How to Manage Constipation During Weaning

5 Nov

One of the most common concerns that comes up for parents weaning their baby onto solid foods is constipation. Weaning is a huge time of transition for a baby’s gut, and it is considered normal or common for babies to develop constipation at this time. Keep reading below to understand what constipation is, why it occurs during weaning and what you can do to stop constipation during weaning, or improve your baby’s pooing (stool) habits.

Bowel habits in babies

Like adults, baby’s poo (stool) habits are very individual to them, and there is a wide variety of stool types and habits which can be considered “normal”. This is because several factors can influence bowel habits. Typical factors that affect bowel habits in babies include their age, how they are fed, their weaning diet and stage of weaning, illness, and medications, among several others! Ultimately, what is important is trying to understand what is “typical” for your child, bearing in mind poo habits will definitely change during weaning.

Often the biggest times of change for a baby or child’s stool habits include following milk changes e.g. breast milk to formula, breast or formula milk to cow’s milk, during weaning and when they start potty training. Babies are growing and developing very quickly, and as their gut evolves their bowel movements will change too. For example, typically a one-month-old will often poo more frequently throughout the day compared to a one-year-old.

With all of this and the fact that your little one’s stools may vary “normally” in colour and texture daily, it is very understandable to be worried when your baby’s bowel habits change. Keep on reading to learn more about constipation during weaning, its causes, how to identify it, some tips to help, and more.

Is constipation normal when weaning?

Constipation is particularly common in children under 5, especially during weaning. ,ost children have what is referred to as “functional constipation”. This means that there is not an underlying physical or medical cause of the constipation such as a food allergy.

When introducing solid foods during weaning, the colour, consistency and/or frequency of your little one’s stools may change significantly, for example going from a more yellow-y to a more brown-y colour. It is very common for babies to poo less frequently when they become established on solid foods, and as their gut gets used to processing a wide range of new foods stuffs. Your child’s gut microbiome (microorganisms and bacteria) will be undergoing a huge transformation too.

Signs of constipation in your baby include:

Pooing less than 3 times per week.
Having large hard poos that are difficult to pass. If your little one show signs of straining as they try and pass poo, this could be a sign that they are finding it hard to pass. However, it is important to note that when passing a bowel movement “normally”, babies can appear as though they are straining however if they strain for a few minutes and then pass a soft stool, it is unlikely that they are constipated.
They are passing type 1 or type 2 stools (as on the Bristol Stool Form Scale – please see below) e.g., small, dry, hard poos, like little pellets.or ‘rabbit droppings’
Bowel movements which appear painful, potentially causing your little one to cry.
Your little one has a tummy that may feel firm to touch.
They are pooing fewer than 3 times in a week or passing unusually smelly stool and wind.
Your little one may appear less hungry than usual, and their appetite may improve after they pass a bowel movement.

What causes constipation during weaning?

Your little one’s digestive system is adapting to having solid foods.

Early during weaning, it is very common for babies to experience constipation, as their gut is learning to manage solid foods for the first time. Often, it settles once their digestive food is regularly having solid foods and adapts to digesting new things - the timing varies in each baby.

The types of foods in your baby’s diet.

Different foods can have a different impact on your baby’s stools. Fibre is a common factor to look at when thinking about constipation in babies and young children. This is because fibre absorbs water in the bowel, causing stools to be larger, softer, and so easier to pass so a lack of fibre may make it harder for your little one to pass a bowel movement. Foods which contain fibre include fruits, vegetables, wholegrains, nuts, seeds, pulses, and legumes. That said, with weaning babies it’s very important to get the balance right. Too much fibre too quickly may actually contribute to constipation, and too much in the way of high-fibre foods can fill them up quickly and displace intake of other important nutrients like iron and fat.

A diet very high in fibre can cause stools to become very bulky which can make them harder to pass and contribute to constipation. This can make it confusing and hard to identify the cause, but if your little one is struggling with constipation, it may be worth looking at the composition of their weaning diet overall, or seeking help from a Paediatric Dietitian.

