Constipation in mix fed 4 week old baby

[RidingSixWhiteHorses]

Advice please - is clearly in discomfort when trying to poo. Trying can take couple of hours and is then a poo of volcanic proportions - a poocano!
He is mix fed about 70% bottles and 30% breast. Is a good burper after feeds. Generally content other than the poo.
Have massaged tummy and made sure my diet not spicy.

Constipation is when the poo is hard and dry. Is he pooping every day/every other day? They do put a lot of effort into pooing at this age so may not have a constipation problem at all

No poo is normal (like brown yellow toothpaste) but getting it out a major trial.

Posting because DS has the same thing and always has

Lactulose helps but he still hates pooing, it's a piercing cry and it can go on hours

Just got back from paediatrician thought this might help you OP.

DS is constipated even though he's doing soft poos. Been told to keep giving him lactulose and to give him cooled boiled water several times a day

How old is your ds?

A 4 week old should not get water several times a day. Too much water is dangerous for newborn/ very young babies

Mine is 11 weeks.

pixie the consultant said he should have been having it for several weeks previously as that is why he is constipated

I'm not sure I agree as extra water isn't normally indicated for young babies whether breast or bottle fed

I was told bottle fed babies should have some water to prevent constipation, but that it's not necessary in breast fed babies

Everything I've read says bottle fed babies may need water in very hot weather but would not need it otherwise. Neither of mine had any until they started solids. Formula is predominantly water anyway.

pixie I thought that too but at the hospital I've been told to give him regular drinks