Ask Dr. Marla: My 3-month old goes 48 hours without using the bathroom

My three-month-old often goes 48 hours without a bowel movement. Is that normal? 

You are referring to bowel motility. At three months, babies are not on solids so you might be thinking your child is constipated.

Though constipation is often associated with less frequent bowel movements, it’s really defined by the passage of hard and dry stools rather than the absence of a daily bowel movement (which is in fact common). Constipation may also make stools difficult to pass, harder than usual and cause discomfort. In more extreme cases, there may be soiling, which is called encopresis.

Possible changes in bowel movement frequency may result if your child has transitioned from breast milk to formula.

A change in frequency of stools is common after two months of age. Overall it is important to remember that the frequency is not as important as the consistency of the stool. If your child is distressed and straining then do see your physician.

Rarely – and I do stress rarely – constipation in an infant can be caused by an underlying medical condition such as underactive thyroid, cystic fibrosis or a disease to the anus itself such as Hirschsprung disease. If your child experiences symptoms such as vomiting, irritability or prolapse of the rectum with a bowel movement, then call your physician.