Recently, Nayul seemed a bit off. She strains so hard but still seems unsatisfied! She does have bowel movements once or twice every 1-2 days, but the consistency and amount are questionable. They resemble goat droppings and are about half the size of a thumb. As a parent cleaning her, it's nice that it's less messy, but it's still concerning. I had a feeling she might be constipated and started researching. I've tried stomach massages, mimicking bicycling legs, and consistent probiotics, but nothing seemed to work. 😭
Then I found an emergency measure that suggested stimulating around the anus, so I gently prodded the area with a cotton swab coated in Vaseline for about 5-10 minutes. Fortunately, this seemed to help. Three hours later, Nayul had a soft bowel movement. 😭 However, I hadn't identified the root cause. While researching, I wondered if the problem might be with the formula preparation - perhaps I had used too much water (from 110ml to more than 130ml). In retrospect, I should have been more careful in mixing the formula. Sorry, Nayul..😭
Newborn Constipation
According to the National Health Information Portal, a 1-3 month-old baby typically passes stool around 3 times a day. Breastfed babies might do so 7-8 times, whereas formula-fed babies do so 1-4 times. As babies grow, the frequency and consistency of their stools change, depending on their diet.
The primary reason for constipation in babies drinking formula or breast milk is either due to an inability to digest protein or an imbalance between nutrients and hydration in the formula. If a baby is formula-fed, it's crucial to check the preparation ratio, especially the water content. Dehydration can lead to constipation.
Solutions for Newborn Constipation
When breastfeeding:
While the color of the feces can be influenced by the mother's diet when breastfeeding, constipation is less likely. However, if the baby does get constipated? Consider factors such as the amount of breast milk or frequency, and then try to increase the amount (e.g., consume lactation teas, feed in the early morning, pump more milk after breastfeeding, etc.). Increasing the amount of breast milk may not be achievable with just one or two attempts. If it's urgent, you might also want to consider mixed feeding.
When formula feeding:
If you're feeding formula like Nayul, first check the ingredients of the formula. If that doesn't seem to be the problem, reconsider the proportion in which you mix the formula. Since Nayul was drinking formula with A2 protein similar to breast milk, I thought the manufacturing ratio was the problem (crossed out as it sounds promotional). Initially, I fed according to the guidelines on the formula container, which was 110ml (10ml of formula + 100ml of water). However, when trying to increase the feeding amount, I changed it to more than 130ml (12ml of formula + at least 120ml of water). The problem arose due to the increased water content. I thought more water would hydrate the baby better, but this was a misconception. Because of osmotic pressure, when the concentration of the formula gets diluted, water is extracted from the intestines. A concentrated formula helps to alleviate constipation by absorbing water from outside the intestines, making the stools softer. But, consistently feeding this way can cause dehydration, so caution is necessary! If feeding formula, it's essential to measure correctly. In Nayul's case, the main cause of constipation was the incorrect formula ratio. Starting today, my wife and I plan to discuss the formula ratio in more detail.
Common solutions:
1. Temperature Regulation: This point can't be emphasized enough. Sweating can lead to dehydration, which can result in constipation. If the baby gets too hot, there's a risk of Sudden Infant Death Syndrome. So, always ensure the baby isn't overheated.
2. Hydration: This was mentioned above, but always check if the baby is hydrated. The ratio of formula is crucial! I'm sorry, Nayul.
3. Tummy Massage: Massaging the baby aids in growth and development. For digestion, massaging the belly can be beneficial. For infants, you can massage in a clockwise direction around the belly button. See the "Newborn Massage" section for reference.
4. Probiotics: Pediatricians encourage the use of 'probiotics' and 'prebiotics' for conditions like gastritis, irritable bowel syndrome, colic, and eczema prevention. For constipation relief, it might be worth trying. Nayul has been consistently taking BioGaia for vitamin D intake since the postnatal care center. Refer to the 'BioGaia Baby Drops' section.
However, the above solutions may vary depending on the baby's condition. If the baby, like Nayul, shows signs of discomfort and stress due to indigestion, what should we do?
Misc. Anal Stimulation:
In Nayul's case, I gently stimulated the anus with a cotton swab dipped in Bepanthen. You can use baby oil or any non-irritating product. I didn't insert the cotton swab directly (although I've seen advice suggesting to insert about 1cm for 1 second, which I don't recommend. If it's severe, maybe it's better to visit a hospital).
After the stimulation, it seemed that Nayul's constipation resolved. About 3 hours after, she had a normal bowel movement. The formula ratio problem needs further consideration. Nayul went from having hard dark brown feces due to constipation to having softer stools after anal stimulation. Well done, Nayul 😍.
Event of May 18th, 2023.