Has anyone else's breastfed baby been chronically constipated since weaning?

[Stringervest]

I posted a thread on this last week but things have developed since then. I'm really hoping someone can offer me advice from the benefit of their experience.

DS is nearly 7 months and has been on solids for just over a month. Before we started weaning he was pooing once every week to ten days, but the poo was wet, and he is breastfed, so apparently this was normal.

Since we started weaning his pooing frequency has not increased. He poos once a week at most and really strains. His poos are the consistency of plasticine and one had blood on it, which I understand is the result of an anal fissure caused by straining. Last night he was up in the night for hours straining, but has produced nothing. He is in terrible discomfort and I don't think this can be normal.

We have tried: stomach massage, bicycling legs, prune juice, purées prunes, pears, and peaches, water with all meals, avoiding foods that constipate (eg banana and potato), an infant probiotic. Nothing has worked. He is only eating puréed fruit and veg - nothing that you would usually expect to cause an allergic reaction.

We are trying lactulose now. If that doesn't work we'll use an infant suppository to clear him out. What I don't understand is WHY this is happening. I feel so frustrated that we have tried all the recommendations and still this is happening.

Has this happened to anyone else? Did you find a cause? When did things improve?

I have no direct experiene of this but if you are getting blood in the stools I would seek medical help
childrensmd.org/browse-by-age-group/newborn-infants/long-can-baby-go-without-pooping/

For 16 years, really, really try to get it dealt with as early as possible!

Yes! We had similar & same as you we tried all the usual foods that should help. Took her to drs - they said all fine & potentially an adjustment to switching from breast milk to food. We were given I think lactulose for her which I don’t think made much difference. It resolved over time, but it is very important to go to drs to ensure no build up / blockages. It’s also important to ensure they’re taking in enough water as this can help massively.

We're having this still at 15 months. Still breastfed but eating a really good, balanced diet with lots of fruit and fibre. Think we'll be getting her checked out now as she's really struggled the past couple of days

That happened to my DS at that stage. His paediatrician suggested giving him only stewed and pureed apples and cutting out all other solids and BFing him as much as he wanted. That worked in a few days.

Thanks everyone. We are waiting to see the GP. I agree that blood in the stools is concerning but it's most likely to be an anal fissure which, although painful, will heal. It happened to me when pregnant so I really feel for him. Need to get those poos nice and soft.

@BillywilliamV I'm sorry this has gone on for 16 years! Have you ever identified a cause?

@AcrobaticCardigan Thanks. We are trying to load him up with water. I wasn't sure if I should as I was worried it may reduce his appetite for breast milk, which is mostly water, but if poos are hard then I agree that seems like the right approach.

@HotGlueGun has it been consistently bad for you the whole time?

@Violinmum1 thank you. I had read conflicting reports on apple. Some say the pectin constipates. We cut out all food except puréed pear, peach and prunes for several days but unfortunately there was no change. Once you had tried this, were you able to resume a normal diet after the initial constipation was resolved?

I'm wondering if I should give a suppository to reset him but I think probably better to speak to the GP first.

I just feel so sorry for him, and so helpless.

I had to make sure he has fruit every day and that seemed to help. Bananas are ok as long as they are ripe enough apparently.

@Stringervest her poos have always been solid, which were vastly different to my breastfed son who didn't do a solid one until much older (albeit he had various allergies). She's had trouble passing them (screaming etc) some of the time but other times no issue, despite them being massive and quite firm. This week she hadn't gone for about 3 days (unusual) and nursery have asked if she suffers with constipation (she's only just started there) so it's really made us think that we need to get her seen. I would say that if you've tried everything you reasonably can, then your next step is to speak with HV first. If you've done this already then maybe your GP

Cmpa was big factor for us. Have you tried cutting dairy?

CMPA is a good shout... we are waiting for an allergy referral for our daughter (I've been diary free for over a year now though), although we had CMPA confirmed with our son and he never did solid poos!

@Stringervest, yes, we were able to resume a normal weaning diet, but I was very slow about reintroducing foods. The paediatrician advised us to stick to pureed vegetables only for the first couple of months of weaning and introduce a new one every week. He also told us to let DS drink a fair bit of water, as a PP suggested.

