Ask Moxie

Q&A: pooping in her sleep

Carole writes:

"Is there any way I can engineer my 9 1/2 month old baby's diet to reduce the likelihood of us waking up to her in a messy diaper?

We sleep trained her about a month ago (and it's AMAZING, happy happy girl she is now that she's well rested), and have her on a pretty solid schedule, but when we go in to her at 7am she's been poopy for the last three mornings.  She generally poops twice a day.

I breastfeed her at 7pm, 7am and 1am.  She gets formula at 2:30 when I'm at work, breastmilk when I'm home.  She's a big eater, and loves everything, curry, mildly spiced thai food, fish, tofu, whatever we're having for dinner.  Should I make her evening meal more grains and less meat or fiber?  Are there any suggestions for helping avoid making her sit in poop?  (Other than going in to her every time she wakes up and cries for a minute?  She's usually back asleep again within 5 minutes.)"

See, this is yet another situation in which my Trained Monkey Assistants would come in handy. (I've had this idea for years that I should open a ranch where we train monkeys to do things for tired parents like pop back in dropped pacifiers in the middle of the night, wash out sippy cups of milk, match baby socks, etc. Changing middle-of-the-night poop diapers would be a great job for the TMA. Then my friend who actually works in primate research had to shatter my dream by telling me she thinks monkeys would mostly be ill-suited for this job temperament-wise. Easy come, easy go, I guess.)

I think you have two options: 1) Experiment with stuffing her full of binding foods (like rice and Veggie Booty) a few hours before bed, or 2) Wait it out until her pooping pattern changes on its own.

Feeding her binding foods could do the trick, or it could have no effect whatsoever. There's really no way to tell. And I guess it's also possible that you could end up going too far and constipating her for a day or two until you work the balance back out. But, if you are the kind of person who likes to be actively working on a problem, then you might as well try it and see what happens.

The real truth is that it's going to stop eventually, because as her eating and movement changes her pooping is going to change, too. So you could just cut to the chase and wait it out. If you're feeling particularly tired or worn out, that's certainly going to be the best option. But if you want to work on the problem, try messing around with her food, and it may ease things more quickly, or eventually she'll just stop pooping at night on her own.

If she were older, I'd tell you to teach her to yell out "poop"or some special sign when she's actually pooped, so you'd know it was that and not just that little night-waking thing some kids do. At this age, she could probably learn a hand sign for poop, but that doesn't help any of you in the middle of the night.

Any suggestions to help Carole get to her daughter when she's pooped, without having to go in for every little peep? Did anyone else go through a night-time pooping stage with a baby this old?

Wow

Do you know what is NOT a good idea?

To have had about 30 g of fiber by lunchtime, and then to absentmindedly eat all the dried figs that are sitting on your desk during the afternoon. (They're just so nice and chewy and sweet.) Approximate dried fig count: 15. Approximate grams of fiber that was: 30.

You can do the math there. Not pleasant. I think I'm having flashbacks to Lord of the Flies.

Cheryl, do you know why too much fiber makes a person stink? Because I definitely noticed that a few hours after Figgate I started to smell like I was two weeks postpartum (sweaty, unshowered, a little sour milk-y) and it lasted for a few hours.

Fascinating. And unpleasant. Fortunately my only plans for the evening were watching my DVR'd episode of The Biggest Loser. (Does anyone else watch? I've been rooting for Kelly the whole time, and love how she's blossomed and gotten so much self-confidence during the course of the show.)

About this fiber thing

It's really interesting that so many of the commenters yesterday mentioned that the solution to their children's potty problems (especially peeing problems) was giving their kids more fiber.

Since I've been getting 5 servings of vegetables every day, I decided to take the next step and start looking at my fiber intake. Apparently adequate fiber intake is the lynchpin of good health. Its helps with elimination, moisture maintenance, glucose and insulin level regulation, healthy skin, and weight maintenance. It helps prevent cancers of the bowel, colon, and stomach. (And, according to this book, eating enough fiber is all you need to do to lose weight. Right.)

In short, fiber is good. Adults are supposed to be getting 30 grams or more a day. (I didn't see a figure for kids in the stuff I was reading, so if anyone knows a good benchmark for fiber intake for kids, please post it.)

