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Constipation After Starting Solids

We started my daughter on some solids after her four month old appointment.  We started with rice cereal mixed with breast milk.  She loves it, but we think it makes her constipated.  She went from pooping a couple of times per day to pooping every couple of days, and it was thicker.  We started giving her some sweet potatoes as an alternative with the rice cereal, because we thought the sweet potatoes are supposed to be more easily digestible.  However, last Friday she seemed to be in pain when she pooped, so we stopped giving her the rice cereal altogether.  Anyway, I'm not sure what to do now!  We are giving her some sweet potatoes once per day.  I'd like to give her more solids because she really likes them and she'll be 5 months soon so she could probably use the extra iron, but we don't want to make her constipated or make her afraid of pooping because it's painful, etc.  Should we try oatmeal cereal instead, or maybe give her some baby food prunes every day along with the cereal, or maybe just quit with the solids altogether for a while?  Is the cereal definitely necessary for iron?  I know you also mentioned juice on your website, do you think we should do that instead? 
There are a lot of questions here and I’ll try to answer them all.

The immediate issue is “what should we feed her right now”. I would recommend you put a hold on the rice cereal and the sweet potatoes and just breast feed for another 1 to 2 weeks. If she is still having painful, hard ball or clay stools, I would add 4 ounces of undiluted apple juice. After her stools are more regular then I would proceed with non-banana (and some experts argue peaches and pears) fruits.

I like juice as a tool to help with constipation, but I would not recommend juice otherwise. We pediatricians often see children that “get addicted to juice” and drink it all day long. Juice has little nutritional content, but can fill children up enough that they do not eat the milk/food they need.

Her major source of iron is from breast feeding and unless there are other health issues I would not worry too much about her iron intake. After getting started with a few fruits you could then introduce some green veggies like peas or green beans which contain iron. In our office we typically check a CBC (complete blood count via a finger prick) at 9 months. The CBC is intended to pick up cases of iron deficiency anemia.

Oatmeal is not necessarily better for constipation than rice cereal. After she has tolerated several fruits and veggie I would re-try the rice cereal slowly. While I agree the current likely problem is rice cereal, I’ll bet she will eventually tolerate it without issue.

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Written August, 2010 by
Dr. Gordon, Orlando Pediatrician




 is intended to help parents understand the needs and behaviors of children. The information presented in the site is the opinion of Gregory Gordon, M.D.and does not reflect the opinion of his partners. This website is owned exclusively by Doctors insights LLC. The advice in this site does not apply to all children. Always consult your healthcare provider for your individual needs.

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