Many toddlers have fluctuating appetites, so problems with constipation become more apparent. Too much milk (more than 32 ounces a day) can also cause constipation. Constipation is simply defined as having stools that are difficult to pass because they're too hard. But how do you know if your baby's constipated? Many babies will grunt, push, or strain when passing stool -- these exertions are normal. When your baby is straining, you can try picking him up so gravity helps his efforts, or lightly hold his knees against his chest to help him squat -- the natural pooping position. However, although a certain amount of straining is normal, crying while straining may mean your baby is constipated and in pain from trying to pass hard stools.
Birth to 4 months: In infants up to 4 months old the most common reason for constipation is not getting enough fluid. Breast milk or formula should provide enough, but if you're using formula, make sure you're mixing enough water with the formula according to the manufacturer's directions. If that's not the problem, encourage your baby to take in more fluids, whether that means nursing more or offering more formula than usual. You can even give a few ounces of plain water or a rehydration solution, such as Pedialyte. Your doctor may also recommend adding a sugary substance, such as Karo syrup, to breast milk or formula. Sugary substances draw water into the gut, softening the stool, and are gentle on a baby's stomach. Besides giving your baby fluids, you can also tickle his anus with the tip of your little finger to help what's in there come out.
5 to 11 months: For constipated babies older than 4 months who have started solids, you can help soften stools by increasing the fiber in their diet by adding more fruits and vegetables at each feeding. Some babies may also benefit from 2 to 4 ounces of additional fluid in the form of apple juice or diluted prune juice. Your doctor might recommend over-the-counter infant glycerin suppositories too.
Age 1 and up: For babies older than 1, your doctor can prescribe enemas, laxatives, and stool softeners, although these are used only in severe cases. If you suspect too much milk is the reason for your toddler's constipation, limit the amount she drinks to 24 to 32 ounces a day.
You may have heard that iron in formula causes constipation, but there's no evidence that this is true. Infants should never be placed on a low-iron formula unless it's advised by their pediatrician. Babies born at full term have enough stored iron to last four to six months, but by 6 months of age these stores are too low. Then the baby is at risk for anemia over the next several months. Iron-enriched formula (and iron-fortified cereals once your baby's on solids) can ensure that he will have enough iron for the first year.