Posted: Aug 22, 2014 6:00 AM
Each parent shares his or her story quietly, embarrassed and sure no one else's child does something so messy and, well, disgusting. But the truth is that smearing — reaching inside a diaper and smearing its contents far and wide — is common among children and especially in children with special needs. And help does exist.
Photo credit: Casarsa/iStock/360/Getty Images

So, I'll start. My name is Maureen Rich Wallace and my 4-year-old son with Down syndrome cannot be left alone for a moment after he has pooped during his nap time.

If left to his imagination, his hands immediately slip into his diaper, locate the goods and proceed to smear them everywhere. His athleticism isn't constrained by smearing, though. He also manages to lob juicy bits to all corners of his bedroom.

It isn't pretty and we have used more Clorox wipes than anyone on the planet.

The walls. The dresser. The glider, where I used to rock my sweet, innocent snugglebug to sleep. It isn't pretty and we have used more Clorox wipes than anyone on the planet.

More than one cause possible

"[Smearing] occurs more commonly in children with developmental disabilities," according to Dr. Nathan J. Blum, a developmental-behavioral pediatrician at The Children’s Hospital of Philadelphia. "Like many behaviors I am not sure that stool smearing has 'one cause.'"

Questions to ask, and ways to respond:

  • Is the child constipated? Address the issue.
  • For a toddler, is it occurring repeatedly? "Something is reinforcing the behavior," Dr. Blum explains. "It could be an internal or sensory phenomenon that is reinforcing the behavior or it could be an external (or communication function). For example, it might result in attention."
  • How old is the child, and what is the child's developmental level?
    • For younger children: "If it has happened once or twice in [a child] who is otherwise developing and behaving typically, waiting for them to outgrow it might be appropriate."
    • For older children, toilet training may be an option.
    • If toilet training isn't an option, "doing things to prevent access to stool when not supervised such as wearing a one-piece outfit, or … other solutions … to decrease access might be important."
    • If an older, typically developing child, is intentionally smearing stool on a specific object, Dr. Blum recommends a case evaluation by a mental health professional.

Bottom line? "The hardest thing is to react in a calm, matter-of-fact manner," Dr. Blum advises.

Ingenious invention

Mackenzie's daughter, who has Down syndrome, was 2 years old when she began smearing — a practice that continued for "two long years," she shares.

"She wore toddler onesies from when she left the house, which was mainly for preschool. With those on, she could not reach her diaper. The limit on those was that eventually she figured out how to unsnap the crotch."

Modified pajamas |

Photo credit: Mackenzie (not her real name)

Luckily, Mackenzie's mother is both creative and a seamstress. She whipped together one-piece pajamas created from two-piece, footless pajamas that now zip open and closed from the back. My own son wears them during naptime regularly now, and we are forever grateful.

Modified pajamas detail view |

Photo credit: Mackenzie (not her real name)

More tips and tricks

Jane's son (also with Down syndrome) began smearing at age 2, as well, and continued for nearly three years. She tried everything: double-diapering, putting the second diaper on backwards, duct-taping the diaper tabs, onesies (great until he learned how to unsnap) and even tried to address the issue from a sensory perspective:

"I made it my mission to feed his sensory needs as much as possible while he was awake: sandboxes, I made a corn bin with a storage box and a bag of deer corn, rice, Play-Doh, etc."

"Footie PJs worked for a while until he learned to unzip them," she says. "Then we safety-pinned the zipper shut and eventually he squirmed his shoulders out to slip them off."

"The only thing that worked was timing: We had to be sure to get him up and out of bed as soon as he woke from his nap."

Jane's 4-step advice

    1. Invest in a steam vacuum for your carpet.
    2. Buy Lysol.
    3. Stockpile Mr. Clean Magic Erasers.
    4. Take a deep breath, it will pass.

More about your child and poop