Referrals or Advice re: 13-mo-old Pooping Anxiety
Our 13-month-old is having a rough time with pooping. He stiffens his whole body and cries when he seems to feel any sensations related to needing to poop. We have treated this as a constipation issue for months and have tried to address it that way, as well as treating the intermittent diaper rash that results from his frequent small poops. However, we are now worried that he’s developed anxiety about pooping and that at least some of this may be related to him holding it in. We are looking for advice or referrals for specialists who could help — both with how we react behaviorally so that we can support our kid relaxing about bowel movements, but also about the GI part. We have spoken with our pediatrician but suspect we may need additional help. For more specifics, we are still doing cow’s milk at this point per pediatrician recommendation, and we haven’t done any potty training (and didn’t intend to for a long time).
Thanks!
Parent Replies
I would push your pediatrician for a referral. It sounds like something painful is going on for your little, and you're right, you don't want this developing into a long term issue.
I see that you have treated his behavior as constipation, but have you gotten a more formal diagnosis?
My child had the same issue. Cows milk is VERY constipating. We try to limit cows milk to 1 serving/day, and have switched to oat milk. But watch out for non-dairy milks which add locust bean gum, guar gum, xanthan gum, etc… these food additive gums are added as thickeners and can also be constipating. We drink Oatly which doesn’t contain any of the “gum” thickeners.
Hello,
We had this problem with my daughter and then a little less intense with my son. The pediatrician recommended putting some mineral oil in their hot chocolate. This made it more difficult to hold the stool and also made it more soft. I believe for us it had to do with maybe a small fissure or pain from a hard poop experience that they remember and didn't want to repeat. Also, of course increasing some roughage in their diet. It took a while and then it finally resolved for us. Good luck.
We solved ours (mostly) by following the Ped's recommendation of 2 tsp of miralax per day. You have to get the poop super soft so it comes out easy and stops being so traumatizing. We started Miralax at 18 months and she's still on it now at 4.5, though we have reduced it to 1tsp a day along with a dose of fiber powder.
Our younger child (now 16 months) was having pooping issues that sound similar. I started added 1 tsp of miralax to her milk every day and now her poops are soft and it's no big deal and it doesn't bother her anymore. Pooping used to stress her out so much!
We put the miralax in a cup, add some hot water to dissolve, and then add the milk. It doesn't dissolve well in cold liquids so that's why we take the extra step.
No amount of prunes, pears, or changing her diet (just adding fiber) worked for her. She's also on cow milk and has no other GI issues. The Miralax did it. When I told the pediatrician we started her on it, they said that was just fine. There are no adverse effects from long term use.
It's a simple fix to take away months of potty training trauma if the poops are hard (this happened with our older child).
I don’t have any expertise, but I will tell you what I would try doing to sort it out. I might try talking to a nutritionist who has an expertise in children to see if there are alternatives to cows milk. I’m wondering if your child is lactose intolerant. It is actually much more common than you think. I understand why your pediatrician is recommending cows milk, but I don’t think it would hurt to explore alternatives. My child suffered with stomach stuff for years until we figured out he was lactose intolerant. A nutritionist might be able to suggest foods that would help his digestion. This must be very stressful to watch. Good luck!
Ditto on the Miralax per our pediatrician’s recommendation. Our daughter (around the same age) used to be extremely stressed out and she would cry a lot when she needed to go. Plus it would hurt her and she strained a lot when pooping. I would add Miralax in her soup and made sure she had some type of liquid in her meals for the Miralax. Eventually it stopped hurting her as in she stopped crying when she went. It took a few months before she stopped straining when she went. And about 1.5 years before she went regular. About 8 months after using Miralax, I would reduce the dosage and start skipping in every other meals and then every other days. If she starts straining or not going regular for whatever reason, I would increase dosage again until she gets regular again.
I emphasize how stressful the situation is. Luckily other than incorporating more liquid in her meals, we didn’t have to add mineral oil or do anything else. Good luck!
Are there signs in the stool that it’s actually a constipation issue, as in is it rock hard? Could it be an emotional issue instead? This isn’t conventional advice here, but one from my culture: could it be your baby has retained disgust for pooping themselves? Most American children are trained to poop in diapers, but in the rare case some take poorly to it. From infancy I noticed my baby wailed and fussed when pooping in their diaper, so I tried putting them on a potty during the usual poo times, which baby seemed to prefer pooing on and has been ever since. And reduced the many tiny poos into one or two big poos per day. Around 12mo I noticed my baby throws a tantrum and face turns red when trying to hold it in while sitting in the car seat for a long ride. Perhaps your child is like mine and just really doesn’t like the feel of poo on their butt.