Ask the Nutritionist - Constipation?

Posted 11.24.09 | Nutrition Specialist


Since starting on Neocate a week ago for her milk protein allergy, my 7 month old daughter seems like she might be constipated. She is having less frequent bowel movements (sometimes she goes a whole day or two without pooping!) and I am worried. Is this normal or could it be a sign of something else?


We get a lot of questions from Neocate parents about constipation. Amino acid-based formulas like Neocate do not technically cause constipation. However, because of the way amino acid-based formulas are digested and absorbed, children taking them tend to have less frequent bowel movements.

Neocate is a "low residue" formula, meaning that after the body digests and absorbs it, there is very little waste to pass. This is the major factor leading toward less frequent bowel movements. Also, some babies on Neocate may have already been prone to constipation because of the GI issues caused by food allergies or other conditions, which may have been overlooked. Keep in mind all babies have different stool patterns, but typical stool frequency on a formula like Neocate can be around 1 stool per day or two.

One telling sign of actual constipation (not just the effect of a low residue formula) is bowel movements that are hard or pellet-like. You might also notice that your baby is grunting, straining or seems like he or she is relieved right after having a bowel movement.

If this sounds like your little one, don’t worry! Ask you healthcare team for advice, and see if they can share a few tricks that can help relieve your little one's discomfort. One thing they might recommend could be to try moving their legs around to get things moving through their digestive system. Another could be to gently massage their tummy. Check with your doctor about giving your child some water or a fruit juice to hydrate them, though this might not be recommended depending on how young your little one is. In extreme cases, your doctor can also give you some alternative solutions which can stimulate a bowel movement as well.

Read Comments (12)

  • 2012-04-10 | angie

    Do infants who consume neocate usually drink less per ounce?  My little would drin 4 ounces on the other formulals, I have noticed with neocate he at times drinks less than 4 and or at times drink a little more.  When should I be concern?

  • 2012-04-18 | Rob

    Hi Angie,

    It’s not unusual to sometimes see infants consume a little bit less Neocate at first, while they get used to the slightly different taste and thinner texture compared to other formulas. On the other hand, some infants take in more Neocate, since it’s finally a formula that they tolerate well and can provide the nutrition they need for catch-up growth.

    In general, infants may take a little more or a little less formula from one feeding to another - it’s not always the same amount at every feeding. You can check with the healthcare team for when to be concerned - usually they’ll keep an eye on where your little one is on his or her growth charts to make sure the formula they’re taking in is enough.

    Hope that helps! If you have further questions, you can always reach us at 800.NEOCATE (Option 2) or by email - .(JavaScript must be enabled to view this email address)


  • 2015-02-04 | Diane Marcin

    My six week old grandson has been on neocate 2 ounces every 2 hours for one month now. He is on a medication for reflux too. His main problem is being unable to have a bowel movement. He is taking prune juice one ounce twice daily along with antacid 2-4 times daily in place of infant gas drops. He suffers from not being able to “poo”...It wakes him from his sleep and he is crying and wiggling for about 2 hours every morning about 3 to four and eventually poos…..after 24 hours he is sooo uncomfortable. Please HELP! ADVISE! The doctor says that the formula is so broken down that it doesnt make much stool…..but the little infant suffers every night until he eventually poos. Thank you.
    stomach massage, leg exercises and foot massages so not seem to alleviate the discomfort/pain—-please help ASAP….

  • 2015-02-04 | Rob McCandlish, RDN

    Hi Diane,
      I’m so sorry to hear that your little guy seems to be uncomfortable. A lot of infants on a formula like Neocate Infant don’t go very frequently and parents say they see less stool in the diaper. The physician is right regarding formulas like Neocate Infant, in that there just isn’t much left over after the body absorbs the nutrients.
      I wish we could help, but unfortunately we are not able to give medical advice. The best we can do is to refer you back to the medical team. They may have some more suggestions, such as the possibility of adding a fiber source (in place of or in addition to prune juice) or additional strategies that they’ve seen success with in similar scenarios.
      Best of luck to you,

  • 2016-07-02 | Kelly

    My 4 month old has reflux and is also allergic to my breastmilk and was started on Neocate 4 days ago and hasn’t had a bowel movement since.  Her GI specialist isn’t available for 3 more days.  When should I be concerned?

