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Two-Month-Old Is Constipated

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: My two-month-old daughter suffers from constipation. She gets "advance1" formula and for one of her feedings I add prune juice. Her movements are liquid and it makes her irregular every two or three days. Occasionally, she goes every day, but I sometimes have to resort to stimulation with a thermometer. Is this normal? My daughter's pediatrician seems very calm about this. What do you advise?

A: Bowel movements are a common concern of many parents. Two-month-old infants have varied bowel patterns (several times a day to once every three or four days) and their stools can be hard, soft, or even liquid depending on what they're eating (formula, breast milk, and/or solids). Infants can sometimes strain as they're learning what it means to have a bowel movement. They can push, draw up their legs, and turn red in their face as they try to get the stool out. It isn't easy to have a bowel movement with your legs not firmly on the floor. Most of the time all this behavior is perfectly normal and should not raise any concern.

Adding prune juice or karo syrup to the formula sometimes makes it easier for two-month-olds to have their BM's. However, I don't usually find rectal stimulation very helpful. It may even cause irritation or cracks of the skin around the anus. As long as your baby is growing and developing normally (with the bowel pattern you described), it sounds as if there is no cause for alarm.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.


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