Almost every breast-fed baby causes concern during its first few months of existence on account of “constipation” – that is, infrequent bowel motions. The absence of residue in its diet and the frequency of slight underfeeding lead the child to empty its bowel at widely spaced intervals.
When I am told that a healthy breast-fed baby is “constipated” I ask whether the motion is hard or normal. If it is hard I know that Purgative have already been given. If it is normal I explain to the mother that the baby is not constipated, and warn her against any interference with the natural bowel function such as is certain to be urged by her friends. I have many records now of babies who have for a time, often extending up to weaning, had their bowels moved even at such infrequent intervals as a week, and not one has ever had constipation or subsequently developed it.
Many of these children have never had a purgative in their lives, and the maternal pride when weaning brings three motions a day is gratifying if amusing. Often the crying of a slightly underfed baby us attributed to the infrequency of the bowel evacuation; purgation follows, and depletes it still further. In an effort to retain its fluids the body extracts more water from the intestine, and true constipation result, and is followed by further purgation.
The old practice of giving babies castor oil even on such flimsy pretexts as to get rid of the meconium is dying out, but, indeed, almost any excuse to give a purgative is seized, and life-long addiction may result.
The healthy breast-fed baby whose bowels move once a week needs an occasional drink of water and nothing more.