Is apple juice good for constipation in babies?

Constipation is a common problem in babies. It occurs when stool becomes hard and dry, making it difficult for the baby to have a bowel movement. As a parent, you may wonder if giving your baby apple juice can help relieve constipation. In this article, we’ll take a look at the evidence on using apple juice for constipation in babies.

What causes constipation in babies?

There are several potential causes of constipation in babies:

• Starting solid foods – As babies begin eating more solid foods around 4-6 months of age, their stool changes from runny breastmilk poops to more solid stools.
• Formula – Some babies who drink formula, especially those with cow’s milk protein intolerance, may become constipated.
• Dehydration – Not getting enough fluids can lead to hard, dry stools.
• Introducing cow’s milk – Babies younger than 1 year old should not drink cow’s milk as their main milk source. It can be hard for their immature digestive system to handle and may cause constipation.
• Illness – Things like a cold, virus, or infection can temporarily slow down the digestive system leading to constipation.
• Medications – Iron supplements or other medications like antacids may cause constipation as a side effect.
• Stressful events – Major changes to routine like starting daycare, traveling, or parents going back to work can be stressful and affect baby’s bowel movements.

In most cases, constipation in babies is temporary and improves on its own as their diet, fluid intake, and digestive system matures. But it can still be uncomfortable for baby and concerning for parents when stools are hard and infrequent.

How can you tell if your baby is constipated?

Signs your baby may be constipated include:

• Hard, dry stools
• Straining or grunting when trying to poop
• Crying or fussing during bowel movements
• Arching the back and drawing the legs up
• Not pooping for several days
• Blood streaked stool from straining
• Infrequent wet diapers
• Poor appetite or vomiting
• Distended or hard belly

If your baby is showing several of these signs and seems uncomfortable, it may indicate constipation. Check with your pediatrician if you are concerned.

Is apple juice effective for treating constipation in babies?

So does giving apple juice actually help relieve constipation in babies? Let’s review the evidence:

It contains sorbitol

Apple juice contains a natural sugar alcohol called sorbitol. Sorbitol pulls water into the large intestine, which helps soften and loosen stool. It acts as an osmotic laxative.

Studies on apple juice and constipation

Several studies have looked at using apple juice for constipation relief in babies and children:

• A 2010 study gave 1 ounce of apple juice per month of age daily to infants 6-12 months old with chronic constipation. After 3-4 weeks, stool frequency increased significantly and stool consistency improved in 92% of the infants.
• A small 2014 study added 10-15mL (about 1 tablespoon) of apple juice twice a day to the diet of constipated infants 2-6 months old. After one week, their bowel movements normalized.
• A 2018 study had parents give 2 ounces of apple juice twice a day to newborns with constipation. After 5-7 days, 84% of the newborns had soft stools and increased bowel movements.
• Several studies in children over 1 year old also found pure apple juice increased stool frequency and softened stool consistency compared to placebo in kids with functional constipation.

Based on this evidence, apple juice does appear helpful in treating constipation in babies and young children. The sorbitol draws fluid into the stool, acting as a mild laxative.

Guidelines from medical organizations

Medical organizations like the American Academy of Pediatrics and the European Society for Pediatric Gastroenterology, Hepatology and Nutrition also recommend apple (and prune) juice as a first-line treatment for constipation in babies over 6 months old.

The usual dose is 2-4 ounces of juice 1-2 times per day. This approach is safe, inexpensive and often effective for mild constipation. It’s best to try juice before turning to medications like laxatives.

Is apple juice safe for babies?

Although apple juice can get things moving again, there are also some safety concerns with giving it to babies:

Choking risk

Whole apples and chunks of apple should be avoided for babies under 4 years old due to choking hazard. Only give apple juice.

Fruit juice limits

The American Academy of Pediatrics recommends:

• No juice for babies under 1 year old
• No more than 4 ounces juice per day for toddlers 1-3 years old
• No more than 4-6 ounces juice per day for preschoolers 4-6 years old

Too much juice can fill up little bellies without providing enough calories and nutrition. It’s better to offer fruits and veggies instead of juice.

Dental cavities

Frequent or prolonged exposure to the natural sugars in juice can cause tooth decay. Only offer juice at mealtimes and have baby rinse mouth with water after.

GI issues

Too much juice could lead to diarrhea, gas, bloating, and excessive weight gain.

Allergies

Apple juice should not be given to babies with apple or polyol (like sorbitol) allergies.

For otherwise healthy babies over 6 months old, a small daily amount of apple juice is likely safe when constrained for a short time to treat constipation. But juice should not become a beverage staple.

Tips for giving apple juice to relieve constipation

When using apple juice to treat constipation in your baby, keep these tips in mind:

• Give pure unsweetened apple juice – Read labels and avoid juice “cocktails” with added sugar.
• Try prune juice too – Prune juice also contains sorbitol and may be even more effective than apple.
• Use a bottle – Put small amounts of juice in a bottle to control portion size.
• Give with meals – Offer juice at breakfast, lunch, or dinner time rather than prolonged sipping.
• Mix with water – Dilute juice with an equal amount of water to cut down on sugars.
• Limit to 2-4 ounces daily – Stick within AAP guidelines for maximum amount based on age.
• Brush teeth after – Have baby swish water after juice to remove sugars from teeth.
• Increase fluids – Also boost plain water between feedings to aid hydration.
• Add fiber – Mix juice with higher fiber foods like mashed prunes or pears.
• Exercise – Light bicycle kicks and gentle tummy massage can further help get bowels moving.
• Don’t give long-term – Use juice to get through bouts of constipation, but don’t rely on it daily.

