chronic constipation and poop Q...(long)

adrielegorburu

DD has had issues with hard/infrequent stools since the NICU - she pooped up a storm at first but had a few hard poos in the NICU that gave her fissures. At home the first few months she was breast milk only and took a poop only once every 7-10 days. It would eventually happen and be normal (on the dry or hard side but basically normal) so all her docs always said no big deal.  Once we introduced formula at 7 months actual (we supplemented until my stash ran out then FF totally) she started to go more often but much harder. We would get one every few days. She started having fissure issues again.  When daycare started (Feb of this year - she was 11 months actual) we were still giving her cereal in her formula to thicken for her reflux, she was still having hard stools once every 3 or 4 days and would strain to go, and get fissures. After a while daycare started reporting a normal large stool EVERY DAY.  But at home on weekends we would see nothing, sometimes if she was home 4-5 days.... nothing.  Unless she would start screaming and doing her 'thing' (I'll explain the thing below) and we would find a huge impacted poop that we literally would have to go in and get out ourselves (manual disimpaction or use of stimulant laxitives and enemas/liquid suppositories.) I had major convos with daycare, GI, Pedi, nutritionists etc.  Meanwhile she has fissures and is scared to poop.  Here is her "thing" - during all of the above... she started squeezing her legs together... really hard... really really hard.  She crosses her ankles and squeezes her butt cheeks together. She was doing this on and off and it began to increase and increase in frequency and length - there are days she spends over an hour squeezing. Her docs told me it was a learned behavior because of the pain she feels when she poos. It hurts her so much that she starts to squeeze when she feels the need to go and it makes the need go away and makes her impaction worse. She holds it until she cant anymore and shes screaming etc.  its awful.  We found out that daycare wasnt using cereal to thicken her bottles and so we stopped thinking thats why she was pooping at daycare and not at work. even after stopping cereal she was still squeezing and having really hard poops (were talking larger than golfball size poops that do not leave an indentation if you press on them!) - We began a regiment of water and miralax. She was taking an adult dose of miralax each day and we did see a difference in the consistency of her poopies and she was much more regular (once a day or every other day) - this is how she is now..... but she continues with the squeezing and what was before an obvious reaction to needing to poo - is happening even when she just pooed.  I dont know if now she does it because of pain (after pooping she sometimes hurts from the fissures) or if shes doing it to soothe herself.  She has starting to do this before naps and at night time before bed. This morning she was doing it in her crib before waking up.  Sometimes its mild, squeezing for a few minutes, then she continues doing whatever shes doing then more squeezing.  But sometimes she cant do anything else BUT squeeze. She will lay down and straighten her arms and squeeze and squeeze until her rump is in the air and its just bizzare..... has anyone elses preemie done this???? Its freaking me out now... I just dont know whats going on. I discontinued the Miralax thinking maybe the squeezing was because her tummy was upset and shes pooping the same and squeezing just as much or more..... Please... any advice? (I know this was really long but I hope some of you read it.... this is really got me crazy)

adrielegorburu

Thanks for reading that long hot mess Boston! lol - I have spoken to her GI and she says that its because of the pain and once we get her stools soft that the "habit" will go away.... Its just so bizarre and I feel like the poop is getting better but the behavior is worse... I cant help thinking we are wrong about it - that there is something else causing her pain or making her do this.  I guess shes been doing it so long that maybe it soothes her even if she doesnt have a need to go - but when she does it, it doesnt seem to soothe her - she screams while she does it sometimes or at least shes whiney so I just dont know. I feel like a lot of her doctors (especially her GI) think I should be happy that she is so healthy and I shouldnt worry about this stuff.... its weird how they act sometimes.  Her pulomologist (ex-pulomologist!) actually told me I should consider myself lucky. I do consider myself VERY lucky.... but that doesnt mean that my daughter should live with pain just because shes expected to be sick  

thishappyhouse

I dont have any advice other than to continue to ask anyone that will listen about it... EI folks, regular pedi, and specialists. From your description its sounds like it could go either way.. a learned behavior associated with former pain or actual discomfort.  How does she react if you try to redirect her during the "episodes"?

Big Hugs!  I think that these things can be much scarier to us as parents then the "big stuff" because it is so hard to tell what the root cause is.  Sure you are lucky (we are all lucky, people with full term healthy kids are lucky) but that doesnt mean that your instincts and worries aren't valid.   

adrielegorburu

With all her GI issues shes never had a GI series or any other GI scans done, not even US. there has never been any indication (her belly swells and gets a bit tense with the constipation but shes never completely distended or hard, never has pain on palp etc) - so I supposed something like that might show something. I dont want to put her through any unecessary but I cant shake the feeling that its a symptom of something. I've never seen anything like it.  I have googled the crap out of it and there are some older toddlers that have issues doing this conciously to keep from pooping but they all seem like older kids and the rest is all about toddlers masterbating this way.  No joke, not like a sexual thing but a "this feels good" thing I guess. I'm not ready to consider that as a possiblity though.

 When shes squeezing her legs its actually hard to get your fingers in between to release them, but we try and if she have a bad "episode" she just keeps doing it. I break her legs apart and she re-crosses her ankles and does it again. I put my hand in between her legs and splay my fingers and she will try and crush my hand between her thighs, best way to get her to stop is to have her standing but even then she will cross one ankle over the other and squeeze, even if she tumbles over she will just lay there and squeeze. If you actively stop her she will scream until she can squeeze.  some times she just does it once or twice and keeps going.  I dont know if Im ready to admit it might be neurologic and not gastric..... I've always been waiting for the "other shoe to drop" sort of thing....