Screaming and straining during BMs

My poor sweetie Vivian has been having a really hard time passing BMs for the last few months. She screams and pushes so hard that her face turns almost purple and it is horrible to watch. This happens whether her poos are hard or soft (although they are mainly hard). She also has had rectal fissures that bleed and I have taken her to the pedi several times because I am concerned that this is just not normal. Basically the pedi has tried to assure me that it is only constipation and that I need to avoid things like rice cereal and bananas and other constipating foods while upping her intake of fibrous foods like bran, pears, and prunes. I have done that and there is seemingly no improvement. Her poos have also taken on a rather odd smell - it's hard to describe but the best I can compare it to is the smell of mothballs. It is not pleasant. She also has a bump on the outside of her rectum which gets bigger and often bleeds after a BM. When I pointed this out to the pedi she said it was a rectal fissure that was in the process of healing. When it didn't go away after a few weeks, I took her back to the doctor and she maintained that it was a healing fissure and that it wasn't getting better because I had not altered her diet sufficiently. She had previously been on thickened formula because of excessive spit-up and when my husband asked if that could be contributing she said no. After the appointment, my husband and I discussed her response and determined that the formula must be contributing to her hard, painful stools because it is thickened with rice starch and we were told to avoid rice. So we stopped using the thickened formula and she has been on Good Start with natural cultures for the past couple of months. At first we thought it was helping because she had a few BMs that were seemingly not painful (at least she wasn't screaming and writhing in pain) but pretty soon she started having a rough time of it again. It is so incredibly awful to watch her scream in pain - all I can do is bicycle her legs and hold her until it's over. We have our 9 month appt on Friday and I am going to bring this up again with the pedi and insist that she give us a referral to a pediatric gastroenterologist. This is just not normal.

I guess I wanted to post this topic to ask if anyone else has gone through a similar experience with their LOs and what they've done to address the problem. TIA for your responses.

 

You can try giving her prune juice once or twice a day to help her go, that didn't work for me, so our ped said to try adding dark karo syrup to her bottles. We started with 1-2 tsp several times a day, and increased it if that didn't help, or decreased it if it was working, until we found what amount worked for us. Then I would add that whole amount into the jug of formula when I mixed it up in the morning so she was getting a steady dose all day long. It helped immensely. We did that with our oldest dd from 3 months until she went off of formula, and with our twins from 6 wks until they went off of formula.

Until the karo kicked in and we found the right dose, we used liquid glycerin suppositories. They aren't hard like regular supps, they are like a tiny enema with liquid inside. It helps tremendously, usually works within 15 mins or so.

We went through the all night screaming sessions, trying everything we could think of, and even thought our youngest dd's poop was usually soft, she was still having trouble getting it out. :hug:

 

When one of my DDs was having trouble with constipation (not that bad, though), the ped suggested flax seed oil. I don't remember the exact dosage -- also, she was older (more like 18-24 months) -- I'm not sure if it would be recommended for babies. But that's something you might want to ask about.

I would definitely ask for a gastro referral, too. It may be "only" constipation and not a bigger underlying problem, but it's clearly severe, and there's only so much you can do to alter the diet of a 9-month-old without expert advice. Your ped doesn't seem to be helping much. :hug:

 

i don't personally have experience with this, but i did want to say that if you feel like your pedi isn't listening to you maybe you can ask for a referral to a pediatric GI specialist. or possibly consider seeing a different pedi to get a second opinion.

 

Oh gosh, poor, poor baby!!

Our son had terrible constipation as well, and we did watered down prune juice in addition to completely eliminating all constipating foods - rice, bananas, sweet potatoes, etc. and giving him only prunes, peas, peaches, pears, oatmeal & barley cereals and we changed his formula. He still suffers to this day and is on daily miralax therapy.

You could probably introduce some yogurt now which might also help.

I'm so sorry and definitely ditto the gastro. referral. Hopefully they can help!

 

I don't have a lot of experience with constipation but I wanted to send :hug: 's, I'm sure it's incredibly hard to watch when she is obviously in pain. I agree with Sara, if your pedi isn't helping & you truly believe there's a problem, listen to you mommy-sense & get a second opinion.

