My nearly 2 year old has discovered her poop. It’s disgusting. I walked into her room the other day to get her out of the crib after her nap only to discover feces smeared everywhere. She had completely disrobed and painted the poop all over the crib. After vomiting in my mouth, I vowed to put an end to it.
The problem is that she kept outsmarting me. My daughter was reaching in her diaper from the top, so I put a onesie on her. That worked for a day until she discovered she could reach into the side of the diaper. I decided maybe I could potty train her, but she went ape bananas when I put her on the toilet. I tried one-piece PJs (you know, with the zipper) and she promptly unzipped them. I tried a safety pin threaded through the zipper, which she promptly figured out how to undo and poked herself with it (turns out that was a bad idea). I ultimately concluded that my only solution was to sew her into her jammies so she couldn’t get to her diaper. (Drastic measures, I know.) I simply sewed the zipper flap to the top side of the jammies. After a week of sewing her in at bedtime and naptime, I had conquered the poop problem, but was spending a lot of time sewing her in and cutting her out. (It was kind of ridiculous.)
Then my husband, who is a genius, had a light-bulb moment. He suggested we simply put the pajamas on her backwards. Instead of zipping up the front where she can reach the zipper, the zipper would go up the back. I got new pajamas that were a little large so there was enough extra play in the legs to be able to twist the feet around. And I gave it a try. I am happy to report, it worked. (Did I mention my husband, who may be reading this, is a genius?) She can’t get out of the pajamas, which means she can’t access her diaper. I’ll admit that it’s a pain to get her in and out of PJs for nap time, but the extra minute of work is well worth avoiding the aggravation of cleaning up poop–and it’s a heck of a lot easier than sewing her into her jammies every time she sleeps.
If you or someone you know is struggling with a poop smearing kid, feel free to spread the tip. I figure we’re all in this together and I love to help however I can.
This is a pic of my daughter just before going to bed tonight. The PJs are a little big, so the feet can twist forward and the higher cut on the top, back of the jammies, doesn’t choke her when placed backwards. The zipper is also going up the back.
Here’s the front view:
Here’s the back view:
Teaching kids to wipe their butts effectively is a common parenting struggle. It’s a topic that is never brought up to me (I think due to embarrassment), but one I bring up daily. Often in the well child exam, I will discover poop all over the child’s butt, skids in the underwear, mom is horrified, and the child is oblivious. It is usually in the 4-10 year-old range. In the younger ages, mom is usually still wiping the child’s butt.
When I discover the problem, I respond with: “(child’s name)…you aren’t doing a good enough job wiping your bum. You’ve got lots of poop on it. Let’s review how to do it. Take 2 squares of toilet paper, reach around your bum and wipe back (especially important to emphasize direction of wiping in little girls in order to prevent urinary tract infections). Look at the toilet paper. If there is poop on it, put it in the toilet and get 2 more squares to wipe again. If you have done it 5 times and there is still poop, flush the toilet (to prevent clogging). Keep going until there isn’t any more poop.”
I usually try and pull a few funny faces during the talk (e.g., a gross face when you describe looking at the poop on the toilet paper). The child usually laughs, it keeps the mood light, and it sends the message home.
Keep in mind that most kids aren’t developmentally ready to wipe their own butts until they are 5 years-old. In the beginning, have the child try on his/her own first and then call for the parent to “check” after the child is done. Expect serious smears and poop all over in the beginning. That is normal. Just encourage the effort.
Now here’s the trick. Once your child has learned and is old enough to be doing it on his/her own, hold him/her accountable. If there are skid marks on the underwear, warn the child first. If it continues, make them scrub out the poop in the underwear before it goes in the laundry. Your child will only scrub feces out of his/her underwear a couple of times before they miraculously get better at wiping.
-Photos courtesy of www.123rf.com
Milk soy protein intolerance (MSPI) is a relatively common food intolerance seen in infants. It is caused by the inability to properly digest the proteins found in milk and soy. The proteins cause the lining of the GI tract to get inflamed and damaged. When this happens, the stool starts to get mucous and blood in it, and the infant gets really fussy (they cry all the time because their gut hurts). The diagnosis also goes by the name of food protein-induced colitis (which just means inflammation of the intestines).
