A reader writes: “Grunting baby syndrome. Is this really a thing? My 6-week-old son grunts, strains, and writhes from approximately 3 to 6 a.m. every night. Most of the time he sleeps through it. My GP suspects reflux but ranitidine has not helped. Also, he’s very happy/calm all day rarely fusses or cries. My Google searching came across grunting baby syndrome. Is that a real thing? When do babies grow out of it on average?”
One of the fun things about writing this blog are good questions, or questions about things I had never heard of before. And, yes, grunting baby syndrome is a real thing, and something I’ve talked with parents about for years. I’d just never heard this name for it. I think the name is mostly used in the U.K. (most of the sites I found referring to it come from across the pond), but it seems to be catching on here. Whatever you call it, it’s one of those things that makes sense with a little explanation.
Anyone who’s had a newborn knows that poop doesn’t always come easily. There’s often a big show, with grunting and a red face, and sometimes crying. (This is the baby we’re talking about, here. Not dad. I think.) But the poo itself isn’t hard or even firm; it’s normal, ordinary baby poo, soft as applesauce or weird yellow pudding. So why the big show? Why all the grunting?
Two reasons, I think. One is that it’s genuinely difficult to have a bowel movement while lying on your back. Go ahead, try it yourself. We’ll wait here.
See? With nothing to push your feet against, it just doesn’t work. I’ll bet you were pushing and grunting, and your face turned red too. Perhaps your behavior was puzzling to your spouse, who chased you out of the bedroom with a broom. You should probably go back and explain, later.
But there’s a second reason for the grunting. Have you ever thought about the steps you’re taking to poop? You need to tighten up your abdominal muscles to push, while simultaneously relaxing your pelvic floor and anus. Tricky! It’s like patting your head while rubbing your stomach; another trick that newborns can’t do well. Tightening one set of muscles while relaxing another isn’t easy. You can tell a baby’s having trouble coordinating this if you pat their bottoms while they’re grunting. Their little buns are squeezed together, all tense. It’s no wonder the poop can’t come out! And it’s no wonder that when it eventually does, it’s a noisy explosion that startles Junior and parents alike.
So: what should parents do? Relax. Don’t get anxious; that will not help your baby get through this. Gently bicycle his little legs, and hold him, and help him relax. When gas passes, and it will, make a little joke. “You sound like Daddy!” would be appropriate, or “Here comes Grandma!” if she’s not in the room. A bad thing to do is to get wrapped up in the drama, and add more worry. If it’s at night, and the grunting is keeping you awake, turn down the baby monitor. The poop will come, I promise.
This isn’t constipation, which requires hard stools. Giving a stool softener won’t work, and neither will changing formulas. (Though it will get you off the phone with your pediatrician’s office. I probably shouldn’t have told you that.) Rectal stimulation with a thermometer will work, but only in the short run; that won’t help Junior figure this out himself, which is the only long-term solution.
If you’re worried that your child just cannot pass stools, talk with your child’s doc. There are some rare conditions that prevent poopage. But the vast majority of grunting, red-faced babies have this grunting baby syndrome, which is another thing you don’t have to worry about.
Roy Benaroch is a pediatrician who blogs at the Pediatric Insider. He is also the author of A Guide to Getting the Best Health Care for Your Child and the creator of The Great Courses’ Medical School for Everyone: Grand Rounds Cases.
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