Formula and Constipation

Updated on June 10, 2007
L.E. asks from Downingtown, PA
24 answers

My question is everyone's experience with formula and if their babies get constipation. My first son got constipated and then blood in stools. Now my second son has been constipated off and on since we brought him home 3 weeks ago. I currently breatsfeed for 10 minutes or more on each breast and then supplement with 3-4 ounces of formula (I do not produce enough milk to exclusively breastfeed - my 3 sisters have all had same problem) When we brought him home - 3 days later we had to give him a suppository. We have done the tummy rubs and leg movements too. We have now been doing 1 tsp of karo syrup in a bottle - it gets his bowels moving, but he gets cranky and painful as well as gets watery stools for 12 hours after - then binds up again. I cannot do the karo syrup any more and now the ped is recommending prune juice and water. This is driving me nuts - does everyones child on formula get constipated? Has anyone else gone through this - I am so stressed

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M.T.

answers from Philadelphia on

Hi L.,
I wasn't able to breastfeed my daughter, so she was on strictly formula, but I had a terrible time with her constipation. I switched to a soy formula and it was so much better.

Missy

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L.M.

answers from Philadelphia on

I would ask the doctor about switching formulas. I had the same problem with my son. I did the whole Karo syrup, I didn't try the prune juice because I thought it was harsh. He was on Similac with Iron and I tried Enfamil Lipil, it was easier on his stomach and was going regularly.

Hope this helps.

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J.R.

answers from Allentown on

Wow. That seems like a lot of a supplement for a 3 week old baby. None of my 4 kids would take that much from a bottle until they were well over 6 months old. We actually never bought bottles bigger than 4 oz. All 4 of my kids were breastfed, with pumped milk in bottles because I was working.

Also, the feed time seems short. Mine always fed for much longer than 10 minutes per breast at that age -- at least the first breast. I'd nurse the baby on the first breast until the baby seemed disinterested (about 10 minutes), burp, then put the baby back on the first breast for another 5-10 minute session. It really is important to feed long on the first breast to make sure your baby is getting enough hind milk--the high calorie milk.

I see babies consuming 8 oz bottles, and it really amazes me. Why? Because the stomach of a 16 lb baby is barely 3 oz in capacity. So where is all that milk going? The stomach is flexible...but it's at a cost. Every time a baby consumes a big bottle like that, they are getting the "Thanksgiving full" kind of feeling. And they are learning that this is the feeling they should aim for when eating. I suspect that this is why babies who are bottle fed (regardless of whether it is breastmilk or formula in the bottle) tend to be more likely to be overweight as adults than babies who are breastfed.

Getting more breastmilk into your baby is going to be your best bet at beating constipation. At 3 weeks of age it is still normal to be feeding 12 times or more a day if you are breastfeeding--especially since 3 weeks is "growth spurt" time. So given that...if you aren't already feeding that frequently, I'd encourage you to give it a try. In the daytime, feed your baby every 1.5 hrs in the daytime(or when he cues). This is probably going to work out to feeding him every time he wakes up from a nap, and then again before he goes down. After a feeding, supplement, but perhaps try cutting it back to 1 oz (because a 10 lb baby's stomach is only about 2 oz...and hopefully your baby is getting at least an oz a feeding from you). By feeding every 1.5 hrs in the daytime, you will hopefully be able to get some longer spans at night between feeds.

Also, after your morning feeds, try pumping. That is when you have the best milk supply. Use this pumped milk in supplmental bottles before using formula. Actually, I'd encourage you to consider using a supplemental nursing system rather than bottles--this will keep the baby at the breast more, and stimulate more milk production.

After about a week of 12 times per day feeds, you might be able to cut back to 10--watch your baby's cues. Some women never really cut below 10 feedings in order to maintain supply. My babies never dropped below 8 nursing sessions/bottles prior to 12 months of age--and by then they were eating 3 solid meals and 2-3 healthy snacks per day.

Of course if you cut back the total volume of supplements, make sure to check in on your baby's weight after about a week. If he is still gaining, you might consider cutting back the supplements again...and who knows, you might just be able to make enough milk after all.

Hugs!

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M.H.

answers from Philadelphia on

Hi L.:
I had the same problem with my daughter and it turned out that she was having trouble digesting the cassein protein in the milk based formula.
Milk is made up of two proteins, cassein and whey. cassein is bigger - similar to consistency of cottage cheese and harder to digest, while whey is like a liquid. (think of little miss muffet eating her curds and whey)
Small children often have trouble digesting cassein because their digestive system is not fully devloped. Most outgrown this problem by age 2.
Sorry for the Chemistry lession. Anyway, we switched my daughter to "Good Start" Formula which is only made up of broken down Why protein and she didn't have the problem any more.
P.S. Another mother brought this to my attention -- when I asked my pediatrician, he said it would not do any good to change formulas, but I went with my gut and did anyway. It made such a difference.
Hope this helps you. Good luck.

