Please remember I am not offering medical advice. I am not a doctor. I am sharing our journey with you.
“You’ve got this! Just keep pushing! You’re almost there! I see it! Push, push, push! Come on babe you can do it. I know it hurts but you can do it.” All too often I find myself saying these words and cheering on my 9 month old as he tries to poop. I know this is a crude subject to some, but I have been dealing with this struggle for almost 9 months now and as I sat with a neighbor talking, I realized I am not alone. Turns out she has been going through the struggle with one of her children as well for years. If you have been here, encouraging your child through her poops, wondering why your child can’t just poop, or thinking something isn’t quite right but being assured it is normal by many trusted people, you get it. You are not alone. Many of us have been there or are there right now with our kiddos.
For some, this is a one time thing or maybe it has happened a couple of times. In our house this has been going on since my little bud was about 1 month old. At the time, he was only a breastfed baby. There’s plenty of information out there that will assure you it is normal for a breastfed baby to go 2 weeks without pooping. Maybe it is. I just can’t imagine going 2 weeks without a poop. I was reassured by trusted people and sites telling me this was normal and it was going to be okay. At 5 months, my sweet bambino started really struggling and his poops would be little rabbit pellets that would come out. They weren’t super hard, but they weren’t soft. He would scream and cry and stretch out to clench his little bum together when he was pooping. He was clenching together to keep his poop in y’all…at 4 months old. I had tried to let him have a little it of solid foods just to see if he might be ready. The American Academy of Pediatrics doesn’t recommend starting solids until 6 months. I followed this guideline with my other 2 boys, but my daughter did get solids before 6 months at the recommendation of her pediatrician and didn’t have any problems. I tried the solids with him because he seemed so interested in food and like he couldn’t get enough breastmilk to satisfy. Big mistake. So I stopped any an all solids and decided to wait until the 6 month mark. After restarting solids, I remember one time it was going into the 3rd week without a poop. I was beside myself. He didn’t seem like he was in so much pain that it warranted a trip to the emergency department. If I took him to the emergency department, we would be laughed out of town. “Really, she brought him here for THAT?!!?” Would the insurance even cover such a visit? So I did what I had been doing: pear juice and wait. I know what some of you are thinking: “Nobody cares. This is normal. Shut up and move on.” Or, “How could you possibly wait that long? You are a terrible Mom.” Trust me…I had all of these thoughts myself. But I’ve always been told this is normal. My Mama heart just felt something wasn’t right, but we just kept on doing what we were doing. Talk to the doctor? Sure. Doctor’s advice: more pear or prune juice, maybe some apple juice. “We see this all the time.” I am not in any way trying to be negative to our pediatrician. I love our pediatrician. I trust our pediatrician. I believe our pediatrician knows his stuff. I believe most pediatricians are so accustomed to seeing constipated kiddos that it isn’t “serious” (meaning no life threatening problem or emergency issue) so it is deemed “normal.”
Fast forward to my bambino at 8 months and on solid foods as well as still breastfeeding. Prunes are life. He gets prunes or pears EVERY.SINGLE.DAY. He’s already been backed up and we have done pear juice and some manual removal of poop…And yet, he’s backed up again. We are going out of town so I decide, “Let’s add pears or prunes at EVERY meal.” Y’all, that means pears or prunes with breakfast, lunch, and dinner. That HAS to work, right?!!? It’s been a week since he has pooped and he just seems like he is SO uncomfortable when it comes to pooping. I tried that for a week and….nothing. Nothing happened. So he’s getting pear juice and pears/prunes and still nothing. We set up an appointment with the pediatrician. We go to the visit on a Thursday (now 2 weeks without a poop) and are given the following instructions: “Do half of a pediatric glycerin suppository and 1 teaspoon of Miralax with 8 oz of pear, prune, or apple juice a day and he should poop in the next 2 days.”
Me: “What if he doesn’t? We will be in the weekend so we can’t follow up with you. What do we do?” Pediatrician: “I’m sure he will poop.” Me: “I’m sure you’re right, but what if he doesn’t? It’s already been 2 weeks without a poop. At what point do we become concerned that he hasn’t pooped?” Pediatrician: “Well…if he doesn’t then you can do a pediatric enema. You would just do half of it and then he should poop within 1 day.” Me: “What if he doesn’t?” I know…some of you are thinking I’m trying to create a problem where there isn’t or that I said I trusted the pediatrician and yet here I am questioning him. If you’ve ever tried to get help from your physician’s office on the weekend, you know that it can be darn near impossible or the answer is, “Go to the ED.” I want to be prepared. I know we have had this struggle for so long. I know it has been 2 weeks since he has pooped. I know it is hard and I know it has to be large. There is no where for the poop to go. It has to just be continuing to pile up. Have you ever been constipated? It’s painful. Now imagine not pooping for 2 weeks…I can’t handle this for my babe. I can’t handle watching my normally happy baby be is so much obvious pain when trying to poop. Anyway… Pediatrician: “Well if he hasn’t pooped after that. I mean really the enema will work in about 20 minutes. But if he doesn’t poop after the enema then he may need to be seen by urgent care. But I don’t think that’s going to be necessary. I really think he’s going to poop and I doubt you’ll even have to do the enema. We see this all the time. Give him more of the “P” fruits (pears and prunes) and even a little extra pear, prune, or apple juice and I think we’ll see him poop. Call us Monday and let us know how it went.” Me: “……” Insert blank stare. Insert maybe a few expletives. Insert me feeling like I’m not being heard…So many things. I often hold my babe and cry with him while he tries to poop. Why? Because the pain cry is the worst for this Mama heart. THE.WORST. My Mama gut is just screaming and saying, “This.isn’t.normal. This can’t be normal. There has to be something we can do. In case you’re wondering, he didn’t poop. We had to have an X-Ray that was deemed “normal,” meaning there wasn’t anything that required surgery or any signs of an anatomical malformation that required treatment. His ENTIRE rectum was full of poop. I don’t know how he was able to pee because his rectum was so full of poop. And there was more poop making its journey to the rectum. Now we had to do enemas every day until he pooped and manually disimpact him. Not fun.