I gave in and joined FitDay.com (which I don't love, but it's free and seems to work OK) to track what I was eating to see how I was doing on fiber. You'd think raw kale and spinach would add a lot of fiber to your morning smoothie, but you'd be wrong, because the smoothie ingredient that actually contains the most fiber is the frozen raspberries I've been tossing in just because I like the taste. But I've been getting around 20-25 g of fiber a day without trying very hard (except for the vegetable thing, which was hard at the beginning but isn't anymore).

I'm starting the T-Tapp 60-Day Challenge on Friday, and have decided that my game plan is consistency with the workouts (three a week) and 40 g of fiber a day (I picked 40 sort of randomly). So over this week I've been slowly trying to bump up my fiber intake so I don't cause any sudden stomach issues. The next step is going to be to try to switch around some of the things the boys eat so they're getting more fiber without noticing the difference. I think in the long run, being in the habit of getting plenty of fiber is one of the best things that can happen to them healthwise.

Anyone else interested in investigating the whole fiber thing? Thoughts? Secret recipes? Have you upped your own fiber? Have you upped your kids' fiber?

(My favorite breakfast so far is cooked quinoa, reheated in the microwave at work, with raw almonds, pumpkin seeds, and dried cranberries and a little raw honey. 15g of fiber, and sticks with you for hours and hours and hours.)

Toilet regressions

I know we talked about potty training not so long ago, but in the past couple of weeks I've gotten four (4!) emails from people with kids over the age of three who are mostly potty trained, but who are now having regressions.

The details are all a little different, but mostly similar. The children were potty trained (at least during the day), but is now having accidents or refusing to go in the toilet/potty. Sometimes it's happening at home, sometimes at preschool, and one is happening at daycare. The parents are perplexed and worried, because the kids were using the toilet with no problems, but are now backsliding.

Remember that I really know nothing about potty training and toilet issues. But there are a couple of things I'd take a look at. The first is emotional issues. When something stresses a kid, even in a positive way, elimination control is one of the first things to go. Starting school, even if they love school, can cause backsliding. A new sibling, even for up to a year after the baby arrives, can cause it. Even something like spring break or a birthday celebration can trigger regressions.

If you think it's some kind of emotional thing that's causing the backsliding, then the best course of action is probably just to try to get things on an even keel again as soon as you can. Get into a new solid routine if things have changed, and get back into the old routine if it was seasonal excitement.

The other thing to look at if the accidents are pee accidents, is a urinary tract infection. If you've ever had one you know that one of the symptoms is feeling like you have to pee all the freaking time. Imagine this for a 3-year-old who's being reprimanded for not  holding it in. A doctor can diagnose it with a urine sample, and it's easy to treat, so if you even suspect that it might be a UTI, swing past your pediatrician's office and get it tested.

I have no backup on this, but I'm going to guess that food allergies could probably trigger toilet regression, too, since they basically make a kid's system go haywire in lots of ways. The same way food sensitivities/allergies/etc. can cause tantrums and horrible behavior in 3+-year-old kids, they could be the final thing that pushes a kid not to be able to control elimination.

Anyone else go through a child who regressed? Do you know what caused it? Was there anything you did about it that worked? Or did you just wait it out?

Setting the scene for potty training?

After I posted that my younger son went into underpants on my birthday, I got four emails from people asking how I set the stage for him to be able to make his own decision.

I don't actually know. I really really thought he'd be so different from his brother, who was doing all the potty-training stuff (always went on his own inside the house) but still wore a diaper when we went out. But, go figure, they both ended up doing the same thing, which was telling me at the last second that they weren't going to wear a diaper that day.

I honestly don't think it's anything I did, but rather that they're potty-training anomalies.

Now, if you'd asked me that question 3 years ago, I'd have said that I hopped on my oldest son's interested as soon as he expressed them (getting him a potty when he was 16 months, for instance, and stopping to watch every dog on the street do his business). But my younger son wasn't interested in underpants until I bought them, and, in fact, told me several times that he was going to wear a diaper "fow-evew, mom-mom."

Maybe it was because I took his claims seriously, while still giving him an out. Maybe it was all the talk about "big boys wear underpants."Maybe it was seeing his friend O wearing underpants and peeing in the potty.

At this point I have the luxury of not caring, because he even switched into underpants at night and has been getting up to pee on his own for three nights running.

