4 Week Old with Constipation

Updated on July 24, 2008
K.E. asks from Philomath, OR
40 answers

My friend has a 4 week old boy, he had jaundice when born and spent a week on a bili-blanket and is just fine now. But now he has another problem, he seems to be constipated. He only goes once a day and it is fairly hard. Before he goes he spends a lot of time fussing and straining. He is on formula and his Mom is hesitant to give him anything else (since the Dr. says not to feed him anything else). Has anyone had this problem before and how did they solve it?

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M.H.

answers from Seattle on

I didn't have time to read all of the previous responses so I don't know if I'm reapeating someone else. But my son seemed very irregular at that age and I asked his doctor and he said all babies are different (just like all adults are different) and that some babies only have a bowel movement every 4-5 days. And to count my lucky stars. :) But I would have her ask her pediatrition. They can probably just answer her question over the phone instead of taking all of her kids to the doctor.

I wouldn't recommmend giving a baby that young anything to help with constipation unless directly reccomended by the baby's doctor.

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A.O.

answers from Portland on

I'd recommend an infant approved probiotic. My son was constipated for several years, starting from the time he was a couple of days old. He was hospitalized several times, put on Miralax, etc. What finally helped him at age 3 was giving him a probiotic powder. It helped to regulate his gut and get the good bacteria in there. Wish that I had known about it sooner!

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T.F.

answers from Eugene on

A friend told me to use a little olive oil on their tummy and rub/massage it in and that helps digestion system move. I have never had to try it, but I have heard of some others doing that.

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Z.A.

answers from Seattle on

While it's unlikely that our cases are parallel (because ours was caused by an odd genetic thing in our family...a SUPER small percentage of the population has it), we went through the same thing. Since this wee one is on formula, it is most likely related to that. Since there are Sooooooooo many reasons to feed a baby formula (from mom being on meds to adoption to etc.etc.etc.) I'm not even going to enter into the nursing v. formula discussion and just assume it's the best option they have.

In our family babies are either born with a nearly adult sized large intestine (ouch!!!), or twisted intestines (surgery needed). My son has the large kind....so we spent LOTS of time rocking and comforting, and being supportive. And by LOTS I mean nearly every time for about 3 years and every other time for a whole year after that. We kept diapers on hand for over a year after he was potty trained, because even though he knew it was going to hurt & be scary, he was more comfortable pooping in them. Even as a big boy I'll still occasionally go provide moral support...and we understand that spending 40 minutes in our (only!) bathroom is what it takes. This, for us is the easy part. Rocking a sobbing toddler for 2 hours...poor kiddo.

The point of all of this is: If your friend works with her pediatrician, tries different formulas, bioactives, etc. all to no avail...beg her patience. Because if nothing helps, while it most certainly will annoy her at times, he's the one in pain, and in fear of pain.

On the upside, few children remain constipated for very long, and his is probably situational, not medical...and will pass soon. :)

My best wishes to the three of you,
Z.

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S.J.

answers from Portland on

I haven't read any of the other responses so I apologize for any duplication. Try a different formula. If that doesn't work then try using goat milk formula. IT is more expensive but seems gentler on the stomach than other formulas. As for immediate relief I have two words. Gripe Water! You can find it Fred's New Season's, Whole Foods, and Target in their pharmacy. It is safe and it helps the digestive track. Watch out for blow outs.

One thing I did before going to goat milk was every third or fourth bottle I would give a really watered down one so if the formula calls for 2 scoops for 4 ounces I would do 1 scoop for 4 ounces of water.

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J.T.

answers from Louisville on

K., please let your friend know that first of all this is common. Babies this age, however, cannot be given just "anything." The Dr. is correct in saying not to feed him anything but formula, however, a little water is ok and probably needed. Make sure she is mixing the formula correctly...a little too much powder can cause constipation and a little too little can cause decreased weight gain. As long as he is having a bowel movement daily, he'll be fine. To help she can place him in a warm bath when he starts fussing, or even a warm, not hot, washcloth across his tummy. Gentle massage to the tummy is good too, it helps to stimulate the bowels. Letting him have floor time is important even at this age. I tell my patient's parents to be sure and do "exercises" after they recieve their shots. Moving the legs in a bicycle or knee bending motion is a good exercise. We all know exercise stimulates the bowels as well. Make sure not to force the legs into a bent or straight position, it can cause muscle damage. I always counted with my kiddos while doing it. Hope this helps! If it continues after these methods she needs to talk to the Dr. It could be a problem with the specific formula.

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M.P.

answers from Portland on

Constipation is usually caused by a lack of fiber and/or water. Does he drink enough? Does he drink water? Milk can also cause constipation. What is in the formula?

