Why does my baby strain, grunt and cry before doing a poo?

Understanding Infant Dyschezia (Sometimes Called "Grunting Baby Syndrome")

Few things worry new parents more than watching their baby strain, grunt, cry, turn red in the face and appear uncomfortable when trying to do a poo. A question I am often asked in clinic is why is my baby crying grunting and so noisy before a poo with a tomato face!

Many parents assume their baby is constipated or in pain. In fact, if your baby is otherwise healthy and eventually passes a soft stool, they may have something called infant dyschezia, a common and temporary developmental stage.

The good news is that it is usually completely normal and gets better on its own.

What Is Infant Dyschezia?

Infant dyschezia occurs when a young baby is still learning how to coordinate the muscles needed to have a bowel movement. To do a poo successfully, babies need to:

• Increase pressure in their tummy by pushing with their abdominal muscles.
• Relax the pelvic floor and anal muscles at the same time.

Newborns and young babies are still learning this skill. As a result, they may spend several minutes:

• Grunting
• Straining
• Crying
• Pulling up their legs
• Squirming
• Going red in the face

Before finally producing a soft, normal stool.

Although it can look distressing, it is usually a coordination issue rather than a sign of illness.

Is My Baby Constipated?

This is one of the most common questions I hear from parents.

The answer is usually no.

Signs of Infant Dyschezia

✓ Straining and crying before a poo

✓ Stool is soft when passed

✓ Baby feeds well

✓ Baby gains weight normally

✓ Baby settles once the poo has passed

Signs of Constipation

✗ Hard, dry or pellet-like stools

✗ Pain when passing stools

✗ Infrequent bowel movements with hard stools

✗ Ongoing discomfort

Constipation is about the consistency of the stool, not the amount of effort used to pass it.

How Long Does Infant Dyschezia Last?

Most babies grow out of infant dyschezia within a few weeks as their nervous system matures and they learn to coordinate the muscles involved in pooing.

It is most commonly seen in the first few months of life.

Does Breastfeeding Cause Infant Dyschezia?

No! Breastfeeding does not cause infant dyschezia. Breastfed babies can still strain, grunt and cry while learning how to coordinate their bowel movements.

Breastfed babies also have a wide range of normal stool patterns. Some may poo several times a day, while others may go several days between bowel movements once they are a few weeks old.

If the stool remains soft and your baby is otherwise thriving, this is often normal.

What Can I Do to Help?

The most important thing is reassurance. Your baby is learning a developmental skill and usually does not need treatment. Many parents find the following comforting:

• Plenty of cuddles and reassurance
• Gentle bicycle leg movements
• A warm bath
• Tummy time when awake and supervised
• Responsive feeding
• Holding your baby upright after feeds if they seem more comfortable

Remember, your baby is not being difficult and you are not doing anything wrong.

What Should I Avoid?

Experts generally advise against:

• Rectal stimulation
• Cotton buds in the bottom
• Thermometers used to trigger a bowel movement
• Suppositories
• Laxatives unless prescribed

Although these methods may produce a stool in the short term, they can interfere with your baby's opportunity to learn this important skill independently.

When Should I Seek Medical Advice?

Please contact your GP, health visitor or paediatrician if:

• Your baby is not feeding well
• Weight gain is poor
• The tummy appears swollen or distended
• There is blood in the stool
• The stool is hard or pellet-like
• Your baby has persistent vomiting
• Vomit is green
• Symptoms seem unusual or concerning

If you are worried, trust your instincts and seek professional advice.

A Reassuring Final Thought

Watching your baby struggle to do a poo can be upsetting, especially when you're already tired and adjusting to life with a newborn.

The reassuring news is that infant dyschezia is common, temporary and usually resolves naturally as your baby matures.

In most cases, a baby who cries, strains and goes red before passing a soft stool is simply learning how to coordinate the muscles needed for a bowel movement.

Like so many newborn stages, this one does pass. If you're concerned about your baby's feeding, digestion or comfort, seeking support early can provide reassurance and help you feel more confident in understanding your baby's cues. If you are concerned that your baby has tension throughout their body drop me an email and we can talk it through on the phone, if I think that treatment is appropriate I can book you an appointment.

‍