Infant gastrointestinal distress is a common concern for new parents. Colic is defined by the “Rule of Threes,” involving prolonged, intense crying in an otherwise healthy infant. Constipation is characterized by hard, painful, or infrequent bowel movements. While colic does not directly cause constipation, the two conditions frequently coexist because they share underlying digestive challenges stemming from the developing nature of a baby’s digestive tract during the first few months of life.
Differentiating Colic and Constipation Symptoms
Colic is primarily a behavioral diagnosis, formally defined as crying for more than three hours a day, at least three days a week, for three weeks or longer. These crying episodes are typically inconsolable, often occurring suddenly and peaking in the late afternoon or evening. During these bouts, babies may exhibit physical signs of distress, such as drawing their knees up to their chest, arching their back, or having a tense, distended abdomen.
Constipation is focused on the physical characteristics of elimination, specifically the consistency of the stool. Signs include the passage of hard, dry, or pellet-like stools, which can be painful or difficult for the baby to push out. While a decrease in the frequency of bowel movements may be noted, the firmness of the stool is the more important indicator of true constipation. Straining and turning red in the face during a bowel movement is normal for babies, but if the resulting stool is hard, it indicates constipation.
Shared Underlying Factors
The frequent co-occurrence of colic and constipation is traced back to the functional immaturity of the infant’s digestive system. A baby’s gut is still developing its nervous system, digestive enzyme production, and intestinal motility. This developmental stage can lead to symptoms often grouped under Functional Gastrointestinal Disorders, which includes both infantile colic and functional constipation.
Dietary factors also play a role in the simultaneous occurrence of these issues. Some infants may have a transient sensitivity to cow’s milk protein found in formula or passed through breast milk. This sensitivity can cause inflammation and discomfort in the gut, manifesting as the pain and fussiness seen in colic. It also slows intestinal movement and contributes to harder stools.
Excessive gas production is another shared factor, often creating a cycle of discomfort. When a baby cries intensely during a colic episode, they swallow more air, which leads to gas buildup in the intestines. This trapped gas causes abdominal distension and pain, exacerbating colicky crying.
The resulting pressure can also make it more difficult to pass stools, worsening constipation pain. Furthermore, an imbalance in gut bacteria, known as dysbiosis, has been observed in some colicky infants. This altered microbiome can affect fermentation processes, leading to increased gas and impacting stool consistency.
Strategies for Relief
Parents can employ several non-pharmacological techniques to ease the discomfort associated with these overlapping digestive issues. Physical interventions help move gas and stool through the digestive tract. Examples include gently massaging the baby’s tummy in a clockwise motion or performing the “bicycle legs” exercise. Warm baths and holding the baby in an upright position can also provide soothing relief during fussy periods.
Adjustments to feeding practices can minimize air swallowing and improve digestion. Ensuring the baby is held upright during feeds and is thoroughly burped afterward reduces the amount of air that reaches the intestines. For formula-fed infants, confirming the correct powder-to-water ratio is important, as an overly concentrated mix can contribute to dehydration and harder stools.
If discomfort persists, parents should consult a healthcare professional to discuss underlying causes and management options. A doctor may suggest a trial of a hypoallergenic formula if a protein sensitivity is suspected. They may also discuss the use of certain probiotic strains, as some have shown a benefit in reducing crying time for colicky infants. For confirmed constipation, a doctor may recommend dietary changes or the occasional use of a glycerin suppository for temporary relief. These early life digestive issues are typically temporary and represent a normal developmental phase.