With the birth of a child, new parents emÂbark on a steep learning curve. One of the first bodily mysteries that inexperienced parents must rapidly learn to decode involves the babyâs elimination patterns. Most crucially, parents want to know whether their baby is peeing and pooping normally.
Unfortunately, it appears that constipation in the young is not only frequent but often begins in the first year of life.1 One study estimates that up to half of all infants may experience gastroinÂtestinal symptoms (including colic and âspitting upâ as well as constipation).2 Systematic reviews assessing constipation prevalence worldwide have estimated that the affliction affects from 1 to 31 percent of infants and toddlers,3 and anywhere from 0.5 to 87 percent of children and adolescents.4
Pediatric constipation may be common, but it is not innocuous. Researchers observe that while it can start out as a âsimple complaint,â constipation that is ignored can lead to fecal impaction and eventually even affect a childâs growth and development.5
Constipation is also highly uncomfortable for children, âcharacterized by infrequent bowel movements, hard and/or large stools, painful defecation, sometimes in combination with feÂcal incontinence, and. . . often accompanied by abdominal pain.â6 Indicators of constipation in babies include straining to pass stools, painful stools, and large, hard stools accompanied by straining or pain.7
The vast majority of published studies on pediatric constipation focus on the condition known as âfunctionalâ (or âidiopathicâ) constipationâso-called due to the absence of any structural or biochemical explanation for its occurrence.6 Most researchers remain at a loss to say why this form of mystery constipation is so widespread in the young.
BREAST VERSUS BOTTLE: WHAT IS âNORMALâ?
In infants, researchers quite reasonably point out that understandÂing âabnormal defecationâ and constipation requires first knowing what normal pooping looks like.8 Ascertaining what is ânormal,â in turn, requires knowing what the baby is eating, because breastfed and formula-fed infants do not have the same stools or pooping patterns. In fact, as parenting websites put it, âThe stool of [a] formula-fed baby is totally different from the stool of [a] breastfed baby.â9
Thanks to the digestibility and ânatural laxativeâ properties of breast milk,10 constipation in breastfed babies seems to be rare, at least initially. Infants who are exclusively breastfed in the first few months of life produce stools that are more frequent, softer and of a different color and smell compared to the stools of conventionally formula-fed babies (see Table 1).11 A Dutch study published in 2014 found that the feeding approach (breast, formula or a mixture of the two) could explain up to 24 percent of the observed differences in how often babies defecate.8
The Dutch researchers also proposed that âgreen-coloured stools in standard formula-fed infants. . . be considered normalâ; however, some medical websites flag green stools as a possible sign of slow digestion, food allergies, food intolerances or other problems.12 This should come as no surprise to readers of Wise Traditions, as digestive difficulties and allergies are well-known problems associated with commercial soy formulaâan âabnormalâ baby food if ever there was one. Typical soy formula not only contains high levels of unhealthy soy phytoestrogens but may also feature fluoride, aluminum, cadmium, glyphosate residues, hexane-extracted soybean oil and other toxic ingredients.13 In addition to digestive distress, researchers have linked soy formula to seizures, autistic behavior and other neurological symptoms.14
LIKE MOTHER, LIKE BABY?
A study conducted in rural Turkey, pubÂlished in late 2019, found that half the number of infants whose first food was breast milk suffered from constipation compared to non-breastfed infants (15.4 percent versus 32.1 percent).5 Twenty-one percent of the constipated infants defecated twice or fewer times per week, and 5 percent âhad stools that were like goat droppings.â Interestingly, sales of breast milk âsubstitutesâ have skyrocketed in Turkey in recent years, growing by 72 percent between 2008 and 2013.15
In addition to a decline in breastfeeding, factors that increased the Turkish infantsâ risk of constipation included starting on supplementary foods before the age of six months, being mildly or fully obese (a likely proxy for a diet high in processed junk foods) and having a mother who also suffered from constipation.5 In fact, fully half of the constipated infants had constipated mothers, and the presence of constipation in the mother was statistically significant at the p<0.0001 level, reflecting a 4.7-fold increased risk.
