Need Help With DCM Discussion

[TwinKristi]

So I posted about this a couple times here and there but I REALLY need he'll here with one DCB. He is delayed in many areas, particularly speech and some of his fine motor development. I've been concerned that perhaps he falls in the ASD category but mom is kind of in denial about it all. I referred him to early intervention, he gets speech and PT/OT weekly but the meetings with their coordinator get cancelled often or done here at DC. They actually prefer here because he behaves so much better (less clingy, more focused, more interaction and truthfulness from me on what I see) but now we're being transferred to a 3rd case mgr. now. I don't have any concerns about him being in my care as far as those issues are concerned. He needs redirection daily but so does every other 2yr old.
My big problem, more than anything else, is that he has explosive messy diapers at least weekly. Thank God it's always been when my dh or older kids or teens are home because otherwise it would be a major problem. I mean from belly button to back covered in poop. Sometimes leaking out, sometimes only in his clothing... Last week he pooped whole blueberries and tried to eat one! I've had to bathe him on a couple occasions because it was so bad, otherwise I end up using about 50 wipes on him not to mention the clean up of any leakage, my changing pad, me... I am starting to be grossed out. This happened more often with different diapers but now we just have once a week issues but this is even too much. If I was alone when this happened it would be hazardous to everyone and a much bigger mess. My most selfish concern is the fact that we're getting a new couch soon and I'm afraid one of his blowouts will ruin our new couch even if I don't allow him ON it, it's in our main DC area.
I honestly feel this is dietary but mom & nana don't seem bothered by it. I'm thinking of starting with a food log to see if we see anything obvious and then a referral to either his dr or a dietician. I know he's got issues with milk but other dairy seems ok. I rarely give him milk anymore so I know it's not that.
Anyone else deal with this? Anyone have DCKs with ASD that have this issue? The one person I know with ASD (severe) has some of these same GI issues.

[EntropyControlSpecialist]

Holy cow. I would ask for them to take one of them to the Doctor to figure it out. That is unsanitary for everyone involved, unfortunately, including other children around him.

[daycare]

So I posted about this a couple times here and there but I REALLY need he'll here with one DCB. He is delayed in many areas, particularly speech and some of his fine motor development. I've been concerned that perhaps he falls in the ASD category but mom is kind of in denial about it all. I referred him to early intervention, he gets speech and PT/OT weekly but the meetings with their coordinator get cancelled often or done here at DC. They actually prefer here because he behaves so much better (less clingy, more focused, more interaction and truthfulness from me on what I see) but now we're being transferred to a 3rd case mgr. now. I don't have any concerns about him being in my care as far as those issues are concerned. He needs redirection daily but so does every other 2yr old.
My big problem, more than anything else, is that he has explosive messy diapers at least weekly. Thank God it's always been when my dh or older kids or teens are home because otherwise it would be a major problem. I mean from belly button to back covered in poop. Sometimes leaking out, sometimes only in his clothing... Last week he pooped whole blueberries and tried to eat one! I've had to bathe him on a couple occasions because it was so bad, otherwise I end up using about 50 wipes on him not to mention the clean up of any leakage, my changing pad, me... I am starting to be grossed out. This happened more often with different diapers but now we just have once a week issues but this is even too much. If I was alone when this happened it would be hazardous to everyone and a much bigger mess. My most selfish concern is the fact that we're getting a new couch soon and I'm afraid one of his blowouts will ruin our new couch even if I don't allow him ON it, it's in our main DC area.
I honestly feel this is dietary but mom & nana don't seem bothered by it. I'm thinking of starting with a food log to see if we see anything obvious and then a referral to either his dr or a dietician. I know he's got issues with milk but other dairy seems ok. I rarely give him milk anymore so I know it's not that.
Anyone else deal with this? Anyone have DCKs with ASD that have this issue? The one person I know with ASD (severe) has some of these same GI issues.

I have this kid too and milk or any kind of dairy is the culprit for this kid. It got so bad up to 8 massive blowouts a day that I told dcp after 2 I have to send home. The parents were in denial that there was any issues there. I did a food log and discovered that it was milk. Monday is the worst, all the junk from the weekend blows up.

