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Dear Dr. Heather,

Mel

Hi Mel,

At 3 years of age, your son now has an awareness of his body. He also is sensitive to any changes in it, and worries whether the changes mean something is wrong. Children crave consistency, and when things are different — they can get upset and worried.

Your son is not alone. Most toddlers and preschool-aged boys show an interest in the sensations and changes happening in their penis. (I guess it’s an interest that starts in early childhood — and never goes away!) It’s a perfect opportunity to convey the overall message that:

Your body is a good thing;
The sensations your body produces are healthy and normal; and
It’s OK to touch and explore your body — in private, by yourself.

Talk to your son about his private parts. Use short, simple sentences, and don’t try to convey too much at once. “Yes, sometimes your penis gets big like that. Sometimes it is small. But we don’t take off our clothes in the living room. You can go look at it in your room, if you want.”

Make sure nobody is giving him a negative message about his body; check with sitters, grandparents and others to see if this has “come up” with them, and how they’ve handled it. You want to make sure he’s getting a consistent, positive message.

Of course girls show the same interest in their bodies; check out this post. It also describes the limits of “normal”, and when to worry.

It’s not too early to begin to send a healthy message to young children about their bodies. Aim for striking a balance; you don’t want to instill a sense of shame or negativity about the body. Yet you want them to internalize the sense that their bodies are private and should be respected. It will help them to eventually feel a sense of physical integrity and safety, and to set appropriate boundaries later on.

Aloha,

Dr. Heather
The BabyShrink

Thanks to all of you who wrote your comments and emails of support over the past couple of weeks while I anxiously awaited our 2-year-old’s hernia surgery. He’s fine today; a little tender, walking around like an old man who put his back out. He’s covered in the dirty, gummy remnants of surgical tape, and has two (yes, TWO) inch-long diagonal scars in his groin. But he is fine. So while the memories are still fresh, here are some important things I learned yesterday:

Be Ready for Changes in the Surgery Schedule
Not easy for a control freak like me, but important to know. The schedule can be changed for any number of reasons, so plan accordingly. For us, T was found to need more extensive surgery, requiring more time (2 hours, as opposed to the 30 minutes we had expected). That meant the doctor had to shuffle his schedule, which affected our arrangements. Stay light on your feet, and keep your options open on the day of surgery. If at all possible, arrange to have both parents present AND a support person (like a grandma — Thanks Mom!) so you can juggle communication with the staff, care for your child, and other basics like parking, travel arrangements, and food.

Don’t Be a Hero
I’m a health-care professional, right? I grew up in a medical household; my Dad was a physician. The sight of blood doesn’t bother me, I have more than a passing familiarity with medical practices, and I’ve been roaming around hospitals since I was 3.

But yesterday, I was just “Mommy”. A shaky, scared Mom who was an idiot and asked to help carry her baby to the Operating Room, and assist with the baby until he was asleep. I thought that helping out as much as possible would be best for the baby. Big mistake! The sight of my baby struggling and screaming while he was being held down (by me) while the nitrous was administered — that’s an image I’ll never forget. And it certainly didn’t help T. Take my advice and don’t be a hero. Treat yourself with some TLC as much as you can. And let the professionals do their job. I don’t care if you’re in the profession yourself; on Surgery Day, we’re all Just Mom, or Just Dad.

Don’t Be an Idiot — EAT Something!
I assumed my stomach would be too upset with worry to eat anything, so by the time 11 am rolled around, I was shaky, dehydrated, and bitchy. Not too helpful (nor very appreciated by Mr. Dr. BabyShrink). If you’re used to caffeine in the morning, make sure you get some. And at least bring a banana and some trail mix to the hospital; I picked at it, and once T woke up, he devoured it (and the outpatient surgi-center usually doesn’t provide food afterward to the kids; you need to bring something for them, since they may very well get hungry afterwards). And since the surgery took so long, I actually did go to the cafeteria for 20 minutes. I forced myself to read the paper, have a snack, and NOT picture my baby being strapped down to the operating table. Even though part of me didn’t want to be farther away from the operating room, walking away from the surgi-center for a short break gave me some perspective and allowed me to decompress for a bit.

Thank You To The Doctors and Nurses
We are all incredibly indebted to the doctors, nurses, and other health-care professionals who take care of our kids; those like Dr. Sid Johnson and post-op nurses Jessica and Mike who were among those who took care of TT yesterday at Kapiolani Women’s and Children’s Hospital. These people have the stamina, dedication, courage and expertise to take care of difficult, challenging, and often very sad cases every day. But mostly they love kids, and it shows in the work that they do.

