Please help - older premmie

Hi

My eldest daughter, Seren, was born at 33 weeks weighing 3lb6oz and spent 7 weeks in NICU, tube fed, basically well but a low birth weight.

Ever since, she has always been underweight, very very skinny, and she won't eat much at all.

She is 3 next month, and weighs just 21lbs!!:(

She is anaemic, and has a hb level of 10.8 . She is due to start iron supplements tomorrow, to see if things improve.

She has been constipated from birth, and lately, has been wetting herself and pooing in her knickers - which is VERY unlike her, as she has been potty trained now for quite a while.

Does this ring any bells with anyone, as to what could be wrong? The doctors don't know.

She has been tested to celiacs disease, which came back negative.

Thanks
gwenxx

My nearly 11 year old was born prematurely at 32 weeks. She has had no problems with weight gain, so I can't help you there.

But she was a fairly constipated baby, and from about the age of 5 she started having 'accidents' even though she had been toilet trained since she was 2. After years of visits to a variety of GP's and many invasive tests, she was diagnosed with encopresis and enuresis (both pooing and weeing accidents.) ETA - The diagnosis was done by a paediatrician who did not even have to do tests, just on her medical history alone he knew what it was (and he also commented that she was the 3rd patient he had seen that day that had the same condition - so it is a lot more common that you'd believe) There's a recent thread that has been discussing this very problem - I'll find you the link. ETA - here it is
Here's a brief overview I found for you -

What Are Elimination Disorders?

Elimination disorders occur in children who have problems going to the bathroom?both defecating and urinating. Although it is not uncommon for young children to have occasional "accidents," there may be a problem if this behavior occurs repeatedly for longer than 3 months, particularly in children older than 5 years.

There are two types of elimination disorders, encopresis and enuresis.

Encopresis is the repeated passing of feces into places other than the toilet, such as in underwear or on the floor. This behavior may or may not be done on purpose.


Enuresis is the repeated passing of urine in places other than the toilet. Enuresis that occurs at night, or bed-wetting, is the most common type of elimination disorder. As with encopresis, this behavior may or may not be done on purpose.

What Are the Symptoms of Encopresis?

In addition to the behavior of releasing waste in improper places, a child with encopresis may have other symptoms, including:

Loss of appetite
Abdominal pain
Loose, watery stools (bowel movements)
Scratching or rubbing the anal area due to irritation from watery stools
Decreased interest in physical activity
Withdrawal from friends and family
Secretive behavior associated with bowel movements.

I'd recommend getting in touch with a good paediatrician. My daughter also did a course with an occupational therapist that did wonders.

Good luck :goodluck: and I hope that info helps you.

The world of premmies never is far away hey
Perhaps she has a blockage in her bowel from being constipated. This would cause her to have runny poos as it doesn't have a chance to form and comes out quite easily- the smell is also pretty obnoxious as well
also if she was blocked, it puts pressure on her bladder as well - explains the wees.
A blockage would also stop the proper absorbtion of food as well

My DS had heaps of problems with constipation until he had his bum stretched- made a big difference.

The easiest way to diaganose a blackage is with an x-ray
if you are not keen on that then i would treat it like that anyway and get her going.
I used parachoc with my son- its a parafin based natural liquid. Loosens the stools and lets it slide out easier.
You will know when she passes the blackage as it will hurt and her poos will return to normal.
Also i would get her checked for a UTI as well. This is done with a pee sample- very easy
and would explain the weeing in the pants as well

HTH and let us know how you go
poor possum
take care
odette

Thank you for your replies. I am going to bring these things up with the doctor this morning.

I'm just soooo worried people will think i'm a bad mum, but I try so hard to get her to eat etc, so i've started writing a food diary to show what i'm feeding (or trying to) her. :(

Gwen,

Big hugs. I have a fair idea of what you're experiencing. I know where you are coming from but please please remember YOU ARE NOT A BAD MUMMY!!! xx There are so many issues that roll on from a very early start to life that we as mum's cannot have control over. Over the past couple of years I have met a lot of ex-premmies who are chronically underweight for their age. My son,
Gus will be 3 years old on 22 July 2008 and he currently weighs 8.6kg (18.9lbs) and is 84cm (33inches) tall! You may recall I had a tough pregnancy with Gus. He born 12wks early with my waters having broken 6 weeks earlier and his placenta barely functioning.

Gus also suffers from constipation but (so far) hasn't had any problems with accidents now he's toilet trained. Gus doesn't eat or drink at all (literally) and has multiple food protein intolerances so gaining weight is a big challenge for us. Gus has had a gastrostomy feeding tube inserted into his tummy so we can give him his calories that way. (He is fine in every other way - appropriate behaviour for age from a cognitive and motor skill perspective, and for that we are enormously grateful).

But that doesn't change our frustration at the challenges that helping a premmie to overcome their smallness present. We see a myriad of specialists and allied health professionals without anyone really being able to help us work out a solution - other than the elapse of time. We have a Paediatrician, Gastroenterologist, Immunologist, Speech Therapist, Occupational Therapist, Psychologist and Dietician all working to help Gus with his eating/weight gain issues.

From a constipation perspective, our Gastroenterologist has prescribed a liquid laxative for Gus to take twice a day and that helps things a lot. Perhaps you could ask your gp/paediatrician for a referral to a gastroenterologist? I have found ours to be really helpful with our pooping/failure to thrive challenges. Quite a few specialists have told me that we should anticipate it will take 1 year for every week Gus was premature (ie 12 years) until he catches up for his prematurity and reaches his maximum height/weight potential for that age. Seems like a loooooong time to wait, but in some ways I have found knowing that has taken the pressure off tying to "solve" the problem in the short term.

Big hugs. If I were you I'd get Seren thoroughly checked over to eliminate any other possible causes and also to put your mind at ease. Then I guess try to give her a very calorie and fibre dense diet so that what she does eat is giving her the most benefit. xx If I can be of help/support in any way please don't hesitate to email/PM me.