MSPI should not be confused with lactose intolerance. Lactose intolerance is caused by a deficiency in the enzyme that breaks down the lactose (a milk sugar). It is very rare for lactose to cause a problem in infants.
There is no specific test to diagnose MSPI. It is diagnosed by history, physical exam, and response treatment. As for treatment, there is no specific medication. The treatment is an elimination diet. If the baby is breastfed, mom has to have a diet completely free of cow’s milk and soy. The diet is not for the faint of heart. Practically everything has milk, butter, or soy it in (not just cheese and yogurt, think breads, sauces, tofu, etc.). Frankly, my hat goes off to the moms who can do it (I don’t think I’m that disciplined). If the baby is formula fed, you have to change to hypoallergenic/hydrolyzed formulas (e.g., Alimentum and Nutramigen). On occasion, I’ll have a baby that is so bad that I have to move to an amino acid-based or elemental formula (Neocate or Puramino). Prep yourself, these are all really expensive and there isn’t a generic available. Also, FYI, the formulas generally don’t taste as good and can cause stinky poop (I mean, more than usual).
Time is a trick with MSPI. It can take a while to show up (because the gut isn’t born inflamed and damaged, it takes time for it to happen) and it takes a while to recover after the diet has been changed. So don’t expect overnight onset or improvement (generally two weeks minimum).
The good news in this miserable diagnosis is that it tends to be a problem of infants only. Most infants outgrow the intolerance by the time they are a year (some even younger).
Thanks to the parents who let me snap of a pic of the poop their baby had in clinic. It’s classic MSPI poop.
Thanks M.B.G. from Utah for your question about what is normal baby poop.
There isn’t a day that goes by that I don’t field a question about whether or not a baby’s poop is “normal.” The reality is that baby’s stool is changing constantly, so it’s hard to know what is normal and what to worry about.
The Normal Transition
When a baby is born, his/her gut isn’t colonized with bacteria. Bacteria are required to digest food. So, the first few stools are sticky, tar-like, and black. As an infant eats breast milk or formula, the gut will get colonized and the stool will “transition.” The stool will change from tar-like and black to greenish/brown and finally end at yellow and seedy. How quick this happens depends on each individual infant’s gut and the amount of food (breast milk or formula) the infant is eating. Most infants transition in 2-5 days.
The Poop Rules
After the initial transition, each baby’s poop will vary quite a bit. Over time I have developed what I call the “Poop Rules.” These are rules of my own creation which essentially help parents decide what is normal (no big deal, don’t worry) vs. something could be wrong (your baby needs to be seen).
- Color. When your baby is first born, the stool will be black. After the stool has changed from black to another color, it should NEVER go back to black. The poop should also NEVER be red (like blood) or white (that means another medical problem altogether). Bottom line, as long as the poop isn’t black, red, or white, another color is acceptable. The most common colors are yellow, brown, orange, and green.
- Consistency. Normal baby poop is anything from pretty watery with a few particles (like seeds) to thick mush or paste. You have a problem if your baby’s poop is straight liquid (like pee) or hard like a rabbit pellet/marble.
- Frequency. Babies poop at all sorts of intervals. Some poop every time you feed them, while others go once every few days. The American Academy of Pediatrics says that it’s normal for a baby to go up to five days between stools. Personally, I think five days between pooping is a long time and tend to use the three- or four-day rule. Anecdotally, it seems that breastfed infants tend to go more frequently than formula fed infants (I think it has to do with the fact that breast milk is easier to digest than formula). So, as long as your infant’s stools fall into the “Poop Rules” norms, then you can breathe a sigh of relief and stop worrying. If, however, your baby’s poop doesn’t meet all three areas of normal, then you need to make an appointment to see your pediatrician.
It is also worth noting that every time you make a change to your baby’s diet (e.g., go from breast milk to formula or start solids) that it is common for your baby’s stool to change. You can get temporary diarrhea or constipation. Generally, it is a good idea to allow your baby’s system to work it out. If however, you find that your baby starts to get outside of the “Poop Rules,” you may want to consult with your pediatrician about ways you can help your baby make the diet transition.