I don't know what one should do with a baby that young and would recommend talking with the doctor. Can he drink prune juice. Can you add
Mirelax to his bottle. Miralax completely dissoves in liquids and has no task, It adds fiber to his diet. My grandson used it starting around 6 months of age which is around the time his mother stopped breast feeding.

He was chronically constipated until he was close to 3 when all of a sudden his movements were soft and firm. The doctor could not figure out what caused it. My daughter tried several things, none of which worked. Miralx softend his stools some but he still had difficulty with bowel movements. He always tried and stayed on the toilet until the poop came out. He would cry and I felt so sad for him. He has now outgrown constipatuation.
Fortunately his experience did not make him withhold his feces.

A possible cause of constipation is that his body is not mature enough. There are also causes that need to be medically addressed.

I doubt that he's constipated since he does have a bowel movement once a day. It's just more firm than it should be so that he can easily push it out. Fussing and straining is common at this age even if the movements are easy to pass. His stools have probably been on the soft side until now. He's feeling new sensations.

If she hasn't already talked with the pediatrician I'd encourage her to do that now. If she has talked with him I advise her to call back and explain her concerns.

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L.T.

answers from Seattle on

We put a little bit of brown sugar in the formula for my boys when they were really little and it worked well. If she doesn't want to fee him anything then she may just have to go for a baby supository or put on a glove and rub some vaseline up in his bum.

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K.M.

answers from Richland on

My daughter has crohns disease. She used to fuss and hold her tummy before pooping too, we thought she had colic at birth and then had it a lot... When she was 2 years old she started pooping blood...she was not diagnosed with a colon disease until she was 2, she had it since birth. Please consider taking your baby to a pediatric gastroenterologist. With pain and suffering before a bowel movement, sounds all to familiar. This specialist can help you figure out what/if somethings wrong other than irregularity.

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T.S.

answers from Eugene on

It sounds like the formula being used is not working out with this little boy's digestive system. I can understand wanting to follow the dr's advice, but please know that doctors are not often very well versed in the specifics of nutrition. You would think they would be, but there are typically only one or two actual references to nutrition in the entire time they are in medical school. Our society has become so commercialized, especially with infant care, that we consider it to be "alternative" to feed the baby the way the baby was meant to be fed--at mama's breast with milk her body makes specifically for the baby it grew.

Most formulas are somewhat difficult to digest, even though they do things to the proteins to make them easier. If your friend is open to it, she could work with a lactation consultant to begin breastfeeding--once one has given birth, one has the hormonal ability to lactate. I can almost guarantee that the baby will never be constipated this way.

If she does not wish to do this, it would be wise to discuss different formulas with a nutritionist. Not knowing what formula he is on, I would not be able to say what might need changing, but I would begin with looking at whether the formula is cow's milk based or soy based. The most digestible milk other than human milk for a human baby is goat's milk, so she may wish to try a goat's milk formula.

Also, she should be sure she is using the correct formulation of water to formula, if she is using a dry powder mix.

Finally, a good probiotic that has L-Bifidus and L-Acidolphilus (Bifidus should be higher for babies than acidolphilus) can help "kickstart" his digestive system. It can be added to the formula. A little blue green algae, which contains a full spectrum of amino acids and micronutrients in near perfect balance, can also be added to the formula. These will not add calories, will help with digestion and with immune system development, and will make whatever formula is being used more complete nutritionally and more close to mother's milk.

He should not be given fruit juice, sugar, or other types of non-infant foods. What is important with formula feeding is to make the food as close as possible to what is natural and normal for human infants--which at this age would be totally provided by mother's milk. I do not mean to imply any judgement for her choice or need to use formula--however, it is important to realize that the standard of feeding is what nature gives us, and to do whatever is possible to emulate that standard.

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C.T.

answers from Seattle on

My DD also a premie had this issue at 4 weeks old. I struggled to nurse but having had breast reduction surgery as a teen it just wasn't physically working. I was using Horizon Organic Baby Formula. It was bovine sourced. Turns out she can't handle cow milk.

To ease the immediate problem I did NOT do corn syrup which I know many GENERAL (not specialist) pediatricians recommend. I used some organic olive oil and rubbed it into her tummy following the path of her digestive track.

I also did some bicycle type motion with her legs to help things get moving.

I switched to powdered goat milk by Meyenburg and added a very high quality probiotic and liquid vitamin (Pediatrite from Seroyal) from my naturopath to it for healthy flora and vitamins.

The olive oil helped get things moving and the switch to goat milk helped her thrive and grow through the remaining of the first year of her life.