But I'm betting there are some of you who have systematized ways of setting a relaxed-but-motivating environment for your kids to get out of diapers. I've said it before, but I think it's far easier to push a kid to train when they're closer to two than to three. By the time they turn three, they really dig in their heels. So bear that in mind, that when they're younger they may be less physically ready, but when they're older it's less about technique and more about mind games.

Any comments about creating the right environment for an older kid to decide to make the leap?

Now with extra pooping?

Neil is wondering if anyone else has experienced radically increased pooping from your baby when you switched from regular formula to a formula enhanced with Omega 3s. It makes sense to me that that could happen, but it would be nice to have some data points.

Potty training when you can't control all the variables

It seems like the parenting zeitgeist is all about potty training lately. I got three questions on the same day about potty training last week, and have been thinking about it a lot myself lately because my son will be three in May and isn't out of diapers. Then yesterday I spent the afternoon with my BFF and her husband and son, who is almost three and still not completely potty-trained.

As long-time readers know, my older son pretty much potty-trained himself. He started wanting to try it at 16 months and was just really into all things potty. He'd be our bathroom attendant and hand us the toilet paper, stop to observe dogs pooping and peeing on the street, and watch the Bear in the Big Blue House "Potty Time" DVD on a continuous loop. He was in underpants by 27 months during the day, and by 32 months at night.

So I've got nothing, because I didn't really do much of anything other than go with his interests.

The younger one is more of a challenge, though. His personality is completely different, and he really isn't convinced there are any benefits to being in underpants. Plus I'm at work all day now, so I don't have the same ability to control the situation on a micro level. And it's harder to just leave him in underpants all day and not worry about accidents, since we have to leave the house more to work around his older brother's school schedule.

We've talked here about potty training several times in the past few years, and as usual you guys have been a font of information and experience. I'd like to open up another discussion about it, but pick your brains for ideas about training a non-only child who is at the whim of an older child's schedule, and also for training a child (who isn't so sure about it) when there's a childcare issue involved.

Help?

Q&A: pooping to avoid napping

Happy New Year!

Heather writes:

"I am not sure if this is a problem others have run into or not, but my 10 month old daughter has been pooping a lot lately either 20-30 minutes in her naps or right after I put her down she wakes up and poops, thereby ending the nap. This is a typical day all of a sudden: 20 mins into a nap I hear her babbling away in her crib, not crying and wait and wait thinking she'll fall asleep, because she *must* be tired, right? Well, 45 minutes go by and I finally decide to go check on her and the smell of poop hits me the second I walk into the room.  I couldn't sleep with poop in my pants either, so I feel bad and change her diaper.  By this point, she is in no frame of mind to go back to sleep so we go downstairs and play until she seems tired enough to try again.  We go through the whole routine, I nurse her to sleep, plop her into the crib, close the door gently behind me and I hear, "bah? bah! mamamama!" and it starts all over.  I check 10 mins later and she pooped again!  This has been going on consistently for three days now.  Is she doing this on purpose?  Could she possibly have control over her bowels and be avoiding naps? I should mention she has a very solid routine and normally takes two 1 hr 20min long naps on the 2-3-4 schedule that you sometimes talk about.  Oh, and she usually poops *after* she naps or when she wakes up in the morning.  So, this is totally out of character for her, but becoming a new routine that I feel I can count on, unfortunately."

I feel bad laughing, but that was my first reaction, because I'm a 12-year-old boy sometimes.

I think the pooping has more to do with the nursing than with the napping. Many many many babies poop after they nurse, and it sounds like something about her digestive pattern has changed to make her poop shortly after nursing. (Why do the baby books not tell you that your kid's poop patterns often change right after a growth or digestive spurt? Both of my kids were like clockwork, with a new pooping pattern after the 3-week, 6-week, 3-month, and 6-month growth spurts. It's totally normal, but I get a surprising number of emails from people who are concerned when their kids go from 6 times a day to once a day, or something like that, and you'd think one of the big-name doctors would have thought to put that down.)

It wouldn't surprise me in the least if part of the big 8-9-month sleep regression had something to do with digestion, or if the increased movement around this age changed pooping patterns, or something like that.

Anyway, the point is that I think the trick is going to be to figure out how to get her to poop either before she nurses down, get her to nurse and poop and then fall asleep, or some other possibility.

