Newborn babies must adjust to a new environment, and it takes time to adapt to life outside of the womb. While it may be concerning, infrequent bowel movements are common in newborns. Diet can also affect this process. Understanding what constitutes normal and abnormal bowel movements in your baby can help you avoid unnecessary worrying and know when to seek medical advice.

Baby's First Stool

In the first hours of life, a newborn's body undergoes many changes to adapt to life outside the womb. One such change takes place in the digestive tract. A healthy baby will expel the first stool, called the meconium, within one day of birth. The meconium is a thick black or dark green mixture of amniotic fluid, intestinal lumen, mucus, and other substances that baby ingested in utero and may last for a few days after birth.

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Normal Infant Bowel Movements

What is considered a normal infant bowel movement varies from baby to baby. A formula-fed child may have daily bowel movements, but may also be less regular. Daily movements may be less common for breastfed babies, with up to a week between movements still considered healthy. As the digestive tract develops and muscle tone increases, bowel movements will become more regular.

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What Is Constipation?

Healthy newborns have bowel movements ranging from daily to up to five days apart. While the frequency of bowel movements is important, the ease or difficulty in passing the stool is paramount in measuring constipation. Babies will contort their faces while passing a stool, but a constipated baby will be in visible discomfort.

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Signs of Constipation

Newborn babies are very expressive, and parents can often pinpoint exactly when their baby is having a bowel movement. Crying and straining are typical in healthy babies as they pass a stool, and their weak abdominal and intestinal muscles typically make for soft stools. In addition to the typical strain, a constipated newborn will also show signs of pain and discomfort. Stools that are hard, pellet-like, bloody, black, or infrequent — all signs of constipation — are indicative of a more significant issue.

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Breast Milk and Baby Poop

Diet can also affect the frequency of bowel movements. A baby's body almost entirely absorbs nutrient-rich breast milk, which is why stools may be as infrequent as once a week. Muscle tone also varies between infants, so a breastfed baby may only go once every five to seven days. Bowel movements become more regular as the newborn grows.

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Why Do Newborns Get Constipated?

The first stool or meconium is an early indicator of gastrointestinal health. If a full-term newborn does not pass the meconium within 48 hours, this may indicate an intestinal obstruction. For premature infants, however, the passage of the meconium may occur days later. By the ninth day after birth, 99 percent of preterm infants have passed their first stool.

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Uncommon Causes

A number of gastrointestinal conditions are associated with not passing a stool shortly after birth, however medical problems cause constipation in less than 5% of children. In addition to a lower intestinal obstruction, anorectal malformations and small left colon syndrome can present with this symptom. Congenital disorders such as cystic fibrosis, hypothyroidism, and Hirschsprung's disease can cause newborn constipation in rare cases.

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Home Remedies

To treat newborn constipation at home, make sure your baby is well-hydrated between feedings. If possible, avoid changing your child's diet from breast milk to formula or vice versa. Juice is not recommended for babies younger than one month, but can be a good option for babies between one and three months, with a recommended amount of pear or apple juice of 1 ounce daily per month of life up to three months. A small serving of fruit juice twice daily can draw fluid into the intestine and aids in bowel movements.

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When to Contact Your Doctor

Contact your healthcare provider if your baby's constipation accompanies other symptoms, or if they have a diagnosed condition. If a baby is constipated and irritable or vomiting and refusing food, give your doctor a call. If a baby younger than two months is constipated, it is usually best to err on the side of caution and call your doctor.

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What To Expect at the Doctor

Your newborn's provider will perform a physical exam to check for a distended belly or spinal malformations. After you detail your baby's feeding schedule, bowel movements, and other symptoms, the doctor may feel your baby needs additional tests. Imaging like X-rays and MRIs can help diagnose bowel obstructions and less common intestinal malformations. Ask your doctor for more information on how to treat and manage newborn constipation.

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