Constipation (Newborn)

Your newborn's first stool is called meconium. It's usually passed within 24 to 36 hours after birth. Most breastfed babies pass 3 to 4 stools a day. Some may pass a stool after each feeding. Formula-fed babies pass about 2 stools a day. But some healthy infants may have only 1 bowel movement a week after the first few weeks of life.

A normal stool is soft and easy to pass. But sometimes stools become firm or hard. They are difficult to pass. They may pass less often (2 or fewer per week). This is called constipation. It's common in children. Symptoms of constipation can include:

• Belly pain.
• Refusal to feed.
• Bloating.
• Vomiting.
• Streaks of blood in stools.
• Swelling, bleeding, and or pain around the anus.

In newborns, constipation can be caused by a formula. It may also be caused by medicines or even an underlying disorder like Hirshcsprung's disease. Some newborns may have a meconium plug that blocks stool passage.

Simple constipation is easy to treat once the cause is known. If a meconium plug is in place, it may be removed gently by hand by your doctor. In some cases your doctor will give a stimulant such as a glycerin suppository. Mild constipation usually goes away once a baby becomes old enough to eat solid foods.

Follow these guidelines when caring for your child at home:

• Your child's doctor may prescribe a lubricant or suppository. Follow all instructions on how and when to use this product.
• If your baby is on formula, follow the doctor's advice about the type of formula to use. Watch to see if this stops the constipation. Add feedings of water between breast or formula feedings, if advised, but generally, it's not given to babies. Talk with your baby's doctor before making changes to your child's feeding schedule or formula.
• At certain ages, your doctor may recommend certain fruit juices. Small amounts may be added to the bottle if your doctor advises this.

Follow up with your child's doctor. Your baby may need certain tests.

Get familiar with your baby's normal bowel pattern. Note the color, form, and frequency of stools.

Call 911 if your child has any of these symptoms:

• Firm belly that is very painful to the touch
• Trouble breathing
• Is unresponsive

Contact your child's doctor or get medical care right away if any of these occur:

• Fussiness or crying that can't be soothed
• Hard stools (rather than soft, pasty stools)
• Blood in stool
• Black tarry stool
• Weight loss or inability to gain weight
• Refusal to drink or feed
• Constipation that doesn't get better
• Fever (see Fever and children, below)

Use a digital thermometer to check your child's temperature. Don't use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
• Mouth (oral). Don't use a thermometer in your child's mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker's directions for correct use. Insert it gently. Label it and make sure it's not used in the mouth. It may pass on germs from the stool. If you don't feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child's fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child's doctor may give you different numbers for your child. Follow your doctor's specific instructions.

Fever readings for a baby under 3 months old:

• First, ask your child's doctor how you should take the temperature.
• Rectal or forehead: 100.4°F (38°C) or higher
• Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher
• Armpit: 101°F (38.3°C) or higher

Contact the doctor in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age
• Fever of 100.4° (38°C) or higher in baby younger than 3 months
• Fever that lasts more than 24 hours in a child under age 2
• Fever that lasts for 3 days in a child age 2 or older