You're really stuck between a rock and a hard place, because the whole point of nursing her down is that it always works like a charm, and why mess with something that works so well? But if she only goes down but doesn't stay down, then your beautiful system isn't working so well anyway.

In your shoes, I'd do pretty much whatever I had to to figure out how not to stop the nursing to sleep (having had a child who would not nurse down for naps and one who did, I really think nursing down makes everything so much easier for everyone because it's pretty much a guarantee). I wonder if you could mess around with the solids you're feeding her to see if you could get her to eat some poop-inducers at non-nap times to see if that would leave her without anything to poop out during naps. Raisins, pureed prunes, and squash were big poop-producers in my apartment. (Also, if I drank coffee--even decaf--and then nursed, both my boys would poop. Go figure.)

That's all I can think of, other than trying to get her to stay awake until she poops and then get her down, which makes me feel exhausted even thinking about the logistics. Of. (Some bad grammar for the new year. Did I mention I have some sort of illness that has left me with no voice today? It must be affecting the sentence-writing part of my brain.) OTOH, if you've been trying to get out of nursing to sleep for the nap, this is the perfect time to do that.

Any comment help?

Comments, Christmas week, and other crap

First of all, I know there's something wrong with accessing comments on all the posts from before I switched domain names last Wednesday, and am trying to figure it out with the Typepad people. The comments are all still there, I just don't know how to get to read them yet, but it will all get straightened out soon.

Second, I'm going to be out of town with very limited internet access next week (December 24-28), so I'm going to set posts to autopost every day that week. But in the spirit of combating the stress of that week, I'm going to put an open post up that stays at the top of the screen, so people can just stop by and comment about whatever they feel, whether they need advice, want to vent, or are just looking for some non-family conversation. If you're feeling bored or sad or irate or like you could use a little community, please stop by and see what's up.

Third, we've got another disgusting topic today. In the spirit of the vomit conversation from a few weeks back and the pee overflow question of Friday, can we talk about poop explosions and diarrhea? One of my co-workers was out a few days last week because his toddler had the stomach flu and they were just drowning in vomit and diarrhea. OK, maybe I could have used a different verb there. They were overwhelmed by keeping up with the substances coming out of both ends of the little lad. That's better.

So we're looking for tips on dealing with diarrhea. While we're here, we might as well talk about regular old poopsplosions that newborns have.

I've pretty much got nothing on diarrhea.

I do know about projectile poop, though, and my biggest tip is to put layers on the child's butt to catch the poop. That's one reason I did cloth diapers at the beginning with each of my kids, and not the fancy pocket diapers either. It seems like the extra layers of prefold + cover helps contain the runny newborn poop so much better than a one-layered disposable can, or a pocket diaper that has the effect of a one-layered diaper. The times there was a big poop in a disposable or pocket diaper, the poop got all over the clothes. In a prefold + cover,it all stayed inside the cover.

I've even heard of people who use disposables buying PUL (laminated fabric, what modern cloth diaper covers are made of) covers and putting them over the disposables to make that extra layer to protect the clothes.

Another thing I know about is the two kinds of normal poop that can mimic diarrhea. One is runny green poop. Green poop happens when the milk runs through the kid's system too fast. Sometimes that will happen with a stomach bug (and can continue to be green even after the other symptoms are gone). The other thing that can make green poop is if there's a foremilk/hindmilk imbalance, or the mom has oversupply. The foremilk is the first milk the baby gets, and it's watery to hydrate the child, plus it has lots of lactose. The hindmilk is the milk that comes at the end of a nursing session, and it's full of fat to bulk up the child.

If the mother has oversupply, the child gets mostly foremilk and can never drink enough to get the hindmilk, so they have too much lactose in their systems and their poop can be green. (Other symptoms of oversupply are: falling asleep within a few minutes at the breast then waking up ravenous an hour or so later; putting on weight really rapidly; and making little goat baby noises. If your child is doing this, you may have oversupply.)

The other normal poop that can mimic diarrhea is "drool stool"." When a child is teething, s/he produces drool, and lots of it ends up going down the back of the baby's throat. (If your teething baby has what sounds like a smoker's cough in the mornings, it's from the drool down the back of the throat.) It passes through the stomach and will come out in the poop, as slimy long shards of drool. The drool can also make your baby's poop so acidic you can smell it (eew) and can cause patches on the butt and anus that look almost burned from the acidic drool. (So now your child is in pain in the gums and the butt. Lovely, isn't it?) Use a non-zinc oxide diaper rash barrier cream (plain old Vaseline or Aquaphor will work well) proactively each time you change a diaper to make a coating to prevent the next poop from touching the skin.

