Fructose Malabsorption

After years of trying to decipher what causes my daughters' tremendous pooping abilities, and I may have started to figure it out.  I wrote to the person who wrote a book about potty training (I was on a forum that she mediated back when Audrey was PTing) and told her what I had learned, and she asked me to write a guest post to her blog about it.  So I'm going to practice here, and you will learn what I've been up to!

It seems like the latest "fad" that everybody is allergic or sensitive to some kind of food or another.  I've always been thankful that my three daughters (5, 3, and 13 months) have had no dietary restrictions, other than the self-inflicted kind!  I am proud to say that I exclusively breastfed my babies for a full year, and never had to use a drop of formula.  I am a really good cook, having learned from my mother how to make things from scratch and from Rachael Ray how to do it fast, and we generally eat pretty tasty food around here.  I didn't think my cooking style needed any adjustment until my middle daughter, Audrey, was potty training, and she couldn't master pooping in the potty because she had no control of her movements.  It was insanely frustrating.  I had already gone through a less-severe version with my first daughter Emily, who coined the phrase "surprise poop" - not a term I was happy to have stick around our household as long as it has.  So, what was going wrong here??  I was doing my best to cook nutritious, wholesome food for my family, and they can't digest it?!

Let's take a step back.  I am a lover of food. I am blessed with an athlete's metabolism (undeservedly), a strong stomach, and an adventurous palette, and I come from a family who likes to talk about the food we're eating, freely exchanging recipes and discussing how food was prepared.  When Emily was a baby, she had blowout after blowout of breastmilk poop, and disposable diapers didn't do anything to contain it.  For most of the first year of her life, it was pretty much expected that she'd go through at least two outfits a day.  But since she was that way from day one, I didn't really question diet much. I was just eating whatever I want in mass quantities because I was nursing, and remember that fantastic metabolism? I can't help but wonder if the poor girl would have had an easier time if I had actually given it a second thought, but everyone told me, "She'll outgrow it once she starts solid foods." Until she was 9 months old and discovered hamburger, she seemed to believe that baby food was only for wearing, not consuming, so I was quite happy when she would eat anything at all, and she chose meat. And cheese.  And aside from the surprise poops during potty training, she's been pretty happy ever since, with a few fruits and almost no veggies.  She seemed to know what her system could take.

Welcome baby Audrey, and it's more of the same, except she decided she likes food and will eat nearly everything.  Imagine my relief!  All of my effort making homemade baby food, pureeing things and making a disaster of my kitchen, and then she actually would eat it!  Hooray!!  except... disaster diapers continue.  And continue for a year. Once again, "She'll outgrow it, don't worry..."  And she didn't, clear into potty training at about age 2. (I say about because it was a multiple-month process.  But really, who could learn how to handle her functions when she had no idea they were happening?  Poor girl.  And poor me, because I'm guessing nearly every square foot of my house has been peed or pooped upon.)  Finally, I kept a food diary of everything I was feeding Audrey.  And I mean, every single ingredient in every serving of anything she consumed, which was tricky because not only was she in daycare 3 days a week, but she's also a raccoon and liked to dig through the garbage for edible treasures.  After what I thought was a false discovery of apples, I decided onions were the major the problem.  And my chiropractor recommended probiotics, which Audrey took daily for probably 6 months, and the combination of those two efforts finally, FINALLY allowed her to control her output.  And she potty trained almost immediately after that.

During this whole time, in the back of my mind, was the story of my friend's sister, who had struggled with digestive issues throughout her childhood, IBS in high school, Crohn's disease in her 20's, and then finally colon cancer.  And then she died, leaving behind a girl just the age of my Emily.  I'm not saying that untreated food sensitivities can eventually kill you, because I really don't know much more of my friend's sister's story than what I just mentioned.  But I do know she really struggled throughout her life, and I was watching my daughter struggle, and I was in that rare mental state of a working mother who splits her time at home between cleaning up yet another set of pooped clothing and suffering from first-trimester exhaustion and morning sickness.  I was going a little bit crazy.  Okay, I was really, really crazy, and nothing seemed reassuring.

