S1: This episode contains explicit language. Welcome to Mom and Dad are Fighting Slate’s parenting podcast for Thursday, May 19th, The Pooping Problem Edition and Jamilah Lemieux, a writer contributor to Slate’s Care and Feeding Parenting column and mom to Naima, who is nine. And we live in Los Angeles.
S2: I’m Elizabeth Newcamp. I write the Homeschool and family travel blog that starts guests. I’m the mom to.
S2: Littles. Henry, who’s ten, Oliver who’s eight, and Teddy who’s five. We live in Colorado Springs, Colorado.
S3: I’m Zak Rosen. I make a podcast called The Best Advice Show, and I live in Detroit with my family. My oldest, Noah, is four and my youngest, Amy, is one.
S1: Today, we’re going to be joined by Dr. Christine Steffensen. She’s a pediatric physical therapist who is known as the Constipation coach. She’s going to help us answer a letter from a listener who’s having a lot of trouble getting her little ones to poop. Then on Slate Plus, we’re going to be talking about the very annoying gap between when school ends and when work ends. Here’s a sneak peek of what you’ll hear if you have sleepless.
S3: Recently, we set up a share with our neighbors who have a kid the same age. So they’ll take Noah one day and we’ll take their kid one day. And then the two kids neutralized each other by playing with one another. And it’s very sweet, but it still means that I have to be like, in the vicinity. I can’t just go back up to my office and work. And so after three, like you were saying, my, I’m not getting any work done.
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S3: If you’re new to our show, welcome. Whether you’re a parent, educator or just interested in this wild journey, we’re so glad to have you here on. Mom and dad are fighting. We share our parenting triumphs and fails, offer some advice and share recommendations of things we love. We’re here twice a week on Monday and Thursday to subscribe to Never Miss an episode.
S1: All right. So we usually do triumphs and fails, but we’re going to do those on Monday. Instead, we’re going to talk about a very prevalent problem right now, the baby formula shortage. I cannot fathom being a mom to a young child right now who is reliant on formula. I tried to nurse exclusively and I didn’t produce enough milk, so it just simply was not an option. Like my child would not have been adequately fed if I wasn’t able to purchase baby formula. The idea that something that’s just so essential is in short supply and that there just seems to be so little being done to make it more readily available to parents is terrifying. What are you all thinking right now?
S2: No, I agree. I mean, if you have a baby right now, there is a chance that you will need formula. So I’m also kind of equally disgusted by the like, well, just breastfeed, you know, it’s like there are a lot of reasons why people can’t breastfeed. There are a lot of reasons why babies don’t take milk. There is also like even if you are breastfeeding, there is a chance that tomorrow you might not be able to and that your your baby needs food. And it’s like I can’t even comprehend when I think it’s apocalyptic. Yes. Yeah. For babies, guys, these are babies.
S3: It’s like it’s so scary.
S3: We’d love to hear if you’re going through this. We’d love to hear how you’re making it through. But like of everything we’ve been through in the last couple of years, there’s been so much scary stuff. But this is such a specific way in which like, Damn, this is a desperate moment. I’m so sorry if you’re going through this.
S2: And at the same time that we’re talking about abortion rights and making people have babies, it’s that to me is the other crazy thing. It’s like we have no ability to see beyond our noses. I just want people to be super kind. And this is not the moment for any kind of like breast as best formula is best. Any of that discussion like if if you have had a baby keeping them fed is really challenging whether you are using formula or using breast milk. And the idea that we have now made that even more challenging and and that instead of figuring out how to get formula to these babies, we are into these families. We are instead in a debate about what kind of fed is best is insane to me.
S3: You know how, like, Amish people were, like, making masks to fill the void. Have you heard of any, like, micro, you know, micro formula industries popping up, like to fill in the gap here?
S1: I thought I would see more of that, but I haven’t I know that there have been you know, of course there are people who are able to donate and those who sell their breast milk. You know, I can’t even imagine how you would price something like that. But to be in the position to have to try and purchase something like that or to come up on it, you know, through other means is just really devastating.
S2: Even if you have access to breast milk, there are babies that can’t have breast milk. Right. You know, I have seen a lot on the Facebook groups that I’m on of people stretching, you know, the formula that they have and saying if you don’t have any, come get it. But the crazy thing is like you go through formula so quickly. So that sharing, I mean, I love that people are sharing, right? But then they’re all out there looking for more. And so this idea that we’re just trying to keep people fed kind of week to week is like heartbreaking.
