My baby the Lab Rat - Part 2

85% of babies in Western cultures crawl before they walk, but crawling is not a necessary stepin motor development.

Saw an ad on TV featuring Metamucil; its potency was dramatized by a gushing geyser and I found myself fantasizing that Ryan would have a cleansing bowel movement that would be equally energetic. Clearly, we all needed serious help.

Ryan had become trapped in a vicious cycle: He'd been so constipated that every poop was painful for him. As a result, he avoided going at all, which made the situation worse. An X-ray of Ryan's bulging tummy showed the extent of the problem: His entire large intestine (which includes the colon) was F.O.S. - medical shorthand for full of stool. Luckily, once we understood how Ryan had gotten to this point, we were finally able to help him get better.

The Causes of Constipation

Normally, babies poop about four times a day and toddlers go twice daily, although some healthy children only go once every few days. Generally, poops that are hard, painful, or very large (some toddlers regularly clog up the toilet) signal constipation. Although some parents are too embarrassed to discuss their children's bowel habits (after all, it is kind of gross) studies show that one in three infants are constipated briefly (which generally resolves on its own), but about one in 20 become chronically constipated for several weeks or longer.

My baby the Lab Rat - Part 2

Sometimes kids get constipated from uncommon conditions like spinal-cord defects, celiac disease (an autoimmune disorder triggered by eating gluten and similar proteins), lead poisoning, or thyroid trouble. But most are like Ryan: Beginning in early childhood, they get caught up in the downward spiral of difficult bowel movements.

What starts the whole cycle is not always clear, though in 1998, a study in The New England Journal of Medicine reported that undiagnosed intolerance to cow's milk causes up to 70 percent of infant constipation. Avoiding milk-based formulas can help these kids.

(No evidence suggests that the iron in infant formulas leads to constipation, a common misconception. In fact, the American Academy of Pediatrics discourages using low-iron formulas.)

Then there are more unusual causes: The journal Pediatrics once reported that a 3-year-old boy became terribly constipated after seeing a single television commercial, in which the toilet bowl turned into a monster and the toilet seat was a chomping mouth. The toddler developed a paralyzing fear that the potty would get him. and he stopped pooping for days. Sometimes bouts of constipation can be caused by other stressful events in a child's life, like the birth of a sibling or parental conflict.

Some experts also blame digestive problems on insufficient dietary fiber, exercise, and water intake. But interestingly, altering a child s diet doesn't play the role in curing constipation that you might think it would. Dinesh Pashankar, M.D.. a pediatric gastroenterologist at Yale School of Medicine, tells me that serving fiber-rich foods like prunes or raisins can certainly help a child who has dance' when they feel the urge to defecate. (This phenomenon often begins when they're being taught to use a potty.) Some parents assume their child is straining to go, since he's rocking back and forth, stiffening and crossing his legs, and assuming odd postures. However, kids do this for the opposite reason: to stop themselves from pooping by sgueezing their sphincter muscles closed. It works.

Over time, the large intestine becomes more bloated and can't return to its normal size. Once it's weakened in this way, the colon isn't able to move poop along. That's why punishing a constipated child or forcing him to try to use the potty will never work.