I'd take my children to their regular checkups, because although I am a little bit crunchy (I'm cloth-diapering my 3rd daughter, using chemical-free cleaning products, and get my kids adjusted at the chiropractor), I still vaccinate on time and did the hospital birth, complete with induction and epidurals for all 3.  So at every single checkup, they'd ask, "How are her stools?" and I would say, every time, "Awful.  Horrendous.  Pieces of undigested food.  Slime.  Frequent.  Painful and surprising for her.  I have to change her right away or she gets painful, bloody diaper rash.  The quantity is crazy.  I don't know how she's growing at all."  But because each girl kept gaining weight, no one was the least bit concerned.  I finally requested a stool sample analysis for Audrey, and they were happy to charge me $500 to tell me she didn't have a parasite.  And that was it.  They sent me on my way and I was expected to just let the kid suffer until she outgrew it, "hopefully."  As long as the child isn't constipated (which they would just recommend Miralax for anyway, and not truly diagnose what was causing it) they don't really care.  Western medicine is wonderful for those who are injured or suffering a disease, but for those who are seeking to be healthy, it's incredibly frustrating.

So, last year, I welcomed baby #3, named her Clara, and crossed my fingers that she'd be as exceptional and amazing her sisters in every way except for super-pooping.  Nope - just like her sisters, as I eased off breastfeeding and approached her first birthday, her output got slimier and less predictable.  I actually broke down crying the other day over a diaper.  Even the laundry service who washes thousands of diapers every week couldn't get these clean, and when I complained, they said it was ridiculous that they didn't seem clean - nobody had ever complained before.  Once again, I started going a little crazy, but this time, internet searches yield a little more.  I've been reading more and more about the effects of gluten, preservatives, food coloring, and artificial sweeteners.  Finally, I see it: Fructose Malabsorption.  And things finally start to fall into place.  I remember a friend whose son gets diarrhea after Halloween every year.  I remember another friend who couldn't eat apples when she was in college, and eventually gave up wheat because she felt so ill when she ate it, along with her own odd collection of other things that seemed unrelated (but all contain fructose or fructans!). I remember how things were worse with Audrey, who would eat anything I made, and not as severe with Emily who stuck with meat, cheese, and bananas.  I remember how giving up onions was the magic, healing thing for Audrey, and how giving Clara probiotics in applesauce didn't help her like I thought it would.  So I took the plunge - gluten-free, fructose free for less than a week, and Clara pooped a log.  I was so excited that I wrote to Jamie and texted my husband and called my mom, all about a piece of poop.  Yup.

Someday, Clara will probably outgrow this, which probably means that she doesn't truly have the condition but rather just an immature, sensitive gut.  I don't really care, as long as I know how to keep her from suffering until her little gut matures to the point where she can handle some gluten or fructose here and there.  But it took me 3 children and 5 years to finally figure this out.  I wish so much that I could go back in time with this information in order to alleviate all the struggles we had - not just laundry, but the emotional toil of potty training a kid who I knew was capable and smart enough to go potty but whose colon wouldn't cooperate.  I am so excited that I may not have to face that battle with Clara! I am so relieved that I know how to help my kids when their tummies hurt.  I am glad to have a method to my madness.  Yes, I'm now a part of the annoying culture of, "My kid is special because she can't eat ____," but I'm also okay with providing her own food and not making it someone else's problem.  Like I said, she will probably outgrow this, like her sisters seem to have, since they can have applesauce and pasta without a surprise poop afterwards. 

That's my long, sad story.  I guess the moral is that you've gotta figure it out on your own. Reassurance is nice when you feel like you're going crazy, but you know what's nicer?  HELP.  There are resources like naturopathic medicine that wish I had taken my daughters to, because I could have done better for them.  I did what I could by keeping my diligent food diary and continuing to do internet research, because standard medical professionals are not interested.  You have to do this on your own, and demand help when you know something isn't right.  And you have to pay attention, too, because I'm guessing that a lot of the disposable diapers that I changed on my oldest would have concerned me, but I didn't look because, really, eww, who wants to look, right?  Well, we should.  What comes out of your child was very recently a big percentage of her internal make-up and a very important part of her system.  It plays a big part in how she feels and acts and grows.  I live in Iowa (birthplace of HFCS - you're welcome, America!) and I work in the agriculture industry, so I know that farmers who raise cattle are very, very interested in their cows' output because it indicates that they are feeding them the right things for optimal milk production or weight gain.  If they'll send off samples of manure for a detailed lab analysis, then we as parents can take a peek in a diaper.  And we should care, not just when they're in pain from constipation or we are annoyed that they are withholding.  Doctors should too, but in the end, it's up to us to feed each child what she needs in order to grow and feel her best.