 

Hi we were just in the ped's office last week for the same thing. my daughter has always had hard "rabbit poop" but they have been getting larger and increasingly painful for her. two times we had to help her get it out by chippin away at what was halfway out with a q tip. she was crying so hard trying to pass. it was horrible! We also put a little vaseline on the qtip and put it on the rectum and a little on the inside rim to help it slide out. Up until that point, Pedi had been telling us to get her to drink 3 ounces juice a day but m daughter does not like juice. Went in last week and he said there are four possible things can try: mineral oil, glycerin suppositories (1/2), caro syrup after 12 mos(botulism risk), or miralax (1/4 of a capful once a day) we started the miralax saturday and she still has rabbit poops but they are soft now and no more serious straining and red faces! good luck, i know its horrible to watch your child in that much pain

 

We had bad constipation once and I never ever want to go through that again...I am so so sorry for you. :hug:. My LOs were 9 mos and Miralax was recommended but we tried jarred prunes first only 1/4 jar at the time - they did the trick. Apple juice also helped but it is so sweet. My nephew had issues with BMs until he was 5. He saw several specialists and they tried many formulas early on. Finally he had to get on medication. I would definitely see the GI specialist.

 

I agree about the referral. I don't think an ongoing rectal fissure is a good thing. :hug:

 

Um, not normal. We've been dealing with constipation with DD since birth. She's now 4. NEVER have had any issues in addition to the constipation. Get a GI appointment scheduled stat - it may take a while to get an appointment since it's a specialist.

We finally gave in and do Miralax every single day. I have played with all of the natural options and then the dosage and frequency of Miralax. DD is much more comfortable if I dose her every single day. The bonus is that I don't have to deny her the foods that she absolutely loves, like cheese and bananas.

Fissures are not normal, they are painful and she needs to be seen by somebody else.

 

Thanks for your responses ladies. I will definitely be insisting on a referral to a GI specialist at our 9 month appointment on Friday.

I am not altogether happy with our pedi thus far - she seems to instantly dismiss any issue we bring up as first-time parent hysteria. It sucks because there is an amazing pediatrician that works in her office and takes over when she is away and we absolutely love her. I find myself wishing that our regular pedi would take more golf trips to Florida. In fact, we hardly saw her during the winter because I suppose she spends a lot of time down south in the winter. But now that it's summertime we're more likely to get her. I am reluctant to change at this point because it is hard to find a pedi and many won't take you on unless the children are unborn. We'll see. Thanks again for your responses!!

 

Your story is my Arianna to the "T"! Same exact problems! She was on Enfamil AR & even doing hypo formula she was STILL having problems. She would cry so hard for so long. I felt horrible. We tried EVERYTHING! Prunes, pears, juice, oatmeal, water....EVERYTHING! Nothing worked. I finally got so mad that the Dr. kept saying it's just constipation that I sat in the office until Ari went poop & screamed in front of the Dr. She told me to start mineral oil 1tsp a day right away. Ever since we started the mineral oil (2 weeks ago) she has been fine. Sometimes she will whine a little but no screaming, no bloody poop & no large bumps around her hole. I really recommend trying mineral oil. We bought ours at Walgreens. The Dr. said we can use it as long as she needs it (even though the bottle says only to use for a week in low dose it's fine since it ALL comes out in the poop). Good luck & I hope you find something that works. BTW I totally blame the formula for this problem too. Ari was fine until she started the AR.

 

With DS1 we ended up mixing 1 oz of the gerber appleprune juice into his morning bottle every morning (sounds gross, but he didn't seem to mind it). When he graduated from the bottle, he got it in a sippy and we called it "morning juice." It worked like a charm. The pedi wasted my time with karo syrup etc, but the juice EVERY MORNING WITHOUT FAIL was the only thing that worked.

 

I am going through the exact same thing with DD. NO bumps but she holds her poop so bad and its so hard. We went through a scream fest earlier today. I had to do a gylcerin suppository. I HATE doing anything to assist her because I dont want her to become dependant on it. However, if she doesnt poop in 2 days, the next day its like this. It started bad once we started Similac Sensitive. Im not sure what to do. We have done prunes, pears, juice, none of it works. One time she had a blow out from prune juice and that is yet to happen again

 

We are having the same issue with DD. She has had a fissure for over a month now and it has healed somewhat, but not completely. She's had some very painful BMs, sometimes with bleeding. She tends to poop every other day and have very large BMs. They are usually soft, but so large that it has caused tearing. Pedi said to treat her as if she is constipated, even though she is really not constipated. We are doing lots of high fiber foods and prune juice. We also use benefiber. It seems to be helping somewhat. I am also trying to get her to drink as much water as possible. I have read that fissures are common in young children, but it doesn't make them any easier to deal with.

 

Foods that make you POOP -- pears, prunes, peaches, pineapple, paw paw "p" fruit, squash, figs, wheet-abix, bran, apple juice (but NOT APPLES because apple juice has more pectin), pear juice, water water water, raisins, pieces of cut up prunes. Sometimes flaxseed oil, fish oil -- Omega 3 type options.


foods that constipate --- BANANAS are the worst, carrots can, apples, RICE, cheese.

Hope this list helps. I'm sure if you go online you will find more. Here in Australia Wheet-bix is a common first foods and given most mornings. It is whole wheat.


Heather