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Newborn and Infant Care

Infant formula and constipation

01/26/1999

Question:

My new born baby is having infant formula, the correct ratio of milk powder to water is 1:1, but then the baby started with 3:2, the pedia said after a week I should increase it to 1:1 so that the baby will be receiving proper nutrients, but then ever since he is very constipated, like he will pass bowel every other day, the stool is hard and the baby keeps crying whenever he is passing stool, but then the color of the stool is normal, just hard. does it have anything to do with the milk ? shall I change the milk? because the formula is iron fortified, maybe iron can cause constipation? the pediatrician said that its normal for the baby to be constipated and that there's no need to change the formula, but then I feel really sorry for the baby, please help.

Answer:

The milk and/or the iron in the formula may have a constipating effect on a baby. It is important that a baby receive the appropriate water :: powder ratio for the nutrient content, but I am not sure why a pediatrician would consider constipation to be normal for a baby. Passing stool should not be so uncomfortable that it always is associated with signs of pain for an infant, e.g., "crying whenever he is passing stool."

If I were the mother, I'd trust my instincts when "I feel really sorry for the baby." I'd continue to call the pediatrician to describe the problem and request solutions that might eliminate the pain with passing stools. Trying another formula might be one possiblility, but there may be others. I'd probably ask the pediatrician if she/he thinks there is any harm in trying another formula--why she/he does not think there is any reason to change or try something else. If the mother still is not satisfied with the answers she receives, she could consult another pediatrician.

Bravo to her for pursuing an answer when her baby is hurting. She definitely has her priorities in order!

Karen Gromada, MSN, RN, IBCLC

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Response by:

Karen Kerkhoff Gromada, MSN, RN, IBCLC
Adjunct Clinical Instructor
College of Nursing
University of Cincinnati