My older sister had been unable to tolerate formula and had to live on goat milk as a baby who was failing to thrive until grandma stepped in. She was the one to remind me to try this with my DD and I'm so glad she did.

My did is now a 4.5 y/o very healthy and active preschooler. She now drinks oat or hemp milk.

I strongly urge her not to do the corn syrup. HFCS is not friendly to the body and has been linked to obesity.

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B.G.

answers from Seattle on

True constipation in an infant is rare. The straining and fussy is mostly like just a new baby figuring out how to get it out. I know they look like they are in pain or like it won't come out,but some babies just poop that way.
In addition, when it comes to poop, there are so many "norms": pooping a little all day, pooping once a day, pooping right after eating, poop of all colors, poop of all consistancies....
If you really think that child is having a problem, this is a question for a doctor.

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M.C.

answers from Seattle on

Both of our kids had to be put on Good Start formula to help with constipation. Taking them to the chiropractor also helped a lot. Within a hour getting adjusted they were usually having a dirty diaper.

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E.B.

answers from Seattle on

My experience personally and professionally looks like he can use calcarea carbonica as a start (homeopathic remedy), and get off formula which is probably soy, many issues there alone. You can make oatmeal milk for dairy intolerant or un-nursed babies, I'll explain how if you write me - already posted it for another mom once :)
Constitutional remedy may or may not be needed to follow.
Best wishes,
Liz Brandegee

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S.G.

answers from Seattle on

K.:
When my daughter has hard stool, I put karo syrup in her milk (about 1 tsp in 6 oz). I had also given her juice too. But I think this was when she was a few months old. Has your friend checked with her pediatrician. Good luck!

-Steph

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M.D.

answers from Seattle on

My youngest had this very same problem. The quickest way to solve it is prune juice. Start with half an ounce prune juice to 3 and half ounces water. Just one bottle a day should be enough. His mom should be giving him water anyways so he doesn't dehydrate.

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S.S.

answers from Seattle on

Yes, I had the same problem with my son. I never produced enough milk and had to supplement with formula. My son had lactose issues in the beginning, so we used soy formula. However, soy causes constipation. Do you know what kind of formula your friend's son is on? I found that Nestle Good Start was easy on the stomach. Also, the doctor recommended that we give him 1 oz of apple juice (Use Gerber's for babies) for every month old he was. So at 4 weeks, I gave him 1 oz of apple juice and that brought everything out! He had a blowout and was totally find afterward. Poor thing. Anyway, periodically I used apple juice, which helped a lot when he was an infant. Now he's fine as he's on solids, etc.

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S.L.

answers from Portland on

Only going once a day is fine (maybe a little unusual for his age, but not unheard of). That it is dry and hard is more of a concern. Is it possible she's mixing the formula with not enough water? I know it's important, if using powdered formula, to mix it precisely. The other possibility is that because it is iron-fortified, the iron is making him constipated. Breast milk has very little iron, but it is extremely well-absorbed. Formula has to be much higher in iron because it is poorly-absorbed. And iron can make anyone constipated. She should consult her doctor and perhaps try another formula to see if he digests it more easily.

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B.S.

answers from Springfield on

Sounds like the formula is too thick. Try adding a little extra water to it. The baby needs more liquid.

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M.C.

answers from Portland on

I have not read all the responses, but we had the same issue. Our daughter was born prematurely and spent several days in a "tanning bed" as we called it ; ). She was formula fed mixed with what little breast milk I could produce. We had constipation issues starting at about 2 weeks. However, our problem was a little more serious. She would only go every 2-3 days and they were hard pellets when she did. Our doctor had us give her 1-2 oz of plain water a day. This seemed to help, but not remedy the situation. However, after a few months she wouldn't take the water anymore.

We still have issues, but she is old enough for us to mix a little bit of juice in to sweeten the water up. Now if we could only get her to figure out a sippy cup!

Good luck to your friend!!

-M.

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M.S.

answers from Portland on

Once a day is not necessarily a bad thing. Each baby is different. Also, very young babies do tend to fuss and strain quite a bit even when the poo is very watery. They are learning to use muscles that were never worked before.
If baby's stool is hard though, that is a problem! For a short term fix, you can give baby prune juice. It is not appropriate to use as a long term fix though, so baby may need to have an adjustment in formula. If it is a cronic problem, tell your friend she should speak to the pediatrician about a new formula that will work better with baby's tummy.

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D.D.

answers from Seattle on

The formula you are using may be an allergen or something your baby has trouble digesting. There are many different formulas out there. I'm sure one of them would be fine for him.