I would maybe tell dcp go home after 2. This is not normal and it takes more time than I have to be able to provide care for the entire group.

It is really gross, I puked once from the smell

[Blackcat31]

So I posted about this a couple times here and there but I REALLY need he'll here with one DCB. He is delayed in many areas, particularly speech and some of his fine motor development. I've been concerned that perhaps he falls in the ASD category but mom is kind of in denial about it all. I referred him to early intervention, he gets speech and PT/OT weekly but the meetings with their coordinator get cancelled often or done here at DC. They actually prefer here because he behaves so much better (less clingy, more focused, more interaction and truthfulness from me on what I see) but now we're being transferred to a 3rd case mgr. now. I don't have any concerns about him being in my care as far as those issues are concerned. He needs redirection daily but so does every other 2yr old.
My big problem, more than anything else, is that he has explosive messy diapers at least weekly. Thank God it's always been when my dh or older kids or teens are home because otherwise it would be a major problem. I mean from belly button to back covered in poop. Sometimes leaking out, sometimes only in his clothing... Last week he pooped whole blueberries and tried to eat one! I've had to bathe him on a couple occasions because it was so bad, otherwise I end up using about 50 wipes on him not to mention the clean up of any leakage, my changing pad, me... I am starting to be grossed out. This happened more often with different diapers but now we just have once a week issues but this is even too much. If I was alone when this happened it would be hazardous to everyone and a much bigger mess. My most selfish concern is the fact that we're getting a new couch soon and I'm afraid one of his blowouts will ruin our new couch even if I don't allow him ON it, it's in our main DC area.
I honestly feel this is dietary but mom & nana don't seem bothered by it. I'm thinking of starting with a food log to see if we see anything obvious and then a referral to either his dr or a dietician. I know he's got issues with milk but other dairy seems ok. I rarely give him milk anymore so I know it's not that.
Anyone else deal with this? Anyone have DCKs with ASD that have this issue? The one person I know with ASD (severe) has some of these same GI issues.

I had one like that before.

I did the food log, trying to figure out a solution.

Mom and dad did food log too. Of course, I found out later that they lied a lot about what they did and didn't feed the child because they KNEW the cause of the bad diapers were because of the food THEY fed the child.

So, what I did was start calling the mom EVERY.SINGLE.TIME the child had a blow out like that.

The parents didn't want to help me help them so I stopped and let them deal with it. I didn't exclude the child, I simply required the parent to come deal with it.

Mom brought a box of wipes, a changing pad and gloves. She also HAD to take all the garbage back with her and NOT leave it in my garbage.

That lasted about a month.

The issues seemed to miraculously solve themselves over the next few weeks.

NO clue if that would work for you but it worked awesome for me. I even ended up taking two more future children from the same family.

I know diaper changing is part of the job.

But "THOSE" types of diapers are not.

[TwinKristi]

Yes, luckily I have a small group and can smell quickly when it happens because it's just awful. I usually have him separate from the group, have dh or whoever grab be siupplies (2 plastic bags, gloves, Clorox wipes) and watch the other kids while I start cleaning up . They usually see quickly if there's a mess and move the kids to another area and I clean it up after. But this is literally a weekly occurrence I've talked to mom and Nana about not giving him blueberries because that seems to be a big trigger for these blowouts (he doesn't chew his food well and often stuffs his mouth full and just swallows) so these whole blueberries were an issue for a couple weeks.
His BM is also very "gritty" feeling. Is this from something specific? It's always very soft, not diarrhea (I've sent home for that before as well) but very soft. He's never had a solid diaper in over a year so it's just how he is.

[TwinKristi]

I know he's not getting dairy at home, they use goat's milk but there could be dairy in other processed foods he's getting. He eats cheese in quesadillas here but that doesn't seem to coincide with his messy diapers.

Also, he only does this once, it's not multiple times a day.
And as far as having mom or Nana come change him... Ain't gonna happen. They both work 30-60 mins away and mom takes the bus to &/or from work most days. There's no way I like leave him until they got here. In a true medial emergency there's family that lives about 20 min away but she's not going to come change his explosive diapers.

