In infants who have not started foods, any formed bowel movement may be constipation, but as long as the stool is soft and they're feeding well with good weight gain they are not constipated.
Even if they grunt and turn red when they poop. Babies need to learn to relax the anal sphincter when they increase pressure in their abdomen. Learning to do this can take time and practice. It does not mean they're constipated. It even has a name: infant dyschezia. When a baby has infant dyschezia, you will see at least 10 minutes of straining and crying before a bowel movement in an otherwise healthy infant. As long as the stool is soft, the crying is not due to constipation.
There is no treatment - most babies learn how to coordinate the various parts of pooping within a couple of weeks. Using any form of treatment might delay this process of learning.
First 24 hours of life is important!
If a newborn does not have a bowel movement in the first 24 hours of life, talk to your doctor. This can be a sign of bowel obstruction, Hirschsprung's disease, or other problem. They sometimes don't have a bowel movement after the meconium is gone before breast milk comes in, but work with us to be sure they're feeding well enough.
Differences between formula and breast milk
Formula fed infants tend to have thicker stools than breast fed babies. Intact cow milk proteins can be constipating for some infants. If that is the case, a partially hydrolyzed formula, such as Goodstart or Gentlease, tends to be better tolerated. There are some studies showing a benefit to added probiotics, which can be added to a bottle from a powder probiotic purchased at a pharmacy or included in some brands of formula.
Breast fed infants sometimes wait 2 weeks between stools... this is normal as long as the stool is soft when they finally go. Their stools tend to look like wattery yellow cottage cheese with a few flecks of solids in the initial month or two, then thickens to oatmeal or peanut butter consistency over time.
Starting solids
When infants first start solid foods, they often have thicker stools.
Rice cereal is especially constipating, so avoiding it can help.
Start with vegetables - most vegetables are easily enjoyed by infants. They can be made into purees or cooked and given to babies who are finger feeding. Babies tend to like vegetables more than fruits initially, but fruits can be given to help constipation. See the tips on our main Constipation page for details.