S1: And so terrible. We’re sending lots of love to any parents that are dealing with feeding a child right now that are struggling because of lack of access to formula. We hope that you get what you need as soon as possible. This should not have happened. This absolutely should not have happened. Let’s take another quick break. And when we get back, we’ll get into today’s listener question. All right, we’re back and joined by Dr. Christine Steffensen. Christine, welcome to the show.
S2: I thank you so much for having me.
S1: Before we jump into this listener question, which we think you’d be perfect for. Can you tell us a little bit about your work?
S2: I would love to. So I am a pediatric physical therapist. I was trained about ten years ago to treat kids with bowel and bladder dysfunction. Many, many kids, more than you would guess, have found bladder dysfunction, which means that the muscle of their bladder and their rectum don’t coordinate well with the muscles of their pelvic floor, which, you know, we all have to use to hold in poo a small portion of the time that some bladder dysfunction is due to something that’s physiologic that was a part of the child’s genetic history or a disease pathology. But the vast majority of the time, I am treating kids who have a dysfunction that came from holding pee or poop long before I ever saw them, like right around the time of potty training or starting school.
S1: All right. So we hear this listener question. Yes, we should. It’s being read, as always, by the fabulous Sasha Leonhard.
S2: Dear mom and dad, I have a bright, fun four year old son, but his incredibly particular toilet habits are getting to be a real problem. He has never once pooped in the potty. Every evening he asks for a diaper, poops in it, and then we change it. We have tried offering outlandish rewards and bribes to no avail. I tried all the tips on the internet, having him sit on the toilet in a diaper to poop, having him stand in the bathroom in a diaper to poop, cutting a hole in his diaper, etc. He refuses all of them. We have not tried any kind of negative reinforcement because he’ll just hold it. And I don’t want him to develop constipation issues. He also won’t be without either my husband or me there. Which means that he refused to pee at preschool from 9 a.m. to 3 p.m. every day. Most days he can hold it, but on the days where he can’t, he chooses to pee in his pants rather than use the toilet at school. His teacher suggested that I come into the classroom and help him be in a school party, which I have tried a few times but he wouldn’t do. This is really starting to cause some issues. He won’t pooper PE with the babysitter and we can’t go directly from school to a playground or other activity without switching home to pee in our house. His current teacher has.
S1: Been really understanding.
S2: But I fear not all of his future teachers, coaches, friends, parents will be. Next year. The plan is for him to stay at school till five, which is just too long to hold it in every day. And the final straw. His younger sister is ready for potty training, but refuses to try pooping in the potty because her older brother doesn’t do it and she wants to be exactly like him. We read in books about potty training and watched the Daniel Tiger potty episode about a million times. We tried asking him why he doesn’t.
S1: Want to poop in the.
S2: Potty and have gotten nowhere. We’ve had so many conversations with him about all the advantages of learning how to use the toilet independently, wherever you are. But nothing has worked. Help. Well, I mean, good for this mom and dad for not giving up and for recognizing that the Internet didn’t have all the answers for them. You know, my first thought when I read this letter, it was like, oh, your child is not actually potty trained. It doesn’t have to be negative. It’s just like, you know what, child, you weren’t ready for this. And so right now they’re engaged in a huge power struggle with a four year old. Four year olds need to have power struggles as developmentally appropriate, but this power struggle is a particularly fraught one and can set up bad habits that can really lead to serious health consequences. I would put him back in pull ups and I would say none of this matters to us. The most important thing is that you’re healthy and healthy. Kids poop every day whenever they need to, and they pee when they need to. And that’s what we want for you. So I’m going to I’m going to recommend that she disengage from the power struggle with her kid and just go back to, like, wearing pull ups all day long. Yeah. I also had let natural consequences like wear pull ups. I mean, it’s not the path you want to go, right? But I don’t know what other option practically they have at this moment. Mm hmm. Yeah. And I think, like, parents are human beings, right? So we want our kid to not poop in a pull up every night. But, like, if this kid’s really pooping in a pull up every single night, that’s wonderful. The kid is still being healthy. He’s still responding to his urges. He’s still honoring that. He’s still getting an urge to poop, which many kids lose. And he knows that he needs to get it out. And so I think he should be praised for that. I think. I think that the parents should say, we don’t care where you poop. The most important thing is you’re healthy, so yay, you pooped. And and then, you know, talk to the kid about do you feel like any more is stuck? Let’s try and get that out. Like this kid’s at a very, very high risk for constipation and even pooping every day. He could have constipation. So, like, they need to start talking with him. Like, you know, if that if you don’t get that poop out of your body, then it gets stuck and it can really make you sick. So do you feel like it’s getting stuck? I can’t believe my four year old how many times she’ll say, like, oh, it feels like it’s stuck. And then we get off and we go and play. Or I tell her like, Don’t keep sitting on the toilet, let’s go do something. And then she goes back and she’s able to poop. But I know all the pitfalls of toilet training and I have a four year old who I went through everything I had to, like, rack my brain. We had to come up with a poop song. She, you know, she sits on the toilet and I still will sometimes sing to her like, Hey, Mr. Poo, where are you? Don’t get stuck in Amy’s belly. Boo. And she thinks it’s