Question

What can I do about my baby's hard, infrequent BM's?

Answer

Parents often think their child is constipated because he grunts and strains when having a BM, but that is normal behavior. Constipation means having hard, painful, infrequent stools, and your baby has it in spades!

You do not mention how old he is, but I will assume he is less than 6 months since he is only on formula. You are correct to assume that it is probably the formula that is constipating him, as long as he did not have similar problems in the newborn period. If that was the case, or if his abdomen becomes distended, he vomits, or he has other symptoms, an underlying bowel problem should be ruled out by your pediatrician.

Once hard, dry stool is impacted into the lower intestine, it's difficult for stools to return to normal until the baby is cleaned out a bit. Laxatives are not appropriate or safe to use for an infant. Ask your pediatrician about using a glycerin suppository once or twice a day until his stool is softer. This is merely a way to "grease the skids" and make it easier for him to pass a hard bowel movement. Additional water, mixed with a little prune or apple juice, or pureed prunes or apricots may loosen up the stool that is being formed. (We normally do not recommend juice for infants, but this is an exception.)

When you start advancing his diet, watch for stool changes. Rice cereal, the traditional first food, can cause hard stools. If that happens, ask your pediatrician about alternative cereals such as oatmeal.