  • 2016-07-05 | Nutrition Specialist

    Hi Kelly,
      4 days is on the long end, but it isn’t unheard of, especially for an infant that’s new to a formula like Neocate. The doctor is the best person to advise if you should be concerned, but if your son doesn’t seem uncomfortable and is still taking a normal amount of formula, it may just be a matter of time. And maybe the office could get you in to see a physician’s assistant or nurse practitioner? Hang in there!

  • 2016-08-21 | Kylie


    I have a 8 month old little boy, who was originally exclusively breast feed for just shy six months. In that time he had limited bowel motions which where always soft and was requiring suppositories every 10th-11th day.

    We then told that something in my breastmilk is causing him not to pass on his own. He was put on novalac constipation and he passed every day with out fail. (However he got very mucusy) we have now had allergy skin pricking and now know he is allergic to cows milk and are on Neocate LCP.

    He started on Thursday night 18 August 2016 and Saturday 20th August notice him straining a lot and whinging a little soft but ball was in his nappy.

    Again today Sunday 21st August he was unsettled and grunting nothing was in his nappy. So gave him a suppository and poo pic attached came out… Is this common? Will it pass with time to going having regular pooing like on the other formula?

  • 2016-08-22 | Nutrition Specialist

    Hi Kylie,
      With hypoallergenic formulas like Neocate, it’s not unusual to see bowel movements that are less frequent than when breastfed or with regular infant formula. A lot of parents tell us that their little one only has a bowel movement every day or every other day, or sometimes even less frequently. And bowel movements can vary from soft to pasty to hard. We always defer to the healthcare team for their guidance on the need for suppositories or laxatives.
      Best of luck!

  • 2017-10-15 | Ira

    Hi , i have 3 months baby girl , she drinking neocate since she 6 weeks old , she always go to 4 - 5 days without pooping , i wanna ask , it is normal to take such a long time without poop ? And she always looks hurt everytime she tries to poop ,  She takes 2 Oz every 2 hour , pls answer thank you

  • 2017-10-16 | Nutrition Specialist

    Hi Ira,
        It’s pretty common for infants taking a hypoallergenic formula like Neocate to only have a bowel movement every 1 to 2 days. Going longer, as you describe, is unusual but not unheard of. Our next question is usually ‘Does the baby seem uncomfortable?’ and you’ve already answered that question.
        Unfortunately we can’t provide medical advice and have to refer you back to your daughter’s healthcare team. Here are some questions you can ask yourself and the healthcare team that might help:
      -Could something other than her diet be contributing to constipation?
      -Could it help to use a formula with added pre- and probiotics, like Neocate Syneo (http://www.Neocate/com/Syneo)?
      -Is your daughter growing normally?
      -Could gently rubbing her belly or “leg bicycles” help?
      -Would they suggest fruit juice, if so what juice, how should it be mixed, and how much?
        Always consult your doctor before making any changes to your little girl’s diet or routine. Best of luck to you!

  • 2017-12-02 | Juan Ochoa

    Hi.  My son has been taking neocate jr for several years now due to cow’s milk allergy. He also eats one very small meal in the day (he is not a big eater). Sometimes he poops once a day but other times he goes 3-4 days without pooping. You said to a lot of parents that this is not unheard of with neocate because its a low residue formula.  My son is on Neocate Jr. With prebiotics though. Should I be concerned?

  • 2017-12-04 | Nutrition Specialist

    Hi Juan,
        Thanks for your question! While a lot of parents tell us that their child has one bowel movement every day or every other day, it’s not uncommon for parents to tell us that they see what you’re seeing. With amino acid-based formulas, like Neocate, they may happen every few days. In general, the more solid foods a child eats when they’re taking Neocate, the more regular their bowel movements, but that’s also just a general trend.
        Your son is taking Neocate Junior with Prebiotics, so it already includes some prebiotic “fiber.” Some prebiotics have been shown to help facilitate more regular bowel movements. However, this isn’t the case for every prebiotic, and not everyone has the same experience. The type of prebiotic in Neocate Junior with Prebiotics has been shown to help support beneficial bacteria in the gut. However, the type (and amount added) may not have much of an impact on regularity.
        Hope this is helpful! If your son doesn’t seem uncomfortable, you probably don’t have anything to worry about. If you are concerned, check with his healthcare team to see if they have any advice or strategies to recommend.
        Best of luck,

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Food Allergy Living is a resource for parents of children with food allergies, brought to you by Nutricia, the makers of Neocate. For more in-depth information about our purpose & authors, see our About Food Allergy Living page.