Yes, my daughter had this, also lots of straining, screaming when passing a poo and blood on the poo. My son was never like this so I didn't expect it and was also very worried and upset like you are. To give you hope though it resolved by about 8/9 months. I did lots of fruit, especially pear and peach, and lots of water. And gave her oranges, she would suck the juice out of them mainly at that age. I also put prune juice in her water at first. I know it's horrible, and you've tried these things already. Maybe a suppository would be a good idea to clear him out and then hopefully the other measures will keep him regular. Did you say you're seeing the GP soon?

@Joeyandpacey I had wondered about CMPA but we had the problem when he was only on fruit and veg. Although his pooing was infrequent when he was EBF, it was very loose, so he can't have been reacting to CMP in my milk. Was constipation the only symptom of CMPA that your DC had or should I look out for something else?

@Violinmum1 thank you. Maybe that's the solution. DD was eating 3 meals a day by this point so I had been worried but I need to stop comparing them.

@kiwiblue thanks for your sympathy. It helps to know I'm not the only one who's had to deal with this and that it resolved fairly quickly for you.

Ps yes, hope to see the GP next week

This sound very familiar. My older daughter used to go for up to 3 weeks between poos before starting solids. Once she was on solids things firmed up very quickly. We were fobbed off for much too long. The GP suggested more fruit then tried lactulose and neither made any difference. She used to scream and watching her do a poo was like watching someone give birth.

She was then prescribed movicol although the GP gave us poor advice on this and suggested we would only need it for a short time. Fast forward to her at nearly 4 years old and having been on and off movicol for ages (which I now understand was not helpful and she should have stayed on it) we finally saw a paediatric gastroenterologist privately who did an x ray and saw that she was impacted and her rectum was stretched from the large firm poos she had been doing for so long. Consequently she had lost sensation and was having poo accidents. After disimpacting with high dose movicol and weekly enemas we are now in a better place with a maintenance dose of movicol which she will have to be on for several years at least.

My younger daughter started going down the same route on weaning. We saw the GP and started her on movicol at 7 months. She is now 2 and with 1 sachet a day her poo remains soft and is no problem.

For me I would advise early intervention and research the problem yourself. GPs are woefully bad at dealing with constipation in my experience.

Had this with dd3 when I started weaning her, still has some issues now and she’s almost 16 years old. I think it’s lack of fluids that causes the constipation.

My goodness @user1471468988, what a sad story. I'm pleased to hear you are on the right track now.

Thank you for taking the time to share it. We have private health insurance through my work so I won't hesitate to ask for a referral as you suggest.

Yes, he is now 12 and we still have issues which come and go to some degree.

@SpeedofaSloth Have you developed any techniques for tackling it?

Have you stopped bf altogether?

I had this with Ds2 (now 2.5) and I believe it was down to dairy. Didn't get tested for cmpa and he would be ok with cheese. Any yoghurt, milk,ice cream though and he'd be constipated. It improved massively with the dairy versions of those removed.

He's the same now if he has too much dairy though he can have a cup of milk a day and some ice-cream/yoghurt.

@User0ne thanks for this. There seems to be a theme emerging. I haven't stopped BF so it looks like the next thing might be to cut out cows' milk from my diet for a week or two and see what happens.

Eek! I drink and eat a lot of dairy! (Which makes it more likely to be the problem, I suppose)

I forgot to mention that I completely avoided all dairy products while BFing, as there's a history of milk allergies in our family.

DSs slow start with solid food hasn't hampered him in the least. He's a strapping teenager and as a plus point, he still loves eating his vegetables!

This happened to my daughter - she would then withhold because it was painful and scream when finally going it was awful. I used to take her back to just bf for a few days in early weaning (think that was dr advice) then we had movicol that we used for a few months and took her off a few times when it didn’t work, and then one day it was fine. She still eats loads of fruit. I would ask for movicol - it meant she couldn’t withhold and then stopped associating pooing with pain as early as possible.

Thanks for the input. The last four times DS has done a poo it has been in his sleep so I do think it's possible that he is actively withholding poos.

It's reassuring that I'm not alone and that there are solutions, although I'm sad to hear others have had this problem.

How is your DS now OP?