Baby constipation can be as stubborn as a strong-willed baby !
A few months have passed since we dealt with newborn constipation. Your baby has grown up, things are hopefully becoming a little easier.
You are getting more sleep at night – even though for most parents the nights will still be very much interrupted. But little by little, a routine is being established.
There are a several episodes in your child's early life that might trigger baby constipation. The main one, as we will see in details, is the introduction of solid food. In addition, your baby may be dragging constipation from his first weeks of life.
This article builds upon the newborn constipation article, for which we defined a good framework for this discussion. In a first step, you should review that article, all remedies given for newborns still apply to older babies.
But because your baby is now a little older, you have a few more options in front of you. As you introduce solids into her life, your most important tool will be a wide array of nutritional and tasty foods.
For me, as a father, the introduction of solid foods was always an exciting moment. I enjoyed feeding the babies, introducing new foods and flavors and noticing how they react. I love to eat and cook too, so having them share table habits was quite a milestone.
The introduction of solid food can do one of the three following things:
Those cases need to be tackled separately.
This is the most common case. The first thing you need to ask yourself is this: is your baby ready for solid foods?
The instincts of a baby are usually in tune with her body needs. If the gastrointestinal tract of your baby is not ready yet, she may experience transit issues. When your baby is ready however, she will let you know. I have three sons, and they all signaled their “moment” at different age.
My first son was very curious early on. He was around 4 months old and my wife and I just couldn’t put a fork in our mouth without him trying to intercept it. He was looking at us with big round eyes when we were having a meal, mouth open, gaping, gesturing forward to grab what was on the table. The signs could not be more obvious.
My other two sons waited a little longer, probably around month 6, before they showed an interest in solid food. I would say that 4 to 6 months is the usual range.
Common sense also dictates that your baby is able to sit in an upright position, and is able to hold her head steady and straight. That should be pretty obvious.
Assuming your baby was indeed ready for solid food, the second thing to look at is the type of food you feed her. We have a detailed section on foods that prevent baby constipation further down.
In this case, the introduction of solid food countered the effect of formula milk intolerance. We spent quite a bit of time discussing formula milk and constipation in the "newborn constipation article", I am not going to repeat this whole section here. Please refer to that article.
I will just remind you of this: studies have shown that certain types of formula milk, those containing cow’s milk in particular, induce baby constipation in a significant portion of the children studied. Therefore, lots can be done in terms of experimenting and selecting the formula that will not upset your baby's transit.
But in case you haven’t been able to find the appropriate formula, there is hope! The fact that solid food is providing relief means that solids are actually much better tolerated by your baby than formula milk. As you progressively move her to more solids, her baby constipation will go away.
In the meantime, please review the “remedies” section of the newborn constipation article, step 1 through 7. These are good recommendations to keep in mind.
If your child did not experience baby constipation before the introduction of solid foods, and is still not constipated – fantastic! You are probably reading this article just to stay informed, which is very proactive of you.
If your child had baby constipation before, and still is constipated, then I recommend the following 3 steps:
The primary goal of this section is not baby constipation prevention. The goal is to provide a sound nutritional plan for your baby, giving her all the good nutrients she needs for healthy growth and development. Being constipation-free is merely a byproduct of sticking to a good, natural and nourishing diet.
I hope I can convince you to prepare most of your baby meals from scratch. If your child has baby constipation, this will be a must. Preparing her meals is not hard at all, neither it is costly.
Can you boil a broccoli head with a carrot, grind a piece of chicken, mash everything together and add a sprinkle of olive oil? If you answered yes, you are ready to proceed.
And then it gets even better. As your baby grows up, say around 9 months of age, your best cook will be the food grinder. Take a small portion of what you prepared for dinner, and grind it. Your baby will love diversity. Of course, this assumes that you also follow a balanced diet free of potential constipation triggers.
On the other hand, don’t be consumed by guilt if you use jarred baby food once in a while. They exist for a reason – help the busy parents. Try to find a brand that provides organic food of good quality (shop at your local organic food store, or at larger organic store chains that carry good products).