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T.D.

answers from Philadelphia on

I have many friends who have had problems with that new additive in the formulas. I think it is called DHA. You may want to switch formulas to something softer like Good Start or something without that additive. I had to do the prune juice with my older son. It did work, just make sure to follow the ratio recommendation. Hope things getter easier for you. Nothing is worse than a baby in pain.

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S.B.

answers from Albany on

Hi L.! My first daughter had the same problem (minus the blood). I tried the Karo Syrup and I think your son is too young for the juice but tried that when she was 6 months or older actually. Eventually what did the trick was switching my daughter from Similac (tried a few brands) and moving to Enfamil Lactofree. My second daughter (who is 5 months old) started on Enfamil Lactofree and we haven't had that problem. You may want to talk to your doctor about the switch if you aren't on Enfamil Lactofree already.

S.

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N.G.

answers from Philadelphia on

We had the same problem with our kids. All of them wound up having to be put on a lactose free formula. They could not tollerate the regular formula, soy, or any of the expensive non fussy formulas. I have a two month old and he had the same problem as my two older ones. I would breastfeed and then supplement also (don't produce enough due to breast reduction)YOu could tell when he had been breast fed and when he had formula just by his bowel movements the conistency was totally different. I purchased the store version since it is cheaper and the same thing. We were purchasing it from Walmart but for some reason the ones around here are no longer carrying it. I had to buy a different one to get me through and we bought the gentle ease figuring it was made for babies with problems. He went right back to the same fussiness and constipation. Finally I went to Target and they have it too. Hope this helps.

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R.K.

answers from Philadelphia on

i also ha the same problem my son would cry and screen every time he pooped and the dr told me it was fine as long as the poop was able to be squished well i told him FU and went to someone else. I personally switch his formula against medical advice to neutramigin or how ever its spelled its a lactose free formula that is really gentle on baby tummies it is an orange label with a bunny on it kinda like peter rabbit. it did wonders for my son as a baby but smelled like dog biscuits. lol well worth it. also mlycon droops worked really well for his gas. my husband says it like the infant version of beno. i would say talk to your dr or get rid of him and find another and look up information on these educate your self don't rely on the dr to know what your child needs all the time if your motherly instinct says its wrong then it is.

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H.F.

answers from Pittsburgh on

L.,

You didn't mention which formula he was on. Sometimes a change in formula can help. I noticed with both of my kids that Similac constipated them. They were okay on Enfamil, the Sam's Club brand (Members Mark), the Walmart Brand, and the Target Brand. The Nestle Good Start (with the proteins already broken down) was the one where the bowels were a little looser.

With my cousin and her son, since she was breastfeeding they told her when she supplemented to use the Soy formula. They told her it was easier for the kids being breastfed to transition to. (That was 8 years ago.) If it is a problem with lactose from cows, a change to the soy may help.

There are other specialty formulas in each brand as well. They are usually more expensive. Ask you doctor about trying a different brand. I would recommend trying the Good Start if you are having that many problems with it. Also, let you doctor know exactly what is going on. It is probably nothing serious at all but it is better to have him checked than to wonder and worry.

With my daughter, I breastfed for 6 weeks. Each time she ate, I would feed her for 15 minutes on each breast, supplement her with formula, and then pump for 20 minutes and then would get to rest for about 20 minutes before we started again. My milk supply would not increase and at 6 weeks I was so exhausted that for my sanity and health, we switched to formula. With my son, things were much better. However, even with him eating voraciously at the breast, he was not gaining as he should have. Again, I breastfed and supplemented him. His supplementation was always approximately 2-4 oz. My point is that trying to breastfeed only may be a commendable goal but it doesn't work for every mom. Some of the messages made it seem like that was the ultimate answer. That isn't always the case. You have to do what is best for your family. If you are able to breastfeed exclusively, I congratulate you and commend you for the work and effort. If you aren't, don't feel guilty about the inability. If you want to and aren't able at the moment, get in touch with your local La Leche League. They are able to offer you support and advice on how to increase your milk supply. They were able to help me with my son. At the same time, if you have a happy and healthy child who is getting the nutrition he needs, don't worry about how other moms say to do it. Be guided by the advice that works for you and your doctor. You and your doctor are the ones who can ultimately tell if what you are doing (food wise) is working for your son.

Good luck and enjoy your new baby.