I just don't know what to do. We recently switched from 3 days and sometimes 5, the other 2 on a drop in basis, to a 5 day contract. So I don't want to send him home often and then end up back on a 3 day deal because the 5 isn't working when they have to get him so often.

[daycare]

I know he's not getting dairy at home, they use goat's milk but there could be dairy in other processed foods he's getting. He eats cheese in quesadillas here but that doesn't seem to coincide with his messy diapers.

Also, he only does this once, it's not multiple times a day.
And as far as having mom or Nana come change him... Ain't gonna happen. They both work 30-60 mins away and mom takes the bus to &/or from work most days. There's no way I like leave him until they got here. In a true medial emergency there's family that lives about 20 min away but she's not going to come change his explosive diapers.

I just don't know what to do. We recently switched from 3 days and sometimes 5, the other 2 on a drop in basis, to a 5 day contract. So I don't want to send him home often and then end up back on a 3 day deal because the 5 isn't working when they have to get him so often.

It may only take one time for them to realize that the child needs to see the doc and make some changes to diet..............

Or it could just be that the child takes large #2. If it is only 1 time a day.

[SilverSabre25]

Could be gluten, soy, food dyes....could be something more esoteric. Honestly a severe food allergy or two could well be causing his ASD symptoms. MANY autistic kids improve drastically or almost 100% when put on a strict gluten and casein free diet.

[spud912]

I have this exact same kid. I DREAD him pooping. Usually he doesn't do it everyday but will do it once or twice a week in my care. When he does, it's huge. Parents claim that it is never big for them. The issue with my dck is that he is huge and they consistently provided diapers that were too small so they always blew out. I don't have help or an assistant so when there was a blow out, I have a hard time managing the 5 other children since it takes 30-45 minutes to clean him. I bag up his soiled clothes and put them outside so at least his parents are responsible for that aspect.

I KNOW it's because the parents predominantly feed him fruit and nothing else at home. On days that they load him up with fruit when he wakes up, he almost always has a blow out for me. I've asked them to stop (he wakes up at 7:00 am and we eat breakfast at 7:45-8:00 am so it's not like he's being starved) but they still do it .

I am counting down the days until he is potty trained because it is a mess! The parents have at least switched him to diapers that fit so it has really helped solve the blow out aspect, or at least for now .

[TwinKristi]

Could be gluten, soy, food dyes....could be something more esoteric. Honestly a severe food allergy or two could well be causing his ASD symptoms. MANY autistic kids improve drastically or almost 100% when put on a strict gluten and casein free diet.

This is basically what I've wondered. BUT while I know mom & nana love him to death, I don't think they'd go for it. Mom denies that he even HAS issues and their family practice dr is a quack IMO! I know two patients of his who missed major milestones in the first 12-18mos and he didn't say a word! This DCB has major delays, muscle tone and fine motor issues not to mention the GI stuff and the other girl I know has brachial plexus injury from shoulder dystocia at birth that wasn't diagnosed until after 1yr (I knew something was up as an infant) and she also has diabetes which her father has and her older brother (a previous DCB) was tested for numerous times in childhood due to health issues he had. I don't think she has health insurance for him so I don't think she would rush to take him in which is why I'm leaning towards a food log. I love this little guy to pieces and want nothing but the best for him, but I worry that he needs more help then he's getting. They've admitted to having him watch a LOT if TV (my kids do too but they've all developed normally) but mom also tells me how nana let him have diet soda which caused diarrhea for a couple days (not here) and that he eats a lot of convenience foods. I'm afraid like BC said, they'll just lie about what they feed him.

[NeedaVaca]

Could you discuss this issue with PT/OT-most likely they will be in agreement that is could be dietary. They could actually make the request for mom-make it sound very serious (which it could be) and they could tell mom a dietary log is going to have to start. She may comply/take it more seriously hearing it from the therapist?