During this time we went over to a friend’s house so our kids could play for a bit. I was talking with my friend and we started talking poop troubles. She was well versed in poop troubles as one of her kiddos has been having trouble for years. She has seen specialists and her pediatrician regarding the trouble. Nothing seemed to work. My friend has done extensive research and found a physician that knows a lot about poop. His name is Steve Hodges, M.D. and according to his book he is “an associate professor of pediatric urology at Wake Forest University School of Medicine and a specialist in childhood toileting issues.” (1) I ordered his book, and y’all I cried reading many of the stories. Why? Because they.were.me. Someone got it. Someone understood it. If you have a kiddo that struggles with pooping or has accidents, I can’t recommend the book enough. He has a program he has modified that works for kids ranging in age from 0 on up. So after reading his book, I decided I would be starting this program with my little bambino. I keep saying he’s trying to poop, but really, he tried not to poop. Dr. Hodges discusses this and acknowledges kids will do this. He defines constipation in different terms that what we normally think of constipation. He says it is “more helpful to define constipation as not fully evacuating the rectum every day (pg24).” He gives an outline of ways to tell if your child is constipated. Y’all, it described my bambino. Then it got me wondering if my 2 year old and maybe even my 4 year old are also struggling with constipation. They poop every day. Here’s a secret: just because they poop every day doesn’t mean they aren’t constipated. Dr. Hodges discusses how poop troubles early on can lead to potty training troubles later and even troubles that can make a reappearance later in life (think teenage years). This is my concern. What struggles am I setting my bambino up for if I don’t take care of the constipation/avoidance issue now? How much of a struggle will potty training be? Is this why I’m having trouble getting my almost 3 year old to use the potty. Man, the things he says…they are so spot on. His programs are called the M.O.P. and Pre M.O.P. program. It stands for the Modified O’Regan Protocol. Why? Well, turns out in the 1980s there was a doctor by the name of Sean O’Regan who was having troubles with his 5 year old wetting the bed at night. Through his findings with his son, he found a way to help his son. Dr. Hodges took what Dr. O’Regan found and, well, modified it. I don’t want to spill the beans or give away the secret as the book is not free so you will need to purchase Dr. Hodges’ book if you would like to find out more about the protocol.
We got through the first major round of constipation (well, the one that required an x-ray) and guess what? About 3 days later we were back to where we started. Well, not completely, but my bambino was withholding again. I knew where this was headed. In my mind, despite having read Dr. Hodges’ book, I thought, “Good thing he has a check up soon. I’ll discuss where we are with the pediatrician then.” Something just clicked in my brain though. Why was I waiting when I had an answer in my hands? The short answer is that I really wanted the pediatrician’s blessing in following the plan. I started some of the plan before going to the pediatrician. We followed up with the pedi and I mentioned that bambino was still struggling with pooping. I explained he was withholding which was leading to constipation. The pediatrician agreed. His first though was to add prunes or “other p fruits.” He asked how often bambino was getting pears or prunes. I explained that was now ALL he was getting due to poop troubles. The pediatrician then decided maybe we should add Miralax daily. I was armed with my knowledge from Dr. Hodges’ book and got brave enough to mention it. Our pediatrician had never heard of it, but, to my surprise, he is on board with most of what Dr. Hodges recommends. I was seriously expecting him to tell me it wasn’t necessary. But turns out, he gets it. He even made the comment that withholding now can lead to struggles potty training later. I was so happy our pediatrician gets it! We are blessed to have a great pediatrician. We do butt heads over some things but thankfully this wasn’t one of them. He gave me a handout on constipation that the children’s hospital he is associated with put out. To my surprise, it goes into the definition of constipation Dr. Hodges talks about. What?!!? Maybe the medical community is finally looking at the research of others with regards to constipation!
Now with our pediatrician’s blessing, we will be starting Pre M.O.P.! I’ll try to keep you posted on our poop journey. Please remember I am not offering medical advice. I am not a doctor. I am sharing our journey with you. At the end of the day you should talk with your doctor, talk with Dr. Hodges (yes YOU can set up an appointment with him), and decide together what is best for your family. Visit the website for M.O.P. and Pre M.O.P. here:
https://www.bedwettingandaccidents.com/Reference: 1 Hodges, Steve M.D. (2019). The Pre-M.O.P Plan. O’Regan Press
