How can I tell if my baby is constipated?

When it comes to a baby's bowel movements, there's no "normal" number or schedule — only what's normal for your baby. Your baby may pass a stool after every feeding, or wait a day or more between bowel movements. Her individual pattern depends on what she eats and drinks, how active she is, and how quickly she digests her food and then gets rid of waste. With practice, you'll be able to tune in to your baby's unique habits.

If you're concerned that your baby may be constipated, there are a couple of clues to look for. One clue is less frequent bowel movements than her norm, especially if she hasn't had one in three or more days and is obviously uncomfortable when she does have one. And if she has hard, dry stools that are difficult for her to pass — no matter how frequently — she may be constipated.

By the way, if you notice very liquid stools in your child's diaper, don't assume it's diarrhea — in fact, it may be evidence of constipation. Liquid stools can slip past the blockage in the lower intestine and wind up in your child's diaper.

Why is my baby getting constipated?
There are several possible culprits:

Formula. Babies who breastfeed exclusively are rarely constipated. Breast milk has the perfect balance of fat and protein, so it produces stools that are almost always soft — even if your baby hasn't had one for several days. If your baby is on formula, it's possible that something in her formula is making her constipated. Ask your baby's doctor about switching brands. (Despite what you may have heard, the amount of iron in formula doesn't have any bearing on constipation.)

The introduction of solids. Don't be surprised if your baby becomes mildly constipated as she steps up to solid food. That's often because rice cereal, usually the first food given during this transition period, is low in fiber.

Dehydration. If your baby isn't getting enough fluid, she'll become dehydrated and her system will respond by absorbing more fluid from whatever she eats or drinks — and from the waste in her bowels, as well. The result is hard, dry bowel movements that are difficult to pass.

A medical condition or illness. Though it's uncommon, constipation can be caused by an underlying medical condition such as hypothyroidism, some metabolic disorders, some food allergies and botulism. If your baby passes hard, painful stools, you'll want her doctor to check her out, just to make sure.

Rarely, constipation is caused by a condition called Hirschsprung's disease, which is typically diagnosed within the first few weeks of life. A baby with this disease suffers from a birth defect that prevents her gut from functioning properly.