Is your preemie not pooping or maybe he or she seems to be in pain when pooping?
Let’s take a look att why it is common that pooping is difficult for preemies and what you can do about it.
Is it common that pooping is difficult for preemies? I have a 3-month-old baby premature at 28 weeks. Technically 2 weeks, she is having problems pushing her poop out, she is not constipated because her stool is very loose.I’ve been helping her with a Q-tip and it seems to help. When she pushes, she gets very tense.
What else can I do so she can start going on her own again? She is on formula lactose intolerance.
Thanks in advance,
Pooping Issues When Preemie and Newborn
When Pooping is Difficult for Preemies – The Normal Situation
I’m actually wondering if your baby is having problems pushing out her poop at all – or if what you’re seeing is just normal infant behavior.
Newborn babies (preemie or not) tend to make a lot of noise when they poop, with all sorts of grunts and straining sounds. They may even go quite red in the face. This is quite normal – and the fact that your baby’s stools are loose when she passes them really can indicate that she’s not experiencing any real ‘problem’.
Constipation in Premature Babies
That said, it is true that preemies are more prone to constipation than full-term babies. There are a few reasons for this, such as getting special high-calorie formula with iron, reduced muscle tone (hypotonia), and infections.
It is possible that your daughter has a somewhat reduced muscle tone, resulting in that she needs to work harder to push the poop out.
Some signs of constipation are hard pebble-like stools and blood on the outside of the poop. You can find more signs of constipation in babies in this article. Since your daughter’s poop is loose, she in definitely not constipated.
Medical Reasons when Premature Babies are Not Pooping
In addition to actual constipation, babies can have medical reasons for pooping difficulties, such as anal stenosis and Hirschsprung’s disease.
Anal stenosis is a too narrow anal opening and Hirschsprung’s is a case of missing nerve cells in the muscles of the baby’s colon. Both these conditions make it more difficult for the baby to poop. Depending on severity, there are different treatments, including surgery.
What happens if you DON’T use a Q-tip?
Does it seem to you that she can’t poop at all unless you help her? If your baby really can’t poop on her own, and especially if this is the case despite the stools being soft, have her examined by a doctor and mention these conditions. Hirschsprung’s disease is in most cases discovered already within 48 hours of birth because these babies do not even pass meconium.
Another, quite severe possible reason when a preemie has difficulties pooping is a disease called Necrotizing enterocolitis, or NEC. It is the most common in babies born before week 32 and occurs whentissue in the small or large intestine is inflamed or injured. The intestines will not hold the waste, which can pass into the baby’s abdomen and make the child very sick.
Some symptoms can be constipation or diarrhea, a swollen, red, or tender belly, green vomit, and a lethargic baby to mention some. In case your baby has these symptoms, do not wait with contacting a doctor.
Learn more about NEC in this video:
What to do When Preemies Have Difficulties Pooping
For Normal Newborn Straining, It is Best to Not Intervene
If your preemie can poop, but strains and have difficulties, I would personally not intervene with a Q-tip at least not on a regular basis. If she cries or seems overly distressed, then, of course, you can help her once in a while.
It takes a while for babies’ intestines to mature and for their bodies to figure out how to poop; for some babies, it takes longer than for others. A preemie obviously may take longer than a full-term baby. “Helping them”, which is very natural to do as a parent, may very well delay the learning process.
Instead of intervening, you can try clockwise tummy massage and a warm bath.
An efficient “exercise” for your baby to help her poop is to lay her down on her back, lift her legs up and shake then a little bit. After that, bend her knees and push her knees towards her tummy. This really helps for releasing gas and also poop. Take the opportunity to make eye contact, and talk or sing to your daughter!
Carry in an Upright Position
Being carried either belly down on your arm or in an upright position in a baby carrier or baby sling can also help.
For formulafed, constipated preemies, Assess the Formula
For formulafed babies, it is a good idea to talk to your baby’s health care provider to see if the formula can be changed in any way to improve the situation. As I wrote above, premature babies often drink special high-calorie, iron rich formula, which can certainly contribute to constipation. In such a case, there may be alternatives available.
For those who breastfeed and suppment with formula, increasing the share of breastmilk may help. Human milk has also show to reduce the risk of NEC, so it is prefered for premature babies, whether they are constipated or not.
Babies that Appear to be Ill or Weak Need Immediate Assessment
Finally, if your baby appears to be ill – he or she is weak, appears to be in pain, has a swollen belly, poor feeding or other symptoms, no home remedies should be tried. Contact a doctor immediately.
To conclude; while it is certainly possible that your baby is experiencing normal newborn straining, I do believe you should bring up the matter with your baby’s health care provider. You do not write anything about your baby appearing to be ill, but being so you, it is much better to bring up one “unneccesary” issue, than to miss something that may need treatment.
If her pooping difficulties are due to hypotonia, she will grow out of it.
I hope this helps,
Helpful Resources on Baby Poop and Premature Babies
If you want more in-depth information and tips on baby poop issues, here are a few books to check out. (Links to Amazon)
- Baby Poop: What Your Pediatrician May Not Tell You … about Colic, Reflux, Constipation, Green Stools, Food Allergies, and Your Child’s Immune Health.
- The Ins and Outs of Poop: A Guide to Treating Childhood Constipation.
- Preemies: The Essential Guide for Parents of Premature Babies