#AskTheExpert Session with Dr Ng Yi-Ki, Consultant Paediatrician, Baby and Beyond Child Clinic

vege and fruits are usually good as first foods as they also have fibre to ease the bowel movements. for grains, i recommend baby multi grains rather than just plain white rice. if you do give the packeted cereals or oats, do give a little more water. if baby has constipation, fruits such as papaya, prunes and dragon fruit are great bowel movers.

Hi. Short answer is that there is no particular food or medicine taken by a nursing mother that can explicitly cause constipation in the baby and avoidance of any type of food in mother's diet is generally not recommended. But if you do observe a noticeable change in baby's bowel habits without any other more probable direct factor like introduction of solids, change of milk or unwellness, then it may be worth a try to omit that particular food from your diet and observe for any change/improvement.

2 common movements are massaging the baby's tummy in a clock-wise direction (applying some baby oil first would make it easier to glide your hands) and moving the legs in a cycling movement. The idea is to help the gut to move along.

Chronic constipation can cause impacted stools which can cause alot of tummy discomfort and painful defecation. This pain in turn makes the child afraid to poop and then tries not to, which then subsequently becomes a vicious cycle for further impaction. The bowel is also a muscular organ so it will start to lax to accommodate more backlog of stools. This can cause fecal incontinence whereby the more liquid stools further up the gut starts to leak and stain the undergarments. For an older child, this can cause alot of negative psychological impact. It is also very hard to treat at this stage.

Yes studies seem to show that there is but to various extends, with cows milk protein being the most common. However, it is important to note that not all constipation is due to allergenic foods and food allergy does not always present as constipation. However, if the baby has chronic constipation that does not seem to respond to conventional treatment and management, it may be a good idea to consider food allergy. Most are often temporary and may go away after 12 months.

A baby up till 6 months old do not need extra water beyond the milk he/she is getting. Between 6-9 months old, while solids are introduced and being established, the baby's milk intake should not reduce by alot. So I usually recommend to give some sips of water during and after solid meals, which really may not even come up to 1-2oz. After 9-12 months, that amount can increase a little as baby is taking more solids and even some snacks in between, probably around 4-6oz. It would be easier if baby learns to drink from open cup or straw so baby is more in control of how much he/she wants to drink. offer a little more of the day is really hot or baby has been more active.

I always tell my patients that early is better than later before the long term complications of constipation sets in. 1) During an episode of constipation, if the baby is showing discomfort like crying from tummy ache or is visibly straining and unable to poop and 2) if it has become a recurrent problem spanning over a couple of weeks and it is not improving despite your best efforts to give your baby fibre rich diet and adequate intake of fluids

Yes, constipation can very uncomfortable for the baby hence expressed as crying and straining .

For babies who have been introduced solid foods, increase the amount of fibre rich fruits and vegetables like papaya, prunes, dragon fruits and leafy vegetables. Reduce the amount of cards such as potatoes.

Solid food is not as easily digestible and absorbable as milk, hence it changes the consistency and volume of faeces, making it more firm and bulky. This in turn can slow down bowel movements. If the baby's diet is poor in fibre, then that slows down the transit through the gut even more and end up being constipated.