Dr. Natasha Campbell-McBride, author of Gut and Psychology Syndrome,16 observes that constipation is âalways a sign of deficient gut flora.â In her estimation, the majority of babies in the modern world have an imbalanced gut microbiome. Thus the link between maternal and infant constipation demonstrated by the Turkish study is an important warning to mothers-to-be to get their microbial house in order. Unfortunately, factors such as industriÂalized foods, birth control pills, antibiotics and glyphosate can make this extremely challengÂing. A new study from Finland (in the Journal of Hazardous Materials, no less) reports that 54 percent âof around 101 species of bacteria comÂmonly found in our guts could be damaged or killed if exposed to glyphosate in high enough quantities.â17,18
HOMEMADE FORMULA: TROUBLESHOOTING CONSTIPATION
When breastfeeding is not possible (for whatever reason), feeding baby one of the two types of nutrient-dense homemade formulas recÂommended by the Weston A. Price Foundation is by far the best option (see sidebar below). Many families report considerable success giving their young ones either the raw milk formula or the liver-based formula.19
However, some parents who turn to the raw milk formula report that their babies beÂcome constipated. For a constipated infant, the first explanation to consider is dehydration. Campbell-McBride instructs parents to careÂfully monitor babyâs urine, making sure it is pale yellow; dark yellow (or even brown) urine is a sure sign of dehydration. In addition, the baby should be producing normal amounts of urineâas indicated by a diaper that is full of urine and requires changing after a feeding. The AskDrSears website describes the colon as the bodyâs âfluid regulatorâ and points out that dehydration can cause the stools to harden and become âwater-deprived.â20
If the baby is dehydrated, Campbell-McÂBride recommends adding more water to the babyâs milk formula. In situations where the baby is producing only small amounts of very dark urine, the formula initially can be diluted almost by half; after the urine normalizes, the parents can then experiment with different amounts of water to find the correct ratio for their baby. (She notes that every child has differÂent requirements for water, depending on factors such as metabolism, activity level and weather.)
Sometimes, dehydration is not the triggerÂing factor for infant constipation. Some babies on the raw milk formula find high levels of dairy protein constipating. (Formula based on raw goat milk is more likely to be constipatÂing that formula based on raw cowâs milk.) In these cases, Campbell-McBride recommends switching the infant to the liver-based formula and when the baby is old enough (no earlier than four months of age), carefully starting to introduce appropriate solid foods (see âAvoid the Rice Cerealâ).
Large amounts of high-protein dairyâsuch as whey, yogurt, kefir and cheeseâcan also aggravate constipation in some older children and adults.21 Deemphasizing these high-protein dairy foods and replacing them with more high-fat dairyâbutter, ghee and homemade sour creamâcan help resolve the issue by lubricating the gut wall and softening the stool. Campbell-McBride also recommends increasing animal fat consumption overall as well as prioritizing gelatinous meats over muscle meats.
SOLUTIONS THAT ARE NO SOLUTION
When hydration and dietary changes do not do the trick, or fecal impaction has become a concern, it may become necessary to perform enemas (for children who will tolerate them) or more occasionally, to resort to glycerin supÂpositories. Disturbingly, one of mainstream medicineâs top recommendations22 for disimÂpactionâand often, its enthusiastic recomÂmendation for ongoing âmaintenanceââis to administer an âosmotic laxativeâ featuring a highly problematic active ingredient called polyethylene glycol (PEG) 3350. One of the leading PEG-3350-containing products is the Bayer-owned, over-the-counter drug Miralax; the fact that Miralax has never been approved by the FDA for pediatric use has not stopped health care providers from promoting it as the âgo-toâ remedy for constipated children. In fact, across all age groups, Miralax is the second leading âdigestive remedyâ in the U.S.23
Horror stories abound about PEG 3350âs propensity to cause extreme neuropsychiatric side effects, including rage, anxiety and paraÂnoia. Between 2007 and 2017, the FDA received reports of over fifteen hundred different adverse reactions to PEG 3350 in children, of which nearly three in five were neurological.24 A parent group called Parents Against Miralax has tens of thousands of members, many of whom have joined class-action lawsuits.