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H.P.

answers from York on

dear L.,
i feel for you...and myself!! right now i have a 5 mon. old who is now on formula full time, and i am going through the same thing. i also went through this with my other two childern. i can't stand the karo syrup either,however i started giving my son water a cuple times a day and that seems to help for whatever reason i don't know? i never tryed this with my other two so i can't tell you that this well work for you, but i thought you might like to try it and see. good luck and let me know if you ever find something that works([email protected]____.com) -H.

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N.P.

answers from Philadelphia on

Hi L.,

I am so sorry you are having problems with formula. Both of my boys were strictly formula fed babies and I had no problems with constipation with either of them except for the occacional bout once they started cereal. I agree with some of the other comments, Nestle Good Start seems to be one of the better formulas. I have also used Similac Alimentum (expensive, but my insurance reimburses me for it). I would recomend trying Good Start first. A number of my family and friends swear by it. Good Luck!

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C.C.

answers from Philadelphia on

since you are supplementing with formula i would switch to a non allergetic one like nutramigen (enfamil) and that may ease his problem.

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L.H.

answers from Philadelphia on

My son had the same problem when I put him on formula. It was awful, I felt so bad for him. If you take Fenugreek (sp?) that helps amazingly with your milk supply and maybe you wouldn't need the formula. My son is 9 months and only gets breast milk. It's just so much better. Good Luck, I hope everything works out for you. Oh, and a little prune just with mostly water will help.

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J.Y.

answers from Pittsburgh on

Try different formulas. I swear by Carnation Good Start. Try the kind without DHA and ARA as I have seen this cause problems with constipation in the past.

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S.C.

answers from Philadelphia on

Supplementing may sabotage your milk production. Supply & demand is how breastfeeding works. Also, the amount of formula seems to be a lot for a 3 week old. It seems that he may not be working the breast and just waiting for the bottle to come. Possibly trying less amounts of more more frequently will be easier on his digestive tract unless he had allergies to the formula. BM's with green/loose stools are a red flag. If you commit to the breast it may be the maximum help for him. It is still early in milk production and baby on the breast is key. It may need to be every 2 hours for at least 20 minutes for it to be more productive. It can be hard but given time it usually straightens out with supply and demand.

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N.R.

answers from Pittsburgh on

I had issues with my son over this too. Try to switch to a lower iron based formula.
That should do the trick.
As for juice, pear juice woked like a charm with my child/

Good Luck

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J.B.

answers from Pittsburgh on

Hi, L.! The only thing that worked for both of my children- much to the aggitation of my pediatricians was Enfamil Lipil LOW IRON. The arguments that I had with them finally got so bad that I said that I switched to regular EHi, L.! I decided to just send you a message because you had so nfamil and didnt. My entire family cannot digest high amounts of Iron. It sounds to me that your family may be like that also. Why don't you give Enfamil Lipil Low Iron a try. It worked wonders on both of my kids. Also before you use prune juice try pear. It's much easier to drink and causes less gas.

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R.I.

answers from Philadelphia on

when she was about a month old, my daughter was constipated for 2 weeks while i was breastfeeding. i was also supplementing with formula and tried the Enfamil Gentlease. it seemed to work with her fussiness and gassiness. i put about a tablespoon of prune juice in each formula bottle she received also but my ped told me she was too young for that.

it is said that breastfeeding babies sometimes don't have bowel movements every day and i was very worried and frustrated after my daughter didn't have one for over a week. she seemed so uncomfortable and in so much pain. then one day she finally pooped and it's been smooth sailing ever since!!!

when my first daughter was a baby and had this problem, i took her to my old ped and he stimulated her rectally with a thermometer. lay the baby on it's belly and put a little vaseline on the thermometer tip and insert the entire silver tip, about 1/4 inch into the butt and wiggle it around a bit. if you don't feel comfortable doing it yourself, go to your ped and he will show you how to do it.

i hope this helps and i hope your son has a bowel movement soon!!! you can also try loosening his diaper a little bit and moving his legs around like he's pedalling a bike, that helps with some discomfort too.

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S.

answers from Philadelphia on

Hi L.,
No everyone does not go through this, but I did with my oldest daughter who is now 8. It is very frustrating and overwhelming, because you have a miserable baby that you don't know how to help. I soooo feel your pain!!!!! I don't know what type of formula you are using but you might need to switch. I had my daughter on a regular milk based formula and she was having similar problems and I switch her to a soy based formula and never had any more problems until she turned one. She was no longer drinking formula and was drinking regular milk and we encountered the same problems. needless to say after several tests and trips to see a GI specalist, we found our that she has a severe lactose intolerance which was causing, the constipation, stomach cramping and pain, and an overgrowth of bacteria in her intestines. So You might want to talk to your Dr. about switching formulas and possibly having a lactose intolerance test.
Hope This helps!!!!!