really funny. And then she gets her poop out. And then her dad has told her a story about the poop going down the toilet to have a party with all the other poops. I don’t know where he came up with that one, but she likes that one, too. She will say, okay, get that poop out so it can go to the party. And like that never would have worked with my older kids. So you have to you have to kind of figure out ways to get them to buy into it. But what I would do, get him back to like, whatever you pooped, it’s great. We’re happy that you’re healthy. And then when he starts to express an interest in going on the toilet, or maybe you can start having some conversations about, hey, your boots have been coming out really easy, and they come out at this time of day, almost every day. Maybe we could just sit on the toilet, and every time he does, he gets a reward for sitting, not for pooping, but for being willing to sit and give it a try. And oh my gosh, at school, he cannot hold his pee all day long. He just can’t do it. So like, that’s a really that’s to me was more of a red flag in this letter than the pooping was the whole. Being willing and able to hold his pee for 6 hours a day as a four year old is really not a functional, healthy voiding pattern. So, you know, I with my four year old, I had a reward chart that was nothing specific. It was just a grid on a piece of paper. And every time she went to the bathroom, when she was told if she didn’t fight us or going on her own, she got a little sticker. And she and I had gone to the dollar store and gotten something that she was going to paint when she filled out her chart. And she was really excited about it. And she filled out her chart and she painted her little thing. And toileting was all of a sudden way less of an issue by the time we got done filling out that chart. But the chart was not for success. It was not for successfully getting a poop into the toilet or getting, you know, peeing on the toilet. The chart was for being willing to try it. In your book, too, you talk about the relationship of of kind of the schedule. I guess this is more for poop, but the schedule of like going relating to me like around mealtime for all kids who struggle with any toileting issues. I always say you want to set them up for success, right? So we have what’s called the gastro colic reflex, which means that when we fill our stomach with food, it stretches and sends a signal to your brain and in your brains as a signal to the colon to move, move things along, because more more food is coming. It’s strongest in the morning. So I really recommend. Breakfast routines for kids and adults and all of us like you wake up in the morning, we have your warm liquid or your breakfast. Do a little exercise like unload the dishwasher or do you know some sort of movement thing? And about 15 minutes after you’re done eating or drinking your coffee, doing whatever, consuming something to stretch out your stomach, then going to sit on the toilet and then you’ll have a larger urged poop. And you can totally use that with kids like with with this child. This family should be really aware of constipation. If he is constipated, make his poop off, give him medicine, make sure he’s drinking a lot of water, and then set him up for success by saying, Hey, it seems like you poop every day at 4:00 or every day after dinner. Why don’t we just set up this little thing where we try and it doesn’t matter if you do or not, but it just takes some creativity and finding what motivates your kid and how to convey the importance of good habits when it comes to sitting on the toilet.
S3: Christine, do you have any recommendations for good programming? Podcast TV shows, movies that like handle handle this stuff in a graceful, helpful way.
S2: Who programming. You know, I’ve I’ve watched them all. I’m not crazy about them. I can’t believe. Like Magic School bus and the cat in the hat. Everybody stops at poop. Yeah, yeah. The bus does not come out. Yeah. Went through the whole body and chose to be vomited back. Yeah. I think the Daniel Tiger’s mine. But obviously it’s not doing work. Colorado Children’s Hospital put out a video called The Poo in You. And it’s meant for kids with with incontinence, with fecal incontinence, which this child could very well be a child with fecal incontinence down the line. But if your kid is really is is sharp enough as a four year old, he’d be on the lower end. But, you know, some four year olds are super smart. It’s also super handy for parents to have because nobody knows this. Oh, my gosh. I went through, you know, three years of graduate school and had no idea. And then I worked with kids before I became a born bladder therapist who have so many issues and had no tools to address them and became a parent and didn’t know what to do. And and that’s another reason. I mean, shameless plug for my book, The Constipation Game Plan. But like, if you can understand what’s happening, you can do way better as a parent just because, you know, I know I’ve had friends that whose children have chronic constipation and they mention it to the doctor. And the doctor is kind of like, well, I’ll take something. But is this a good case to, like, ask for a referral? You know, like, hey, can we see someone who might know about how to get things moving or dealing with some sensory issues? Yes, for sure. And it piecing out whether a referral or an O.T. referral is the best one. It kind of depends on the kid where I work. We do a we do a constipation clinic with a an OT together where like the OT will work on inner perception and feeling like interpreting the the sensations that you’re getting from your body and on sensory challenges and on like even hygiene in the bathroom and pulling down pants and pulling them back up and fastening. You know, those are some of the things that OTS work on and the pieces we work on, posture on the toilet. We work on belly breathing and relaxation and hip and spine range of motion things that we do. So oh man, if you can find a constipation clinic and I’m in Rapid City, South Dakota, and we have one. So if this person happens to be in a in a city, it might be hard to find. But but we exist. And I am I am so proud of the Constipation clinic because it’s such a I mean, parents come to us and they’re like, nobody told us all this. And there’s so much involved and it is such a quality of life thing.