Rate of introduction
Even the healthiest food requires baby to adapt to it. Every new food is a new experience for her gastrointestinal tract. You need to take it slowly, introduce one new type of food at a time, and let her adjust. Ideally, you should wait 4 to 5 days before the next introduction.
Cereals and rice
I am going to ruffle a few feathers here. I do not like baby cereals. First of all because in my nutritional approaches, I lean toward an ancestral type of diet (also called paleo diet). Second, I have observed that baby cereals constitute one likely trigger of baby constipation.
So if your baby has a tendency to get constipated, I recommend that you stop using baby cereals. I also recommend that you avoid white bread, crackers, pastas and other type of cereals like cheerios (I know, one of the best finger food ever invented).
I also recommend that you remove rice from your baby’s menus for a while.
Pureed vegetables should constitute a large part of baby’s menus, and will be the main source of fibers. They are the most important part of this baby constipation prevention diet. Taking the time to buy fresh organic vegetables, locally grown, steam them and puree them yourself is obviously preferable.
Most babies love sweet potatoes. They have a slightly sweet taste, and their texture is rich and creamy. Sweet potatoes have a high nutritional value, and bring lots of vitamins, minerals and antioxidants.
Your baby should also appreciate pureed ripe avocados. Like sweet potatoes, they provide a rich creamy texture and bring lots of good fats to your growing baby. The fat content of avocados provides a good stimulation to the gallbladder, which usually helps transit.
Carrots are rich in fibers and contain a significant amount of beta-carotene, a powerful antioxidant protecting us against oxidative stress. The body will also transform beta-carotene into vitamin A, an essential vitamin for the growth and development of your baby. Just like sweet potatoes, carrots have a slightly sweet taste that your baby should like.
Tomatoes also have a slightly sweet taste, and are rich in anti-oxidants. The main anti-oxidant of tomatoes is called lycopene, and has been discussed quite extensively in the health literature recently. Lycopene is released when the tomato is crushed and cooked, and is more available to our body when served with oil (lycopene is fat-soluble). Therefore, the best way to prepare tomatoes for your baby is to buy them ripe, cook and puree them to make a smooth tomato sauce, and add a bit of olive oil or butter for better absorption. You can add a spoonful of this tomato sauce to your pureed vegetable mix and freeze the rest for future use.
Broccoli has many health advantages. It is full of vitamins, minerals and anti-oxidants. The best way to preserve broccolis to keep their vitamin content is to gently steam them so that they become soft but not overly mushy. Broccolis can then be pureed with other vegetables.
I like to add sweet peas in some of the pureed mixes because they add a nice green color along with a creamy, rich texture. They too are full of natural fibers, vitamins and minerals essential to the growth of your baby.
This list is not exhaustive of course, the key is to play with a wide variety of vegetable colors, textures and flavors. Here are a few more ideas:
If your baby like a particular vegetable or vegetable mix, don’t hesitate to make large batches, puree them and store them in separate small containers in your freezer. You can then thaw them as needed and mix and match in different combinations.
There is a variety of fruits that your baby will enjoy. You can cook the fruits yourself, or you can find good quality jars (always read the label to make sure the jar only contains the pureed organic fruit).
Try a variety of fruits, including: pears, peaches, apricot, raspberries, prunes, etc. Make sure you buy organic to make sure pesticides don’t end-up in that jar.
Here are the fruits you should avoid if you are dealing with baby constipation:
Here are the fruits you should propose frequently if you are dealing with baby constipation:
Juices are not recommended in general for babies, but can be handy to solve a baby constipation crisis. Try to use one to two ounces of diluted (half juice/half water) prunes or pear juice twice daily, prunes being more effective than pears.
Once the baby constipation crisis is averted, discontinue fruit juices and rely on prevention only via good nutrition.
Meat, Fish and Eggs
Your baby needs proteins and nutrients provided by meat, fish and eggs. Please do not try to give your baby a vegetarian diet, whatever your beliefs are.
In this section, you will see me repeating over and over one point: make sure you know where the eggs, meat and fish are coming from. Yes, it is a pain to have to check everything we buy. But please trust no label. Do your homework, ask the stores the tough questions. If they cannot answer, walk away and go to another store. Your baby is worth the effort.