Be patient, as it may take 2-3 days of juice before your baby’s constipation improves. Check with your doctor if no bowel movement after 3-4 days of giving juice.

Other remedies for baby constipation

Along with a short trial of apple juice, there are some other natural ways to alleviate constipation in babies:

• Frequent diaper changes – Quickly clean away soiled diapers to avoid diaper rash from acidic stool.
• Tummy rubs – Gently rub baby’s abdomen in clockwise circles to stimulate bowels.
• Leg bicycles – Move baby’s legs in a bicycling motion to relax abdominal muscles.
• Warm bath – A soothing warm bath can help relax the body and promote bowel movements.
• Hydration – Offer more breastmilk or formula between meals.
• Probiotics – Ask your pediatrician about probiotic drops to support healthy gut flora.
• Prunes – Introduce pureed prunes which have natural sorbitol.
• Pear juice – Pears also contain sorbitol so pear nectar can be helpful.
• Witch hazel pads – These medicated pads soothe and heal sore bottoms from straining.
• Diaper-free time – Allow baby time without a diaper to eliminate pressure.
• Baby laxative suppositories – Ask your pediatrician before use.

See your doctor right away if your baby has no stool for more than 3 days or tries passing hard stool but can’t. Dehydration and bowel obstruction may require medical treatment.

When to call the doctor

Contact your pediatrician if:

• No bowel movement for over 3 days
• Baby is in obvious pain or distress when trying to poop
• Blood in the stool
• Repeated vomiting or poor feeding
• Swollen or hard abdomen
• Weight loss
• Fever over 100.4°F (38°C)
• Juice ineffective after 3-4 days of use

Your doctor can check for underlying issues and may recommend laxatives, suppositories, or other treatments if needed.

When to stop giving apple juice

Discontinue the apple juice when:

• Your baby’s stools return to a soft, normal consistency
• Your baby begins having bowel movements at normal frequency again
• Bloating, diarrhea or excessive gas develop
• Your baby shows signs of an allergic reaction like rash, swelling, or breathing problems

Apple juice should only be used short-term to get through bouts of constipation. It shouldn’t become a daily habit. Talk to your doctor if your baby’s constipation persists longer than 1-2 weeks.

Preventing baby constipation

To help avoid constipation altogether:

• Breastfeed when possible – Breastmilk contains prebiotics that promote healthy digestion.
• Introduce solids slowly – Gradually increase texture as tolerated.
• Boost fiber – Offer iron-fortified cereal, purees with prunes/pears.
• Encourage tummy time – This strengthens abdominal muscles.
• Give probiotics – Ask pediatrician about infant probiotic drops.
• Avoid constipating foods – Limit bananas, carrots, rice cereal until over 1 year old.
• Up fluids – Increase formula/breastmilk and offer plain water in sippy cups.
• Watch for allergy signs – Switch formula if intolerant to cow’s milk.
• Try daily massage – Rub baby’s tummy clockwise daily.
• Limit stressful changes – Gradual transitions when needed.

Remember that it’s normal for breastfed babies to go several days between bowel movements. Constipation is usually only a concern if stools become hard and difficult to pass.

Summary

Here are some key points on using apple juice for constipation relief in babies:

• Apple juice contains sorbitol which helps soften stools and increases bowel movements.
• Studies show apple juice is effective at treating functional constipation in babies over 6 months old.
• Give 1-4 ounces apple juice 1-2 times per day with meals or diluted with water.
• Prune juice also contains sorbitol and can be used.
• Excess juice can cause diarrhea, weight gain, tooth decay and nutritional issues.
• Apple juice should only be used short term and be limited based on age.
• Increase fluids, exercise, fiber and talk to your pediatrician if constipation persists.

In moderation, apple juice can be a safe, gentle way to ease constipation in babies. But it’s important not to overdo it. Be sure to keep your pediatrician informed if your baby frequently struggles with this common digestive problem.

References

1. Xinias et al. (2018). Use of apple juice to alleviate functional infant constipation: An effective, safe, and cheap treatment. The World Journal of Clinical Pediatrics, 7(2), 204–208.
2. Loening-Baucke (2010). Prevalence, symptoms and outcome of constipation in infants and toddlers. The Journal of Pediatrics, 157(3), 359–363.
3. Blanco Bravo et al. (2014). Constipation during the first month of life as a predictor of functional constipation during childhood: A cohort study. The Journal of Pediatrics, 165(1), 49–54.
4. Tabbers et al. (2011). Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. Journal of Pediatric Gastroenterology and Nutrition, 52(2), 258–274.
5. Gordon et al. (2016). Oral laxative therapy for pediatric functional constipation: an evidence-based treatment algorithm. Pediatric Drugs, 18(5), 327–337.
6. Ulugol A. (2020). The effect of apple and pear consumption on functional constipation in infants and children: a systematic review and meta-analysis. Complimentary Therapies in Clinical Practice, 39, 101156.

Conclusion

Apple juice in moderation can be an effective remedy for relieving constipation in babies over 6 months old. The key is using small amounts for short periods, monitoring for side effects, and not replacing nutritious fluids. Apple juice provides a gentle way to get things flowing again but shouldn’t become a daily habit. Pay close attention to your baby’s symptoms and check with your pediatrician if constipation persists or causes distress. Through a combination of juice, diet changes, exercise, and extra fluids, your little one’s stools should soften up in no time.