S3: To pivot a little bit. My my daughter has been getting I think it’s mixed messages because I sometimes try to just talk explicitly about pooping and bathroom stuff and she’s like, Oh, that’s a bathroom where, daddy, we’re not supposed to talk about that. And I think she’s getting that at school. So how do you navigate, like, you know, poop talk and normalizing it, but also not, you know, modeling that we should just always be talking about it? It seems like a kind of a delicate balance.
S2: I always just say, like, you know, we we are going to talk a lot about pee and poop and farting and like, that stuff is really important. We don’t need to talk about it outside of the bathroom or in the clinic. You know, we don’t need to talk about it outside of my therapy room when you come to see me. But we do need to talk about it because it’s such an important part of your health. And I do think that grown ups could be a little more open with what’s going on in in their bodies, with their kids. You know, like I have said to I mean, oh, my God, I’m on a national podcast. I’m going to tell you this. But I had told my daughter like, oh, my gosh, I am just really hurting a lot tonight. My poop must be stuck. And the reason I said it is because the same goes for her. She’s four and I, you know, like she’ll be like, no, I don’t need to go to the bathroom. And I’m like, You are farting all the time. Go sit on the bathroom. And she sits on the toilet and poops, you know, but she didn’t want to do it. So I don’t know. I feel like I feel like if we could just talk about this stuff a lot more, it would be better. And we make a huge mistake in our preschools and in our schools when it comes to bell and bladder, when we ask kids to like ignore urges which teachers do quite a bit. I don’t want to paint all teachers with the same brush, but like, you know, no, you can’t go to the bathroom right now. We’re doing this. You have to wait.
S3: That’s terrible drama, right?
S2: I mean, we had to get a504 for my my son has frequent urination that’s part of his pandas and had to get a five before so he could use the bathroom whenever he wanted. It’s I know and I will tell you, if you go to like Australia and the UK, they have public health programs about bowel, bladder health in schools and the. Very first thing is every school has to have a toileting anytime policy. Kids do not have to ask to use the bathroom. They get up and go. And there is a meme that exists. Like in America. The kid says, I have to go to the bathroom, and the teacher says, You need a pass and you need to wait and you need to do this and this and this. And then down below, it’s like in the U.K., I need to go to the bathroom and they just get up and go, you know? I mean, it just I was speaking to some school nurses and they said if they can toilet any time in high school, they’ll go and vape in the bathroom. That is a tough position to be in as a school administrator. But I can tell you there are high school kids that are holding their pee all day long and oh my gosh, does it result in dysfunction for adults? Like talk to any physical therapist who works with adults for pelvic floor dysfunction. They have a much harder job than I do. And it and it all starts with these down bladder habits that people get in schools. You guys. I could go on. I could go on.
S1: Well, Christine, this was very eye opening. Thank you so much for joining us.
S2: Yeah, thanks for giving me a chance.
S1: I learned a lot. I’m sure our listeners did, too. And letter writer, if you want to give us an update, we would love to hear what’s going on with your little one and their poop. Send us another note to mom and dad at Slate.com. And that’s it for our show. We’ll be back in your feeds bright and early on Monday with a question and answer some answers. And we’ll, of course, have some recommendations. So be sure to tune in. And while you’re at it, please subscribe to the show and give us a rating and review on Apple or Spotify. This episode of Mom and Dad or Fighting is produced by Rosemary Belson and Jasmine Ellis for Zak Rosen. Elizabeth Newcamp I’m Jamilah Lemieux. Thank you for listening. All right, Slate Plus listeners. So there’s a conundrum that a lot of us are facing. I know it’s a big deal around these parts, and we were curious to know how you all are dealing with it. School gets out for most kids somewhere around 3:00, and most parents don’t get off work at 3:00. Elizabeth, what are you doing this year? Do you have afterschool programming going on for the kids? What happens when the kids get out of school for you?
