“My daughter is one month old and exclusively breastfed. She has been doing strange things when she is breastfeeding for a few days, but before she used to fall asleep and be full. It has been one week now that she has been very restless; she rolls up, makes a lot of noises as if she wants to poop and strains, and sometimes she spits up milk. Then, when she is at the breast, she starts out very calm, but when she has been there for a while, she begins to stretch, arch back, strain, and make noises. Now she poops much less, but it’s still the same color and her pee is as usual. What could be happening to her?”

Babies are born with an automatic mechanism that allows them to eat and then poop soon after; this is called the gastrocolic reflex. When they breastfeed, they poop almost immediately during the first 4 weeks of life, and this tells us that they are eating properly. Undoubtedly, it also makes it difficult for you to find the moment to change the diaper, but that’s another story. Let’s return to the previous question, what is happening to a baby that has stopped to poo?

Most likely, the gastrocolic reflex has vanished, and the baby has to poop on its own, and this usually happens suddenly, from around one month of a baby’s life. Although, at first glance, this sounds very easy, it is quite an adventure for them. And just like this mother says, babies are restless, arche back and wriggle when breastfeeding, spit up milk when pushing so hard, and can pull on the mother’s nipple.

In addition, this new learning involves the so-called “infant dyschezia.” As so often, complicated terms are used to explain relatively easy things.

So, what is infant dyschezia?

Dyschezia is crying, straining, or your baby being uncomfortable, which lasts for a few minutes, and in which it is believed that babies, instead of relaxing the anal sphincter, contract it and thus make it difficult to expel stool and pass bowel movements.

For babies, this seems to be very uncomfortable, and as mothers, we want to help them and do something so they can poop as quickly as possible and relieve themselves. But as you know, you should never stimulate the baby’s anus (poo hole) by trying to insert something (such as a thermometer or other thin household items), nor routinely use suppositories if they are not medically required. But there are things you can do to help your baby and make it easier for them to finally pass poop:

• Massage their tummy: make clockwise circles on their tummy, draw an I on the right side of the baby’s tummy, and then a mirrored L, followed by an upside-down U.
• Bicycle moves: Gently lift the baby’s knees up and down. This position should be maintained for at least a few seconds, and then stretch the baby’s legs. Lift the legs and turn them in circles, pedaling as if it were the movement you do when riding a bicycle.
• Warm water baths with the baby seated: Prepare the baby’s bathtub with warm water, leave your baby in a sitting position so that at least all of their bottom is covered with water, and wait. But be careful; they may poop in the water, and then you need to take them out to clean.
• Holding your baby in your arms in an upright position for as long as possible, the use of a baby carrier can make this easier.

Finally, the best advice is to wait and be patient because it can take many days for them to pass a bowel movement. It is absolutely common in exclusively breastfed babies; you just have to make sure that when they poop, their stools are soft and that while you wait for them to poop, their tummy is soft as well. This is not constipation; it’s just another stage in the growth and development of a healthy baby with optimal weight gain.