice.org.uk/guidance/cg99 Accessed February 2021
Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal transit time. Scandinavian Journal of Gastroenterology 32: 920–4.