There is growing evidence that PEG-3350-based drugs may alter the microbiome and even increase the risk of antibiotic resistance. A 2018 study in mice showed that the laxative could cause âa long-lasting perturbation to the gut microbiotaâ as well as immune system alterations.23 As the researchers concluded, âThese unintended consequences of PEG treatÂment are particularly important in light of the increased use of osmotic laxatives in pediatric populations, where the long-term health impact of PEG-related immune response is currently unknown.â23 Suggesting that this research may explain the troublesome connection between Miralax and neuropsychological symptoms, one group of lawyers has remarked that âWhen the gut is âoffâ per-say [sic], many other things in the body can, in turn, be âoffâ as well.â25
Consumers should be aware that PEG is a common component of many other drugs and cosmetic products (as well as some of the Covid-19 messenger RNA vaccines under deÂvelopment). Its use is increasingly controversial due to a wide range of documented adverse PEG-related immune reactions, including life-threatening anaphylaxis.26
AVOID THE RICE CEREAL
For the infant who is ready to embark on some solid foods, Campbell-McBride points to the critical importance of introducing foods in such a way as to create healthy gut flora and a healthy digestive function. When adequate care is not taken, the transition from exclusive breastfeeding (or even formula) to solid foods can actually be the catalyst for constipation to develop.
Children under one year of age are not fully equipped to digest grains, which makes the widespread practice of feeding cereal grains to infants particularly ill-advised.27 Some mainÂstream nutritionists are belatedly conceding this point and are also admitting that processed cereals are a leading constipation culprit.28 AcÂcording to the Dr. Sears website, the main reason that so many babies become constipated when initiating solid foods is that health care profesÂsionals tend to recommend the very foods (such as rice cereal) that they know to be constipatÂing!7 âThe truth is,â Dr. Sears confesses, âthere is nothing special about these foods that makes them better to start out with,â and âbabies donât actually even need rice cereal.â
Wise Traditions parents know that babiesâ first solid foods should be animal foods, which the immature digestive system is best able to handle and thus far less likely to promote conÂstipation. This can begin with a daily pastured egg yolk (starting as early as four months of age) and small amounts of grated raw liver (beginning at six months). Pureed meats and simple watery patĂŠs, easy-to-digest bone broths, vegetable purees (with plentiful animal fats), fruit purees and small amounts of kefir or yogurt can be gradually added around eight to ten months of age, with new foods introduced one at a time. Properly prepared (i.e., soaked, sprouted or fermented) grains, nuts and seeds should wait until at least one year of age. (See the Weston A. Price Foundation website for more suggestions.29)
DEEPER HEALING
Dr. Campbell-McBride, Dr. Tom Cowan and other wise healers familiar to readers of this journal emphasize that in the long run the best and only solution for constipation is to heal the gut and improve digestion.30 This is the case whether the sufferer is six months old or seventy years old. Eating a Wise Traditions dietâmakÂing sure to include digestible and mineral-rich bone broths, lacto-fermented beverages such as beet kvass and unrefined sea saltâis sure to make a meaningful difference.
SIDEBARS
HOMEMADE INFANT FORMULA
Breast milk from a healthy mother is usually the best food for baby. However, the quality of a motherâs milk depends on her own diet. Lactating womenâs diets should include plentiful animal products and fats, pastured eggs, liver, bone broths, high-quality raw dairy and cod liver oil.