I hope you finished your breakfast before you started reading this morning. Please post your poop-related tips for all to enjoy.

Q&A: 3 1/2-year-old reverting to wetting the bed

Kecia (another pretty name) writes:

"I need HELP!!!! (please)

My son is 3 1/2.  He has been potty trained since he turned three.  At about 37 months, he told me that he didn't not need a diaper during the night.  I was reluctant, but decided to give it a try, as his diaper was often dry in the morning. For nearly two months this worked perfectly.  Not one accident!!

He would drink a 6 oz yogurt smoothie during his bedtime stories and I would give him water when he went to bed.  He would sleep for 9+ hours and wake up with a very full bladder (and pee in his potty).

In late August, we were traveling and he wet the bed (two nights in a row).  When we returned home, things improved for a few weeks and then he had several nights of accidents again.  The situation has continued to deteriorate.  In the past month he has had an accident every few nights.

I am so tired of waking in the middle of the night to change his clothing, his bedding, etc.  I want to help him, but I don't know how.  The strange part is he seems to have these accidents without a full bladder.  Some nights his pajamas and pants are only very damp - not soaked. On nights when I limit liquid consumption and have him pee before going to sleep, it seems he is more likely to wet the bed.  This can happen as early as midnight, maybe 3 hours after he last urinated.  I have also tried to wake him during the middle of the night and have him pee, but this doesn't seem to help.  I usually find that he is already wet.  Now when he wakes up in the morning he doesn't even need to use the potty!  What is going on?

He has only had one daytime accident over the past few months.

What do you think?

Do I go back to diapers?  Do I continue to do three loads of bedding every time this happens (comforter, mattress protector, sheets and pajamas)?"

Aha. It's the 3 1/2 thing. Did you by any chance read my review of the book Your Three-Year-Old: Friend or Enemy from a few weeks ago? The part of my review that's salient to your problem is here (Isn't it just so classy when I quote myself? Sorry about that.):

Ames and Ilg observed that for kids this age, things seemed to run on a 6-month cycle of equilibrium and disequilibrium. So for awhile children would be fluent and cheerful, coordinated, learning new things all the time, and happy little kids doing things smoothly. Then they'd go through a period of being physically clumsy, stuttering, being in foul moods, and just having things go wrong a lot of the time. According to them, this is normal, so knowing that will help you wait out the periods of disequilibrium, and not get freaked out by things that are developmentally appropriate but seem like regressions (like stuttering).

It sounds to me like that's exactly what happened, that he was in a smooth state of equilibrium when he got out of the diapers at night, but has now moved into the stage of disequilibrium and he just can't control his body like he used to. The pendulum will swing back to smoothness in a few months.

So the question is, what do you do in the meantime? I think I'd ask him what you should do together. Explain to him that it's just normal that he's going through a stage in which his body isn't stopping the pee like he wants it to, and he'll be able to stay dry again in a few months, but not right now. Ask him if he wants to go back into PullUps at night (that would be my vote if I were you, but I think you really need to make this as easy emotionally on him as possible, so giving him a vote will help a ton) or if he can get up and change his own pajama pants in the middle of the night. If he wants to stay out of diapers, you should try to put as much of the clean-up on him as is reasonable (maybe give him a layered bed with towels and protective pads layered so he can just take the top one off after he changes his pajamas, and no comforter).

I'm going to guess that faced with the alternatives he'll chose PullUps for the next few months.

Don't worry that going back into diapers means that you failed and it's forever and you'll send him off to college with a pack of jumbo size PullUps. It's just part of the ickiness of being 3 1/2. And yeah, you could try all the treatments for bed-wetting like the alarms, acupuncture, chiropractic, biofeedback, etc. But all those things are really for bigger kids who are still wetting the bed, not kids his age. Besides, by the time you messed around with all that stuff he'd probably have grown into the next stage of equilibrium anyway.

So just know that there's nothing wrong with him, and this is a laundry problem instead of anything else, so treat it accordingly. You're doing a good job.