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D.P.

answers from Seattle on

Hi K.,

The formula is most definitely the issue. She should continue to feed him the same formula though because changing his formula could be very stressful to his system; but I would give him a teaspoon (very small amount) of apple juice, once in the morning, once at night. Like 1cc, and she can give this to him with a medicine syringe (that the pharmacists will give you) to make it easier on him. Also, when he starts to get fussy an strain, laying him on his back and moving his legs, as if riding a bicycle, is also very helpful...but to actually solve the issue, I think she needs to introduce just a teeny tiny dose of apple, or even pear, juice to his system.

D. P.
Mother of four (from age 5-age 20)

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K.M.

answers from Seattle on

My now 2 year old suffered with constipation since day one, and he was solely breastfed. When he was about 6 months old I found the trick that worked for him. It was, and still is, 2oz of Welch's white grape cherry juice mixed with 3-6 oz water. I don't really like to give my kids juice, I feel that it is just extra sugar/empty calories, but for my 2yo it works magic on his constipation. I don't know if your friend wants to try giving her baby juice so young, but it may be worth a try.

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A.L.

answers from Medford on

My daughter had the same problem and my doctor said that she couldn't handle regular formula. We switched her to a low lactose formula which helped initially but the problem soon returned. We had to use baby suppositories to help soften her bowel movements. After a couple of weeks on the low lactose my doctor decided to switch my daughter to a soy based formula and we have not had any problems since. Also, if you do switch to a different formula make sure you give it a couple of weeks to kick in. I hope this was helpful.

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K.G.

answers from Seattle on

K., My daughter was so constipated when she was little as well even when breast feeding, I wish she would have went once a day but it was more like every 3-5 days. (It stopped when she started using the potty) I would try switching to Carnation Good Start formula and putting 1 tsp dark caro syrup in ONE bottle a day. That is what all of the moms in my family did when the kids transitoned from breastmilk to formula to make digestion easier. Tell your friend good luck. K.

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A.K.

answers from Seattle on

Hi K..

Has anyone tried to help your friend breastfeed? There are many support groups out there to help, even at 4 weeks she can still do it. If she can, there are so many benefits....no constipation, all natural ingredients, and it's free. Best wishes.

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K.H.

answers from Portland on

Years ago, when my children were babies, any child on formula that wasn't breast-fed, the pediatrician recommended adding about a teaspoon of the dark Karo corn syrup to each bottle. It definitely kept their bowels normal. Formula sometimes has a tendency to constipate (depending on the kind). Hope this helps. Good Luck!

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C.M.

answers from Portland on

Congrats on the new baby boy!! My friend had the same problem with her son at around the same age, 3 weeks. I understand wanting to follow what the ped dr said but sometimes you have to do what would work for a baby that is a little older. My friend was told by her dr to try adding half an ounce of pear juice, 100% juice. Allow some time 6 hrs or so and try another half to full ounce. The rule of thumb is 1 ounce of juice per month of age, per day. So it is not so strong for his system I would try mixing it with equal amount of formula. I would give him the bottle and then a warm bath followed by a nice tummy rub with some warm baby oil. This will help him to relax. I would also, after the bath, put some petroleum jelly on his little bum, not inside but just on the outside. My son has always had really hard stool, and I breast feed, and this was recommended by his ped. It helps the stool to glide a little easier with less strain. Most of all relax. You are doing great. If it doesn't resolve in the next few days I would make a trip to the dr just to be sure there is no blockage. You also may want to check out online what formulas are recommended for more sensitive tummys. Good luck. I hope that this advice helps.

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K.K.

answers from Seattle on

I see quite a few people recommeding Karo syrup/corn syrup - but that is NOT supposed to be used with babies because it has been linked to botulism! Older children and adults have immune systems that can take care of it, but babies do not so it is no longer recommended by pediatricians. As for the problem with the bm's it doesn't sound all that unusual to me for a baby to start having one poop a day around this stage. My oldest son and my younger son both had a stint of not having a bowel movement for days... for both of them this occurred around 6 weeks/2 months of age and the doctor said not to worry unless it went on for 2 weeks! I ended up giving them both a little prune juice or apple juice and tummy massages to move things along.... worked like a charm.

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A.W.

answers from Seattle on

This happened to me with my baby. I switched her formula and she was seriously a different baby. SO SO much happier. I switched her to Nestle Goodstart and it was like a miracle for her. In any case, at least call the doctor and see what he recommends. The baby shouldn't be straining and going red in the face when he has to poo. A lot of doctors say it's too early for juice and that babies shouldn't really have juice until 4-6 months old. The doctor will probably recommend switching the formula. If not, bicycle kicks help and so does doing them in a warm bath. They have over-the-counter glycerine suppositories that will also help. I really can't recommend Goodstart enough though. And be aware that it takes 2-3 days for the new formula to start working. If she switches it will take a couple days for it to get better. Hope this helps! I know it's no fun to have a fussy constipated baby. If she can get tht fixed her life will be so much better!