In situations where breastfeeding is difficult or impossible, or if baby is not gaining weight on breast milk or seems always hungry, the Weston A. Price Foundation recommends homemade rather than commercial formula. The foundationâs website provides detailed recipes and instructions for making raw milk baby formula and liver-based formula (westonaprice.org/health-topics/childrens-health/formula-homemade-baby-formula/). Both recipes incorporate a variety of nutrient-dense ingredients, including whole-fat raw milk from pastured cows (for the raw milk formula) and liver and homemade broth (for the liver-based formula), along with cod liver oil, coconut oil, Bifidobacterium infantis and other components designed to mimic the nutrient profile of motherâs milk as closely as possible.
C-SECTIONS AND INFANT CONSTIPATION: AN UNEXPLORED TOPIC
A growing body of research indicates that babies delivered by C-section are more likely than vaginally-delivered babies to experience chronic health problems later in life, including type 1 diabetes, obesity and asthma.31 The hypothesis underlying these observations is that infants born by C-section miss out on exposure to the motherâs vaginal and intestinal microbiota, and that during vaginal births this exposure plays an important role in âprimingâ the infantâs immune system.32 As one researcher describes it, âEvery generation of mothers hands over its microbiome to the next, as the baby is coated with beneficial germs while being squeezed through the birth canalâbut this doesnât happen for babies born through C-section.â33
In 2018, Japanese researchers conducted a first-of-its-kind study assessing the potential correlation between C-section delivery and infant constipation, expecting that infants not delivered vaginally would have higher rates of constipation (as defined by weekly frequency of bowel movements).32 Although the studyâs results did not bear out the researchersâ assumptionsâinstead showing comparable rates of constipation for both modes of deliveryâthe investigators noted that the low overall rate of constipation in Japanese babies (1.37 percent) may have made it difficult to detect meaningful differences. Suggestively, they found that C-section babies were significantly less likely to be exclusively breastfed. One wonders what such a study might find in the U.S., where constipation and C-sections both occur at alarmingly high levels.
OTHER SUGGESTIONS FOR CONSTIPATED BABIES
1. Try a small amount of diluted, homemade prune juice (the juice from cooking prunes) or some pureed cooked prunes.
2. Make a digestive tea (see Nourishing Traditions, page 604). To make this folk remedy used for constipation and intestinal gas in infants, bring two quarts of filtered water to a boil and pour the water over two cups of fresh anise (fennel) leaves and two cups of fresh mint leaves. Let steep until the water cools, then strain. Give the tepid tea to baby about four ounces at a time. Nursing mothers may also drink this tea and pass along the digestive benefits to colicky babies.
3. For babies who are constipated on the Wise Traditions raw milk formula, try eliminating the nutritional yeast and gelatin and adding more cream (one or two tablespoons). This should be a first step before switching to the liver formula.
4. Consider the possibility of a vitamin B12 deficiency. Vitamin B12âfound almost exclusively in animal foods such as meat, liver, fish, shellfish, milk products and eggsâis essential for healthy digestion and intestinal functioning (particularly movement of the bowels) but also requires a sound digestive tract for proper absorption. Soy is a key culprit interfering with the ability to absorb B12âyet another reason to avoid giving babies soy!
REFERENCES
- Da Silva Souza D, Tahan S, Weber TK, Bezerra de Araujo-Filho H, Batista de Morais M. Randomized, double-blind, placebo-controlled parallel clinical triÂal assessing the effect of fructooligosaccharides in inÂfants with constipation. Nutrients. 2018;10(11):1602.
- Vandenplas Y, Alarcon P, Alliet P et al. Algorithms for managing infant constipation, colic, regurgitation and cowâs milk allergy in formula-fed infants. Acta Paediatr. 2015;104(5):449-457.
- Ferreira-Maia AP, Matijasevich A, Wang YP. EpiÂdemiology of functional gastrointestinal disorders in infants and toddlers: a systematic review. World J Gastroenterol. 2016;22(28):6547-6558.
- Boronat AC, Ferreira-Maia AP, Matijasevich A, Wang YP. Epidemiology of functional gastrointestiÂnal disorders in children and adolescents: a systemÂatic review. World J Gastroenterol. 2017;23(21):3915-3927.
