Defecation Ask for a history and clinical assessment of defecation to understand the frequency and nature of the infant’s stools and how long it takes for the infant to defecate. Difficult bowel movements: the infant strains or cries for about 10 min before passing soft stools; Dry stools: the infant has dry stools, as shown below (Bristow types 1 to 3). Concomitant symptoms Whether the infant is accompanied by crying, blood in the stool, and whether anal fissures, perianal inflammation, perianal abscesses, or anal fistulas have been or are currently present. During the abdominal examination, pay attention to the presence of mild abdominal distension and whether a stool mass can be felt in the left lower abdomen; during the perianal and perineal appearance examination, pay attention to the presence of perianal erythema and anal fissures, the presence of fecal remains in the perianal area or clothing, and perform the testicular reflex and anal reflex examination; check the muscle tone of the lower limbs; if necessary, perform abdominal ultrasound, stool routine and occult blood test. Personal and family history Find out the timing of fecal discharge, any history of recurrent urinary tract infections, gastrointestinal diseases (congenital megacolon, colon polyps, inflammatory bowel disease, etc.) and other diseases (allergic diseases, thyroid and parathyroid diseases, etc.). Feeding Pay attention to feeding patterns and the amount of milk fed, paying special attention to whether the formula is too thick, the mother’s excessive consumption of spicy foods, and the recent addition of complementary foods; pay attention to the intake of fiber and fat, and the application of calcium, iron, and zinc supplements. Growth and development: Find out the gestational age, birth mass, current body mass and length, and assess for poor growth and growth retardation. If you have any of the following symptoms, you should consider the presence of pathological conditions, such as congenital megacolon, anal stenosis, intestinal polyps, anal fissure, food allergy such as milk protein, etc., and need prompt referral or consultation: 1. difficulty in expelling feces; 2. frequent vomiting and abdominal distension; 3. blood in the stool (strong positive fecal occult blood test); 4. abnormal lumbosacral curvature at the anal perineum, absence of anal reflex, absence of testicular reflex, lower limb muscle 5. Poor growth (poor growth in length and body mass). 1. Explain to the parents the mechanism of difficult defecation or dry stools, and that some breastfed infants may have less stool, which is a physiological phenomenon. 2. Encourage the parents to maintain a positive attitude, pay attention to the infant’s physical growth, and cultivate good defecation habits over time and patiently. Care guidance 1.Guidance on infant care, especially hip care, to avoid red buttocks and anal fissures; 2.Guidance on the cultivation of regular bowel movements. You can start from 2~3 months of age and give infants a certain amount of toilet time after meals to keep the memory of defecation frequency. Defecation training is a long-term process, be patient enough; 3, abdominal massage, centered on the umbilicus, rotate slightly clockwise; 4, more exercise, passive exercise or active exercise can promote intestinal peristalsis. Feeding guidance and dietary intervention 1.Advocate breastfeeding, breastfeeding mothers have a balanced diet, reduce or avoid the intake of spicy food; 2.Combine dietary intervention with behavioral modification to ensure normal bowel movement and maintain good bowel habits; 3.Add supplemental food at the right time and reasonably, increase fiber and fat appropriately to soften stools; 4.Add water or other liquids (such as plum, pear, apple and other juices containing sorbitol) in an appropriate amount to increase stool intake 5. Nutritional supplements such as calcium, iron, zinc, etc. may increase the dryness of stool and should be added under the guidance of physicians. 6. For infants with suspected milk protein allergy causing difficult bowel movements/dry stools, they should be referred to a specialist for diagnosis and intervention.