[Cradle2crayons]

This is basically what I've wondered. BUT while I know mom & nana love him to death, I don't think they'd go for it. Mom denies that he even HAS issues and their family practice dr is a quack IMO! I know two patients of his who missed major milestones in the first 12-18mos and he didn't say a word! This DCB has major delays, muscle tone and fine motor issues not to mention the GI stuff and the other girl I know has brachial plexus injury from shoulder dystocia at birth that wasn't diagnosed until after 1yr (I knew something was up as an infant) and she also has diabetes which her father has and her older brother (a previous DCB) was tested for numerous times in childhood due to health issues he had. I don't think she has health insurance for him so I don't think she would rush to take him in which is why I'm leaning towards a food log. I love this little guy to pieces and want nothing but the best for him, but I worry that he needs more help then he's getting. They've admitted to having him watch a LOT if TV (my kids do too but they've all developed normally) but mom also tells me how nana let him have diet soda which caused diarrhea for a couple days (not here) and that he eats a lot of convenience foods. I'm afraid like BC said, they'll just lie about what they feed him.

Well, if mom isn't going to change he way she's feeding him, there isn't a point in the food logs anyway.

And second, if you aren't going to require a dr visit... Then you really only have one option here.

Deal with the blow outs.

Either you are willing to keep doing it or you aren't.

Can't thi of anything else.

[TwinKristi]

I have this exact same kid. I DREAD him pooping. Usually he doesn't do it everyday but will do it once or twice a week in my care. When he does, it's huge. Parents claim that it is never big for them. The issue with my dck is that he is huge and they consistently provided diapers that were too small so they always blew out. I don't have help or an assistant so when there was a blow out, I have a hard time managing the 5 other children since it takes 30-45 minutes to clean him. I bag up his soiled clothes and put them outside so at least his parents are responsible for that aspect.

I KNOW it's because the parents predominantly feed him fruit and nothing else at home. On days that they load him up with fruit when he wakes up, he almost always has a blow out for me. I've asked them to stop (he wakes up at 7:00 am and we eat breakfast at 7:45-8:00 am so it's not like he's being starved) but they still do it .

I am counting down the days until he is potty trained because it is a mess! The parents have at least switched him to diapers that fit so it has really helped solve the blow out aspect, or at least for now .

I had a DCB who ate a lot of fruit and his diapers, and eventually when he went on the potty, were actually very soft and gritty as well so I wonder if that's part of it. He does love fruit and the blueberries are healthy and great for him, but I asked that they cut them up or put them in something so he doesn't poop them out whole. And the diapers were the Huggies Pull-Ons which were cute and easy to use but didn't contain his poops. Switching to regular Huggies helped a lot but again, we're still down to once a week.
He's up at 5:45 some days and doesn't come here until 7-9am so I'm sure they feed him something in the morning before getting here and he eats breakfast here as well.
Thank God it doesn't take that long to clean him up, but same scenario if I'm alone. It's like panic mode.

[TwinKristi]

Well, if mom isn't going to change he way she's feeding him, there isn't a point in the food logs anyway.

And second, if you aren't going to require a dr visit... Then you really only have one option here.

Deal with the blow outs.

Either you are willing to keep doing it or you aren't.

Can't thi of anything else.

Well it's not that they wouldn't, I just don't think they want to even consider that he's autistic, or even showing signs of autism, so they don't want to take steps down that path ya know? I have spoken to the case manager about my worries with him dietary needs, both of them actually, but mom absolutely hated the first guy and the 2nd girl ended up dealing with me. I asked last week what referral system there is if his Dr won't refer him, like can they make recommendation or something. They're not drs so they don't "diagnose" but both have relayed to me that they are concerned with how far behind he is.

I just don't know what to do. I will definitely ask mom about taking him in and maybe even seeing another dr. But I know if she gets info she doesn't want to hear you turn into an enemy and I don't want to be that person. But I also want her to listen to my concerns.
If someone asked me my professional/personal, etc opinion, I would think he has some form of ASD, but mom claims he does things that I don't see and his therapists and case manager don't see either. I think the routine of my home daycare is beneficial to him as opposed to what happens at home. He's very clingy and unhappy at home.

[TwinKristi]

She just texted asking how he's doing, which she does every day, and I told her he had a blow out and I'm thinking maybe we can all do a food diary and a asked if he eats a lot of fruit at home... We'll see how this goes!