The 1980’s introduced a lot of bad press on eggs. Supposedly, they had bad fats and cholesterol. The low-fat craze of that period dictated that two eggs a week were a grand maximum, more and you would face the risk of increased heart disease.
Erase all of that from your mind. Throw away those old books and magazines. We know better today. Eggs are very healthy.
But here is the important factor. The good fats are in the good eggs. You need to buy organic eggs from free-range hens. Beware of the egg industry, they know how to use and abuse the labels (e.g. the “organic free range” one). So ideally, try to find a local provider at your farmer’s market. Eggs from battery raised hens do not contain the right balance of the good fats. Avoid those.
The egg whites are almost pure proteins, they are therefore good for your growing baby, participating in the building of organs and muscle mass. But the yolk is even richer in essential nutrients, particularly vitamins (A, D, E, B12) and a very essential nutrient: choline, which is involved in neural and brain development.
Some people are allergic to eggs. If egg allergies run in your family, check with your pediatrician to see when to introduce eggs.
In terms of cooking them, the usual advise is to cook them well (scrambled, hard boiled) to make sure the risk of salmonella is averted. But salmonella is a problem that mostly exist in the context of battery raised hens. Local eggs from local farmers who care about their hens do not present as much of this problem. Some of the constituents and fats of the yolk are fragile, and the best way to protect them is to soft boil the egg, then empty it and mix the whole egg with the vegetable mash.
Chicken is also a very good source of proteins, which is important for the growth of your baby. Gently cook chicken breast in olive oil, then grind it finely and mix it with the vegetable mash. Alternately, you can boil the breast in a bit of water with thyme, rosemary and a clove of garlic.
Of course, other type of birds are very good too, and will vary flavors and tastes. If you can find duck breasts, quail or other type of birds, by all means give it a try. Diversifying your baby’s food sources will ensure she gets all the nutrients she needs to ensure a healthy growth.
As usual, make sure you don’t buy battery raised chickens. Those chickens live a very sad and sick life, they fight all day, some are wounded, and they are fed industrial pellets that do not look like food at all to me. This type of meat will be empty of nutrients.
Beef is a great source of iron, and iron from red meat is much more absorbable than iron from vegetable sources. Iron is a building block of hemoglobin, a protein contained in our red blood cells, which carries oxygen from the lungs to the different parts of our body. Iron is essential to life, and is involved in many processes at the cellular level. Your baby needs a good source of available iron, and red meat is one of the best sources.
The same comment made for chickens applies for beef. Buy organic beef from animals raised in open spaces with access to grass and able to eat grass at least for a large part of the year.
Cook the meat gently in olive oil, then grind it finely and mix it with the vegetable mash. Or just like chicken, you can boil it in a bit of water with herbs and a piece of onion or a clove of garlic, then grind it.
Fish is also a good source of protein, and a good source of iodine. Fat fishes such as salmon, mackerel and tuna are very good source of essential fatty acids, including those in the now famous omega 3 family, essential for the development of cerebral functions.
Select fishes that have the lowest risk of mercury contamination. Avoid the following fishes which contain the highest levels of mercury(1):
Instead, prefer the following fishes that contain the lowest level of mercury(1):
Of course, out of that list, pick those that do not contain a lot of bones and that can be mashed easily. Sardines are easy to deal with (once the central bone is removed).
Forget about the fat-free craze of the 1980's. Good fats are essentials to life. Mother's milk contains lots of fats for a reason. Good fats are essential to the growth of your baby.
First, make liberal use of organic mechanically pressed olive oil. Drizzle olive oil in your baby’s mash.
If your are dealing with baby constipation, add half a teaspoon of olive oil to the first bottle in the morning, to encourage the gallbladder of your baby to release more bile, our natural laxative.
I am also a strong believer in the value of organic “farm fresh” butter. A bit of butter can be melted in the vegetable mash. But not all butters are made equal. Industrial, regular supermarket butter is not as digestible.
