CONSTIPATION

Many infants who go through Neonatal Abstinence from any substance exposure will have constipation or stools that are harder than normal. This is seen when the baby has dry hard stools and at times fouls smelling stools. They may also have a hard belly and may cry or have discomfort before or during a bowel movement. Our team has noted constipation frequently in infants who have a sensitivity to the formula. We also note this to happen most frequently in infants with both opioid and stimulant exposure (eg Fentanyl or Heroin with Methamphetamines or Cocaine).

NOTE: The Following Videos found in this kit under the Parenting Tips from Specialists will provide more information and/or demonstration that might be useful for some of the interventions recommended here.

NAS: Early Interventions

The SOOTHE Technique

NAS Babies & Movement

STRATEGIES BY DISCIPLINE

NEURODEVELOPMENT

First consider all the potential physical reasons the constipation. If your baby has constipation consult your baby’s doctor office for recommendations. It is important to note that constipation stools can be related to dehydration as well and your baby may need medical attention.
Keeping them calm during feeds will help. You may want to swaddle during feeding to decrease fussiness or motor movements so the baby can focus on feeding and digestion. (the Ollie swaddle was specifically designed with the NAS baby in mind as it offers moisture wicking and stretch with pliable restriction). Make sure to use safe swaddling instructions offered by the manufacturer.
Movement (playing bicycle with the infants legs etc) helps with moving the bowels. Infant massage may be very helpful to help a baby that tends to constipation, but it is important to learn the correct technique and direction so that you are not moving the stool back into the intestine. Gently holding the infants bent legs (knees) near the lower part of the baby’s abdomen can also help the baby with stooling.

MEDICAL

It is important to determine the root cause of the constipation with the help of your baby’s doctor.
- Your baby’s doctor will want to know:
  - How long your baby has been constipated and how often does your baby have constipation
    - Every day?
    - How many of the diaper changes?
    - Sporadic vs consistent constipation?

NURSING

It is important to determine the root cause of the constipation.
Monitor your baby’s weight to make sure they are gaining weight.
You want to encourage fluid intake to keep the baby hydrated
A gentle infant massage of the abdomen may be helpful.
Your baby may have a food sensitivity and you should ask about changing formula with the baby’s doctor.

OCCUPATIONAL THERAPY

The Joy of Tough Time (amazon.com) has strategies for infant massage for the stomach for constipation and gas.

SPEECH PATHOLOGY

Use a pacifier and calming strategies to assist the baby with stooling.
Monitor stimulation (do not over stimulate the baby) during feeding to help for better digestion.

RETURN TO TOOLKIT MENU