Behavior: Ask the Experts: A TODDLER SMEARS FECES REPEATEDLY

February 1, 2005

For the past few months, a 2-year-old in my practice has been smearing stool on herself and her crib almost every time she has a bowel movement. What can help stop this behavior?

Q. For the past few months, a 2-year-old in my practice has been smearing stool on herself and her crib almost every time she has a bowel movement. The child will sometimes even unbutton her clothes and remove her diaper to get at the stool. Mom usually ends up having to give her a bath, which is an enjoyable experience for the girl. This child has never demonstrated any unusual behavior before. She has mild speech delay (she uses only a handful of words) but has very good nonverbal communication. Do you have any suggestions to help with this behavior?

David M. Denton, MDPocatello, Idaho

A. Having fewer than 25 words at 2 years of age is a major red flag for developmental disability. Studies show that, even in cases in which early language delays have improved, 42% of children are later found to have reading or cognitive deficits.

Karen Olness, MD

Dr. OLNESS is professor of pediatrics, family medicine, and international health, Case Western Reserve University, Cleveland.