The fluids your little one is consuming.

If your little one is not drinking enough fluids, this can contribute to stools becoming dry, difficult to pass, and thus constipation. Managing fluid intake in babies can be tricky, especially as they are getting to grips with cup drinking and water initially. They should however still be achieving adequate fluid intake from their normal milk intake, alongside some fluids from the foods they will start to eat. Keep reading for some hydration tips for babies.

It’s also worth noting, especially if your child is over 1 year of age and has transitioned to cow’s milk, that excess milk intake can also be a contributor to constipation. One reason for this is that milk intake can very quickly displace solids, especially when it is over 450-500mls per day.

Your little one may have a cow’s milk protein allergy.

It’s important to know that constipation may also be a symptom of cow’s milk protein allergy. This may affect both formula- and breast-fed babies, however, it is more likely that if a baby were exclusively breastfed symptoms of cow’s milk protein allergy become evident during weaning. This is because, in breast milk, the cow’s milk protein that they are allergic to is partially broken down by the time it reaches breastmilk, which means some babies do not react to it at this point. For these babies, their first exposure to the whole cow’s milk protein occurs on weaning, triggering a reaction.

Constipation as a stand-alone symptom is very rarely cow’s milk protein allergy, but if your child has other symptoms that could be associated with a food allergy such as persisting eczema, reflux, vomiting, abdominal pain, food refusal, poor growth please discuss with your GP, or speak to a professional with allergy expertise, such as a Paediatric Dietitian.

Check out my blog on symptoms of cow’s milk protein allergy here.

Top tips to manage constipation during weaning.

Have a look at the composition of your little ones weaning food and fluid intake, and see if any of the above potential causes of constipation may resonate with them. Based on that you may try the following suggestions to see if they help:

Adding foods which provide a source of fibre to their diet for example oats, lentils, pulses, beans, smooth nut butter, ground flaxseeds, as well as fruits and vegetables. Fruits high in sorbitol (a natural laxative!) can be really helpful for babies with constipation, as they help bring water into the bowel. P-fruits like prunes, pears, plums and peaches are great. Top tip - if introducing seeds like chia or flaxseed to a baby, ensure this is alongside fluid-rich foods and water, and start with very small amounts. They are very high in fibre, and too much too quickly can contribute to constipation.
Try some Kiwi, it’s an underrated fruit for constipation management but is a fantastic option to try. Not only is it a great source of fibre and fluid, it also contains an enzyme which helps digest protein in food. Check out Lucy’s kiwi flapjack recipe here.
With fibre-rich foods - adding fibre too quickly can cause other gastrointestinal symptoms such as bloating and abdominal pain. Furthermore, make sure they are consuming adequate fluids when increasing fibre intake as fibre draws in water from the bowel.
Reducing the proportion of highly processed foods in your little one’s diet, and swap for foods high in fibre (as above).
Pull back a little on the amount of fibre your little one is having, if they are having very high-fibre meals.
Ensuring your little one is receiving enough fluid from water, and milk feeds. During weaning, you may offer small amounts of water at mealtimes to help increase their fluid intake and get to grips with cup drinking. During weaning, you can also continue providing fluids and nutrition via breastmilk and/ or formula feeds.
If constipation persists or starts to cause other challenges for your baby like recurrent abdominal pain please speak to your GP. Some babies will require laxatives to support regular bowel movements, and it’s important these are used appropriately following your GP’s advice.

Do also remember that constipation is common during weaning, while your little ones tummy’s adapt to having solid foods for the first time and it may just mean that they need a little time.

This blog is general advice and does not replace personalised advice from a medical professional. If in doubt, please always seek advice from a registered healthcare professional such as a Registered Paediatric Dietitian or your Paediatrician.

Constipation during weaning resources

This Bladder and Bowels resource provides more in-depth information on understanding constipation and bowel movements in children and babies. The ERIC website is also a fantastic resource.