S2: Yeah, so far. So for us, I’m I’m pick up, but not just for me, for other moms. So since I’m home, I have become the the after school between work care and carpool for my kids, plus other kids. So I drive a minivan, load a bunch of kids in. Sometimes we’re dropping off at after school activities. Sometimes everybody’s just kind of coming back here to help fill that void. Right. Because I mean, I know listen, if Jeff were in charge of picking up, we’d be in we’d be in. Huge. Trouble, right? Not only are my kids in different places and the pickup times are kind of all over the place. But but also, like I, I think that the conundrum for me is just like. One of the things we’ve expected school to be is kind of a place for kids to be while we work, right? Mm hmm. If that’s true, then the times need to line up. And if it’s not true, then we need to be providing something else. And even though my kids, like, mostly, even when I have the kids here, they can kind of entertain themselves, but they still need to be somewhere. Right. They’re hungry. There’s, like, basic needs. Even the ten year olds need to be supervised. Like they can get to a lot of trouble if they’re not supervised. Like there needs to be an adult present. And I definitely feel for for parents where I happen to be home and can can do this. But that is one of the reasons why I’m happy to pick up other people’s kids, because I don’t know what your other options are, you know?
S3: Can you pick up my kids today? Elizabeth?
S1: I really wish you could pick up my good. This is the first time that Naima hasn’t been in an after school program, essentially. And it’s rough. You know, when we were in daycare, we had after school care until 730, you know, and our 630, rather. And and I remember being so hesitant to, like, sign her up because I was like, Oh my God, I’m going to keep her there until 630. And that’s absolutely what ended up happening. I needed every minute, you know, of my time at work. I have a different kind of work schedule now. I’m a freelance writer, but my day basically ends at 230, you know, on the days when I am is here, and that’s all. But that’s three days out of the week for me. And like, I’m just not getting as I’m writing a book, I have a deadline. They pay me. I have to write this book, you know, like it’s not a joke, it’s not a game, and I’m just not getting things done. There is an after school program at her school, but we don’t really like it, you know? And I think next year I don’t know that we’re going to I don’t know that I can go on like this, like I think I’m just going to be without any other option. But to put her in.
S2: After coming out free, though, either, right?
S1: It’s free, but it’s one of those free programs, just like you kind of get what you pay for. Yeah. You know what I mean? Like, it’s.
S2: Just an adult supervisor.
S1: It’s just. Just adult supervision, you know? And the kids and after school get into a lot of stuff. And, you know, we did it our first year here, didn’t love it, but, you know, it gave us the ability to work. And I think when I got to have to lean back into that. But it is really interesting that like, I mean, this is just one of the many ways that our society does not provide for parents. Yeah. You know, Zach, what kind of daycare situation are you using and what time of day does it in? Because for younger kids, it usually ends even earlier.
S3: Yeah, no school gets out at three. She doesn’t like the extended care either. And so a couple of days a week, it’s my responsibility. She gets off early a couple days, so she takes it. And a recently we set up a share with our neighbors who have a kid the same age. So they’ll take Noah one day and we’ll take their kid one day, and then the two kids neutralize each other by playing with one another. And it’s very sweet, but it still means that I have to be like in the vicinity. I can’t just go back up to my office and work. And so after three, like you were saying, my, I’m not getting any work done. And then if I have a lot going on, I’ll work at night. But like, I don’t want to be working at night if I can avoid it. I want to like relax for a minute if I can. And so it’s it’s a challenge. And it forces me to be more efficient during the day, which is an okay thing. Like that’s okay. I think when I really stop fucking around and like get to work at nine and like really focus and try not to be on social media and stuff between, you know, nine and 230, I actually can get a lot done, but those really good, you know, stretches of days are few and you know, what is it, few and far between.
S3: Um, and there’s always, like, something I always need to run an errand or there’s, you know, someone coming over. So, you know, it’s life is scattered inevitably.
S1: Relentlessly know mom and dad. Listeners, we’re curious to hear what’s your after school life like if you’ve got any interesting stories, rants, raves, anything you want to share about what you’re doing with your kids? When the school bell ends, please send us a note. Mom and dad at Slate.com. Thank you so much for your support of Slate Plus and we will be back with you soon.