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B.R.

answers from Philadelphia on

My son was a premie and had the same problem. Switching formula did not help. My doctor also told me to use Prune juice and it worked. My little guy had it so bad it was causing him to get a hernia from all the straining and he couldn't sleep or eat without maoning. After using the prune juice about a month later i started to notice the difference in his belly button because he wasn't straining anymore it was going in. Go with the prune juice you will see a difference in a matter of days. I used the prune juice for about 2 months everday and gradully started to give him less he is 10 monhts now and he is perfectly fine.

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M.O.

answers from Pittsburgh on

All four of my kids have been on formula. We had this problem with our third child and he was switched to Alimentum. You should ask your doctor if it would be alright to try switching. Also, if he says it's okay try to go on Nutramigen instead. Alimentum stinks, literally. It smells disgusting. I do not think putting a newborn on prune juice is the right solution.

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K.S.

answers from New York on

despite the common assumption, iron in the formula does not cause constipation. more than likely it is the lactose in the formula. my son had the same problem and i switched him to gentlease (enfamil) which has 1/4 the lactose as the regular formula and it also has partially broken down proteins, both of which aid in digestion and bowel function. i put him on soy for a little while and he became very cranky. i took him off it immediately. i would try the lower lactose formula before the soy and i would not try the nutramigin (enfamil) without speaking with your dr. when i thought my son had colic i asked my dr about it (it is indicated for colicky babies) and she said not to put him on it. she would only recommend it if the baby is colicky for more than 4 hours a day. try the gentlease and you will see a big difference within the first few feedings! let me know how it works...

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R.G.

answers from York on

L.,

I'm so sorry to hear you're having difficulties with feeding your little one. It is entirely possible that the combination of too much foremilk and the formula is making your little one's digestive tract work overtime. First I highly recommend switching your nursing method just slightly to nurse exclusively on one side for each feeding. 20 minutes, for someone who is not producing a large amount of milk is probably hindering the situation considering you're only allowing a feeding of 10 minutes on each side (too much fore milk and possibly middle milk, with not enough hind milk to help alleviate the constipation). Two of my little ones could empty (not really) a breast in 10 minutes flat. One of my little ones took her sweet time, but for all of them I only nursed on one side per feeding. This will help tremendously with your supply. The advice by hospital staff to switch sides is generally counterproductive.

Constipation and bloody stools is the number one sign that a child has issues with milk. Now that doesn't mean all milk and doesn't necessarily indicate lactose or protein allergy, but it could be the formula, your diet, or the lack of hindmilk when nursing. It could also be a combination of some or all of these. Start with the one sided nursing, for at least 20 minutes, then try switching formulas. I will not recommend any formula other than homemade or Baby's Only (it has both soy and dairy and a soy only formula too). I used the Baby's Only (supplementing) after months of online and off-line research with no issues. And a low Iron formula is best as Iron has a tendency to constipate as well.

I strongly recommend contacting LLL and perhaps attending a few meetings, if you don't do so already. Your mention of low supply is a great concern and that all 3 of your sisters had the same problem is a huge red flag. The average of women that cannot supply enough milk is around 10% and for 4 of you in the family to have had that issue just doesn't jive. I'm wondering what indicator you were given to show that there's not enough of a supply...

Give LLL a call... here's the info for the Downingtown group:
La Leche League of Downingtown meets the fourth Tuesday of every month at 7:30 PM
These meetings are held at Messiah Lutheran Church, 46 W Lancaster Avenue, in Downingtown.
Call Naomi ###-###-#### or Judy ###-###-#### for more information.

There is also a group in West Chester:
La Leche League of West Chester meets the third Thursday of every month at 7:30 PM
These meetings are held at the St. Maximilian Kolbe Catholic Church, 15 E. Pleasant Grove Rd, in West Chester.
We gather in the Kolbe room, in the main church building.
Call Dana ###-###-#### or Judy ###-###-#### for more information.

I know you asked about formula and constipation, but it's entirely possible and probably likely that the short nursing sessions might contribute to the issue at hand.

Best wishes for finding the answers you need.

Blessings,
Rolinda
Wife, Mother, Friend

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L.B.

answers from Philadelphia on

I am going through the same thing right now with my 2 month old son. He is on Enfamil Lipil with Iron and started backing up a few weeks ago. I did the karo syrup route but that didn't work quickly at all (I probably wasn't giving him enough) and the doctor recommended 1 oz of apple juice for every month he is old. So right now he can have 2 oz 2x day....straight apple juice.

I'm told that the peds dont like to take the babies off the iron formula but I'm sure there are other options they could recommend since this happened to your baby so young.

Its so hard to watch them suffer. All we can do is trust our pediatricians.

Good luck.

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