I also like coconut oil, which adds a sweet taste to foods. Half of the fatty content of coconut oil is lauric acid. It also represents 6% of the total fat content of breast milk. If a mother makes so much of it to feed her baby, it must be packed with nutritional qualities. Coconut oil is solid at room temperature, but will melt easily when you add it to baby's warm mash.
As explained in the “foods that cause constipation” article, milk and dairy products can be a major baby constipation trigger. One study quoted in that article concludes that "a clear association between cow's milk consumption and constipation has been found in more than one third of children".
So if you are dealing with baby constipation and if you want to play it safe, I recommend avoiding dairy products. There are better sources of calcium in the vegetable world (look-up the calcium and other mineral content of vegetables on the internet, you will be pleasantly surprised). Milk proteins can be replaced with egg, meat and fish proteins.
As always, part of what makes dairies so indigestible for some children is probably the complex industrial processes being used today to transform milk.
If you want to try dairy products nonetheless, please make sure you buy dairies made from non-homogenized milk. The homogenization process breaks the fat bubbles of milk into tiny droplets that are not well digested. Our stomach needs to curdle milk in order to digest it. Homogenized milk cannot be curdled, and it is believed that the tiny fat bubbles obtained via homogenization pass undigested into the blood, causing health issues (in addition to baby constipation) in the long run.
When it comes to cheese, buy cheese made from raw organic milk, and offer tiny cubes to your baby, making sure she does not choke on them.
Herbs, spices and other flavors
I assume that just like me, you do not enjoy bland foods. Why would your baby do? Over the last decades, we have evolved toward a very bland model of baby nutrition. Rice, pasta, and other “empty calorie” meals without much of a well defined flavor.
In certain cultures, herbs and spices are introduced early in the child’s life. In the south of France, parents don’t hesitate to add a twig of thyme or rosemary to the boiling water when preparing the vegetables for pureeing. In Latin America and other Asian countries, babies are given moderately spicy food on a regular basis.
So make the eating experience fun and flavorful. Here are my favorite adds to the cooking water, adding not only taste but also health benefits.
If your baby does not like the new addition, remove it and try something else. This is not an exhaustive list. Be innovative! Ground fennel or cumin seeds maybe?
Some babies are allergic to certain types of foods. If your baby has eczema for instance, you will have to be careful with the introduction of eggs, dairies and fish.
Stick to the simple approach of introducing one new food at a time, and giving your baby a few days to process the new addition. If it makes the condition worse, remove it from her meal plans.
If allergies, asthma or eczema runs in your family, be particularly careful.
Important note on storage
Do not freeze precooked food in plastic boxes or ziplock bag. There is good evidence that both of those containers leach toxic and carcinogenic substances into the food.
Instead, I recommend buying small glass containers. In certain health food store, you can buy yogurts in small glass jars. Save those jars to store small batches of food, with a piece of wax paper on top, kept in place with a rubber band.
We have covered a lot in the previous section. Now that we have reviewed the different food categories and types, we need simple rules to mix those foods and create an appealing, flavorful menu.
Here is what I suggest:
Fruits can be kept for snacks.
Taste the mix. Do you like the flavor? Does it tickles your taste buds? If yes, your baby will surely enjoy it. If not, think about how you can make it tastier next time around.
Here are some additional tools you can use to address baby constipation:
In this article, we have focused on nutrition as the best natural remedy to prevent and act upon baby constipation. We have seen that some categories of foods are best avoided: cereals, rice, dairies, and certain fruits like bananas.
We have stressed upon the importance of buying the right type of food too. I am a practical person, and I have never obeyed the organic marketing craze unless there was a very good reason behind it. Unfortunately, the organic label has been overused and abused lately. The future of food is buying local, from a place where you can see for yourself how the cows or chickens are raised, how the vegetables are grown.
Farmer’s markets are a great place to start. They are now running in more and more cities, and are a place where you can initiate one-on-one discussions with local producers.
Finally, we have evoked additional tools to help with baby constipation. The 7-steps approach presented in the “newborn constipation” article can be, of course, still used for your growing baby.
Let thy food be thy medicine and thy medicine be thy food”.
Hippocrates (460 B.C.)
(1) Food and Drug Administration, "Mercury Levels in Commercial Fish and Shellfish (1990-2010)"