- ĂaÄlar HS, Hisar F. Identification of prevalence of constipation in infants aged 0-12 months in rural areas. Rural Remote Health. 2019;19(4):4870.
- Flemming G. Chronic functional constipation in infants and children. Handb Exp Pharmacol. 2020;261;377-396.
- https://www.askdrsears.com/news/sears-family-blog/my-6-month-old-constipated-what-do.
- Den Hertog J, van Leengoed E, Kolk F et al. The defecation pattern of healthy term infants up to the age of 3 months. Arch Dis Child Fetal Neonatal Ed. 2012;97(6):F465-F470.
- https://www.newkidscenter.org/Formula-Fed-Babies-Poop.html.
- https://www.healthline.com/health/constipation-in-breastfeeding-baby.
- https://milkology.org/content/breastfed-baby-poop-frequency.
- Sissons C. Baby poop color: causes and when to see a doctor. Medical News Today, December 4, 2019. https://www.medicalnewstoday.com/articles/327218?c=1592093637981.
- Onusic S. The scandal of infant formula: a poor replacement for motherâs milk. Wise Traditions. 2015;16(3):22-53.
- Teller M. Soy infant formula and autism. Wise TradiÂtions. 2016;17(3):45-49.
- Dehghan SK. âFailingâ food system leaves millions of children malnourished or overweight. The GuardÂian, October 15, 2019.
- Campbell-McBride N. Gut and Psychology Syndrome (revised and expanded edition). Cambridge: MedinÂform Publishing; 2010.
- Albert H. Glyphosate exposure could disrupt human gut microbiome. Forbes, November 25, 2020.
- Leino L, Tall T, Helander M et al. Classification of the glyphosate target enzyme (5-enolpyruvylshikimate-3-phosphate synthase) for assessing sensitivity of organisms to the herbicide. J Hazard Mater. 2020 Nov 14;124556.
- https://www.westonaprice.org/health-topics/childrens-health/formula-homemade-baby-formula-testimonials/.
- https://www.askdrsears.com/topics/health-concerns/childhood-illnesses/constipation-2.
- Frequently Asked Questions: Constipation. https://www.gaps.me/faqs.php.
- Waterham M, Kaufman J, Gibb S. Childhood conÂstipation. Aust Fam Physician. 2017;46(12):908-912.
- Tropini C, Moss EL, Merrill BD et al. Transient osmotic perturbation causes long-term alteration to the gut microbiota. Cell. 2018;173(7):1742-1754.e17.
- Hussain SZ, Belkind-Gerson J, Chogle A et al. Probable neuropsychiatric toxicity of polyethylene glycol: roles of media, internet and the caregivers. GastroHep. 2019;1(3):118-123.
- Beasley L. How drugs like MiraLAX can affect the microbiome. November 20, 2019. https://www.drug-injury.com/drug_injury/2019/11/how-drugs-like-miralax-can-affect-the-microbiome.html.
- Childrenâs Health Defense. Components of mRNA technology âcould lead to significant adverse events in one or more of our clinical trials,â says Moderna. August 6, 2020. https://childrenshealthdefense.org/news/components-of-mrna-technology-could-lead-to-significant-adverse-events-in-one-or-more-of-our-clinical-trials-says-moderna/.
- https://www.westonaprice.org/health-topics/childÂrens-health/feeding-babies/.
- https://www.healthline.com/health/constipation-in-breastfeeding-baby#causes.
- https://www.westonaprice.org/health-topics/childÂrens-health/nourishing-a-growing-baby/.
- Teller M. Uptight and out of sight: the global constipaÂtion epidemic. Wise Traditions. 2018;19(2):42-46.
- Blustein J, Liu J. Time to consider the risks of caesarean delivery for long term child health. BMJ. 2015;350:h2410.
- Yoshida T, Matsumura K, Tsuchida A et al. AssociaÂtion between cesarean section and constipation in infants: the Japan Environment and Childrenâs Study (JECS). BMC Res Notes. 2018;11:882.