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S.H.

answers from Seattle on

I strongly suggest baby suppositories, as my family practice doctor of a grandfather advised my mom with her six kids. I used them with my five kids. They work very well to teach the baby what muscles to use to push out gas and poop. Remember this is a person who hits him/herself in the head with their own arm--just as they don't know about their own arms, they also don't know what to do when they have gas.

The suppository is available at all pharmacies. It is harmless. It is a rounded stick made of glycerin and just melts away to nothing in heat. It is tiny.

Put the baby on his back on the changing table with the diaper underneath to catch whatever comes out. Grasp the baby's feet and pull up to expose the rectum. Warm the suppository in your fingers to make it slippery. Gently insert into the rectum about 2/3 of the way in. Wait. sSme gas may escape or the suppository may pop out. Re-insert. Wait. Meanwhile, if the baby was fussing, as soon as the suppository goes in, the crying stops. The baby gets this very funny look of concentration on his face. Soon gas and poop come out. If you suspect there is more to come, re-insert.

Remember, these newborns hit themselves regularly with their own arms since they don't know they are attached. Similarly, they don't know what to do when they have gas pains or even the urge to push. The suppository teaches them where to push.

The suppository will not cure the underlying reason for the constipation, but it will resolve the symptoms. We used to use karo syrup and warm water also to help out with cosntipation.

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T.O.

answers from Portland on

Both my babies fought constipation, due to the iron in the formula. I gave them a teaspoon or 2 of prune juice in their bottles each day. My doctor said it wouldn't hurt them. My kids really struggled and were in pain, so I a little juice was worth giving them relief. I know people also use dark karo syrup in the bottle in a pinch. It is too hard to watch your baby be miserable, try the prune juice!

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C.P.

answers from Bellingham on

My pediatrician recommended a teaspoon of dark karo syrup in 4 ounces of warm water when my kids got constipated as infants. It really helped them alot.

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C.K.

answers from Seattle on

Hi there,

A few things you might try:
- switching to a hypoallergenic formula like nutramagen lipil (the orange cans, which unfortunately do cost more). The baby may be sensitive to dairy, which lots of formulas contain.

- giving the baby about 1 tsp of cod liver oil daily; Carlson's brand is very refined, tastes like lemon, no risk of mercury, and babies and kids tend to love it. It softens up the stool, and is also good for brain development, respiratory and skin health

- adding some probiotic to formula daily; you can buy regular acidophilus capsules (only buy refrigerator-kept brands) and just open a capsule onto a plate, then moisten and dab your finger into the powder - the baby will suck it right off your finger. Helps normalize bowel flora and often helps constipation.

Hope that helps,
C. K

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D.S.

answers from Anchorage on

I have two girls and both have/had Bowel issues. He needs to be seen by a Pediatric Gastroenterologist. The difference with mine are they were both nursed and did not start having problems until they were around 12 mths.
There is an answer, though he needs to be seen and some tests may get done. Both of my girls have been treated with an easy remedy.
My Peds. Gastro. dr. says one in every four kids has a bowel issue and that sometimes is it more noticable than others. I hope that this helps and that your friend takes her baby in soon to be seen. It is not easy watching your child struggle to have a bowel movement.

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M.P.

answers from Portland on

Formula can be constipating because of the added iron. She should of course talk to her pediatrician, but many will advise you to put a little bit of prune juice in with the formula to help with constipation.

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M.W.

answers from Seattle on

teaspoon of karo syrup in each bottle is what a leading GI doctor told me to do because my daughter had the same promblem. Soy is really a constipating. The karo or any corn syrup makes the stool soft w/o making it runny. Im cheap so Mrs. Buttersworth at costco is what I used because the main ingredent is corn syrup. It worked great!
Good luck
M. Whelan CST

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N.B.

answers from Seattle on

I would definitely recommend that your friend takes the child to the doctor again. If the doctor saids nothing is wrong, take the child to a different doctor. No matter how much she likes and respects the doctor, he/she is only human. Get a second opinion!!! Something else could be wrong.
Best of luck to you.

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J.N.

answers from Seattle on

I would switch formulas. Constipation can be a sign of a dairy allergy or intolerance. She may need to try a low lactose or soy based formula. Although, some babies are also allergic to soy. We used to put a splash of prune juice in with my daughter's milk to help with this issue, but that was after she was a year old. I wold talk to the doctor about what is recommended in a baby that young.

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