Infant Nutrition – Bowel Health

Bowel Health

Checking your baby’s bowel movements is normal for parents to do and is particularly important in babies with CF. Bowel movements can give a good idea as to how well they’re digesting and absorbing their food.

If you notice the following signs, your baby should be reviewed by their dietitian:

  • Tummy pain and discomfort – in babies this may include squirming or tensing up muscles as well as facial expressions such as squeezing eyes shut or grimacing.
  • Excessive, smelly wind
  • Greasy, oily poos
  • Diarrhoea and/or constipation
  • Hunger despite feeding well/eating lots of food
  • Poor weight gain and/or growth

If your child has regular bowel problems, the CF care team will investigate to find out what the root of the problem is. Some babies may receive regular bowel washouts in hospital. These help to clean out the bowels by removing gas and faecal matter using a saline (salt) rinse.


If your baby has frequent diarrhoea, they can lose a lot of valuable nutrients and calories from their diet. Diarrhoea may result from not having enough enzymes (Creon), a viral or bacterial infection or from antibiotic use. A combination of dietary changes (depending on age) and fluid can often help regulate your baby’s bowel motions.


Constipation is very common in CF, and usually presents with a gradual onset of symptoms.

Symptoms may include:

  • Hard or pellet-like stools
  • Bowel movements that appear painful or difficult to pass, causing your baby to arch his or her back or cry, accompanied by hard, dry stools
  • Bowel movements that are infrequent or less frequent than usual

Constipation may result from having too many enzymes, having experienced meconium ileus at birth, dehydration, illness and some medications. If you think your baby is suffering from constipation, you should contact the CF team. The dietitian may make some modifications to your baby’s diet, and the doctor may recommend using stool softeners or laxatives to help.

Meconium Ileus

In CF, the digestive system contains thick, sticky mucus and because of this, some babies with CF are born with a bowel obstruction, known as meconium ileus. This occurs when the bowel becomes blocked with thick, dark and sticky meconium (babies first poo).

Meconium ileus must be treated immediately and in most cases the meconium can be flushed out of the bowel using an enema. More severe cases may require surgery to remove the blockage.

For some families, this may be the first symptom of CF. Click here to read more on meconium ileus.

Distal Intestinal Obstruction Syndrome

Distal intestinal obstruction syndrome (DIOS) is a complication of CF which occurs when faecal material and intestinal contents stick to the lining of the intestines and cause a blockage.

Symptoms can be similar to constipation, such as:

  • Cramps
  • Abdominal pain
  • Bloating
  • Hard stools
  • A reduced amount of bowel movements
  • Loss of appetite and
  • Vomiting

Babies who were born with a meconium ileus, have had bowel surgery or have had DIOS previously are at an increased risk of DIOS. DIOS can occur with a change in diet, illness, exacerbation (chest infection) and dehydration in hot weather. DIOS needs to be diagnosed with an abdominal x-ray.

Ways to prevent DIOS or minimise the risk are:

  • Making sure the enzymes are matched to the daily fat intake
  • Ensure enough fluids are given to prevent dehydration
  • Giving enough salt in warm weather
  • Including adequate fibre in your baby’s diet, once on solids (e.g. wholegrain breads and cereals, whole meal pasta, rice fruit and vegetables).

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