- Rutgers University. The hidden reason children born by C-section are more likely to develop asthma. Medical Xpress, November 11, 2020.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Winter 2020
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Dakotah says
I love this read. Here is another great tip we used with both my babies, breast milk yogurt. We took our sourkrout and made it ourselves, but with my new baby we plan on using kefir. My son as a newborn had the worst gas, so we would give him a super tiny amount of sourkrout juice on my nipple. We figured it was better and healthier than the gross sticky shelf stable probiotic we where recommended. (We bought it but I couldnât bring myself to put it in my mouth, let alone my newborns. It looked disgusting!)
Also another reason this is a problem is due to going against nature for âpotty trainingâ. Look into elimination communication, or as I think of it as the natural way of doing it. Just like breast is best, not letting your baby sit in poop or train them to go in a diaper is best. My son has been almost completely potty trained since 1, no poop accidents other than in traffic since 6 months old. Diapers are a gross scam and chemicals.
Breast is best, but the key to it would be information. I suggest you add a link on any page or article about lactation in humans to The la leche league.
Gail Blum says
This article is very good. However, I am looking for ideas of what to feed my 7 month old who needs to have toothpaste consistency poop at least once a day because of a deformity. She is on homemade formula but introducing solids has been tough. The doctor said that 100% of these kids are constipated and end up on Miralax or some other stool softener. I am trying to avoid this. This will be a lifetime issue for her.
S R says
Try adding mechanical means in addition to foods that work for her. Release the ileocecal valve regularly, and do gentle tummy massages as you can! Craniosacral, chiropractic
and Skin brushing can also help!
Zoe says
My 10 month old baby has been constipated for a month. She’s going about every 4-7 days.. usually starting with pebbles that make her cry a lot and seem very painful, and eventually a big poop. We started solids according to WAP guidelines at about 5 months with the bananas and egg yolks. But I really haven’t given her much of the cod liver oil.
She LOVES the egg yolks.
Anyhow, about the same time my baby got constipated, I started working with a functional medicine practioner to address my gas and bloating. She ran a GI map on me and told me I had too much beneficial bacteria in the gut.. causing dysbiois. She told me to cut out all of the probiotic foods I was eating (homemade yogurt, kombucha, and sauerkraut). So I stopped all those foods, I also stopped my home milled organic wheat sourdough bread and other grains & seeds (all properly prepared), and stopped eating many fruits. She also told me to cut dairy completely.. so I did.
I am not sure that I believe these are all good things to cut out, and I am wondering if the foods that I cut out are contributing to my babies constipation. I am also taking a powdered supplement that she gave me (a multivitamin) and some herb tinctures (the constipation started before I began the herb tinctures though). My baby is now mostly refusing to eat carbs. She pretty much only wants bone broth, ground beef, chicken, egg yolks, and greek yogurt (all purees), as well as sauerkraut. She LOVES sauerkraut. Sometimes I can also get her to eat some sweet potatoes or carrots (in butter), but for the most part she is not at all interested in anything but the fat and protein. I gave her some refried beans, but I’m not sure they’re doing her any good. I tried giving her prunes, but she refuses. She also refuses apple juice.
I’ve added back in raw milk against the functional med docs advice, because I was really craving it and feel it is a heplful thing to drink.. but my baby is still constipated. My baby was not constipated before I changed my diet. (note: I am also dealing with a case of gas, bloating, and frequent constipation myself.. can mostly be controlled by foods. Functional medicine doc said it is caused by having TOO much beneficical bacteria in gut). My constipation is mostly at bay right now through different vitamins as well as diet.
Does anyone have any thoughts? We are coming up on day 6 for her of not pooping, and Google is telling me to call my doctor, but unfortunately, she doesn’t have a doctor because all of the local doctors (Connecticut) required her to follow their vax schedule in order to be seen.. so I am at a loss at what to do. I also wouldn’t be a fan of taking her in, because they’d likely just give her miralax.