A Hernia Is Just a Hernia; Nothing More.
When TT was resting in the “wake-up room”, Jessica shared stories with us about some of the very sick children who come in and out of Kapiolani every day. It gave me some healthy perspective: To them, TT is a healthy, strong child who just needs a little patch-up work. The child on one side of T was a 9-year-old who has had leukemia for 3 1/2 years. On the other side was an 18-month-old who has had multiple surgeries from birth defects, and had reconstructive work done on her pelvis. She was put into a full-body cast. And although our little guy will be sore for awhile, in comparison, this was small potatoes. So while the day was grueling, and we hit some tricky spots, we’re home, and everyone is on the road to recovery. We’re extremely grateful for the health of our family; even more so, after our experience yesterday.

BabyShrink readers Angie, Sharon and Stacy have emailed me over the past few weeks with the same horrified question: Why is my toddler suddenly smearing poop everywhere, and HOW CAN I GET THAT DISGUSTING BEHAVIOR TO STOP?! Although I tried to offer some suggestions, I had never experienced the same thing with my kids, so I really didn’t have much “oomph” behind my answers.

And then the Great Karmic Finger pointed at my household. And that finger had poop smeared on it.

Our TT is now 2 1/2. He’s kinda-sorta potty trained. He’s healthy (minus one hernia, which I will update everyone on later in the week), developmentally on-track, and he’s got the “easiest” temperament of all our three kids. But over the past few weeks, it’s happened three times; he’s pooped in his diaper, then reached in to decorate his crib with it. And it’s the grossest clean-up job I’ve ever had to do.

Your story is similar. Your toddler is somewhat engaged in potty training. They’re at the age when they can understand most of what we’re telling them…and certainly understand that poop is yucky. Then all of a sudden, you discover your little darling has smeared poop all over the place. Reader Sharon tells her stinky story this way, “She’s in her crib about to nap, and I hear the usual noises of her just talking to herself. Then I hear this: “Mommy, yucky.” So I go in there and see the worse scene of my life!!!! She apparently had a poopy diaper, took it off, and proceeded to smear the walls, her crib and everything in the vicinity with poop. I was mortified! I quickly yanked her up, stripped her down and got in her the bath as fast as possible. I had to call my husband and tell him to come home so I could sanitize her room. Ugh, it was awful!”

Is This Normal?
Yes dear reader, it is. Not necessarily common, but normal. A 2-year-old is struggling with attempting to master his own body, to control it’s functions, and is quite curious about his productions. (They don’t call it the Anal Stage for nothin’!) Preschool teachers will tell you it’s common to see children this age quite interested in messes, too. They can alternate between being quite the obsessive neat-freak, OR the poop-smearing opposite — as they struggle to master this stage. I would say, however, that poop-smearing past the age of 3 1/2 — 4 would concern me. An evaluation, starting with your pediatrician, should occur in that case.

How Do I Get It To Stop?!
First, know that, for an otherwise typically developing toddler, this should be a time-limited, passing phase. Nobody likes the smell of poop. It’s an experiment that is naturally self-limiting!

The most important thing is to control your own reaction. Don’t overreact; you risk reinforcing the behavior. If Junior knows that Mom will FREAK every time this happens, he’s got a potent weapon to use, when necessary! Instead, calmly say “Yucky. Poop is dirty. It belongs in your diaper or the potty. No more touching poop.” As grossed out as you may be, take a deep breath (outside of the room!), clean up the offensive little beast first, and close up the room until you have backup. You’ll need time, and someone to watch Mr. Stinky, while you break out the Clorox.

Next, it’s time to get practical and LIMIT ACCESS TO THE DIAPER. Go out and find some toddler sized “onesies”, or other one-piece clothing. Some creative parents have even put one-piece PJs on backwards to further limit access to the diaper area. Keep them clothed this way as needed, until the phase has passed.

Also, take it as a sign of interest in potty-training. Use it as an opportunity to review the proper use of the potty, and validate their interest in poop. “Here, make your poop in your potty. Then when you’re done, you can look at it. We don’t touch it, but you can look at it if you want to see what it looks like.”

Finally, create opportunities for your creative genius to make acceptable messes. One of the hallmarks of this phase is the desire to make — and clean up — messes. It’s how we eventually learn to keep things clean and organized, and how to handle all the messes in life. So it’s a vitally important lesson to learn. Offer messy finger painting, kitchen mixing and squashing, and outdoor mud play, liberally. Talk about it, as you do. “I know you want to make messes. THIS is a good place to make a mess. I will help you clean it up later. Here, let’s make a mess together!”

Hope that helps, Gang. Happy Cleaning!

Aloha,

Dr. Heather
The BabyShrink

PS: THIS POST HAS BECOME MY ALL-TIME MOST-READ ENTRY! (Is that weird, or what?!)
FOR MORE TIPS ON THIS GROSSEST OF PROBLEMS, SEE MORE OF MY THOUGHTS ON IT HERE.