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My 3 year old son says his private area hurts during diaper…

My 3 year old...

My 3 year old son says his private area hurts during diaper changes. He screams during EVERY diaper change, no matter if it's pee or poop. (I've been trying to potty train him but we moved a few months ago and it kind of disrupted the process) He will lie and say he's not pooped to try to avoid a diaper change. There's no rash at all! He doesn't have pain when pooping or peeing. He doesn't seem itchy, and when I ask him where it hurts he says everywhere. I'll point to his penis and say does this hurt? Yes. Point to his anus. Does this hurt? Yes. Point to his knee. This too? Yes. He just seems so terrified to get it changed. I'm at a loss.

Doctor's Assistant: How long have you been dealing with this? Does anything in particular seem to make the itch better or worse?

Nothing. not warm wipes or diaper rash ointment even theres no rash.

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Customer reply replied 1 month ago
started 2 months ago
Answered in 14 minutes by:
3/15/2018
Paul
Paul, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 9
Experience: Pediatrician / Owner at Marion
Verified

Hello. Let me try to help with this question. It started 2 months ago. Does he complain everyday? Any injury or trauma to that area. Any possibility that someone did something to him or inflicted pain in that area (sorry to ask)? Is there anything that you can do to help with the pain? Is there any lumps or bumps in genital area?

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Customer reply replied 1 month ago
He complains every time I have to change his diaper. Every time screaming bloody murder and I have to pry his legs apart. I'm going to record it and ask the doctor by me to look at the recording so I can help him get the full extent of the issue, but I'm waiting for my insurance to go through (we just moved to a new state). No trauma that I know of. And don't be sorry; I actually was wondering the same thing - he just started a new daycare and the last one he LOVED and was happy. Then he starts this one and he hates it and cries daily when I leave him, and the diaper issue crops up. I'm not thinking necessarily sexual abuse, I'm wondering if maybe one of the workers is rough with him during diaper changes? He says everywhere hurts but he seems particularly protective of his anus; I cannot clean it without him screaming like it's a red hot poker. I wish I was being dramatic; the kids literally seems traumatized when I'm changing his diaper. No bumps or lumps. I've tried A&D ointment and other creams (but again, the skin isn't broken or rash - its cream on healthy clean skin) and I've tried warm soft cloths or dipping the wipes in warm water before wiping.

As a pediatrician of 22 years, my first concern would be some sort of abuse. That is a very disturbing thought. There are "Child Advocacy Centers that could evaluate him for free and ask him, in an age-specific method, if anyone has abused him - that might be a thought. Obviously, he needs a physician to take a look. Anything unusual about his stools, ie. have you examined to stool to make sure there is not pinworms? Any itching? At age three, what is his interest in potty training. You may want to encourage him to work on potty training and get him into cotton underwear.

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Customer reply replied 1 month ago
I was really dreading you to confirm what I had already thought. It was in my head but I was praying I was overreacting and I wanted to get another opinion before I brought it to his new doctor. I began potty training him about 9 months ago and he was doing great, but we moved to PA from MD into a friends home in September 2017, then we moved again December 2017 to our current home so he got off track and kind of disinterested, but I keep plodding along to make sure he's ready for pre-k. I haven't checked his stools for worms, but I will make sure to do so. They're normal; not overly hard or soft, and he is a big time pooper, usually going at least once, but up to 4 times a day. The one daycare worker has mentioned that he poops frequently, so that's why I was thinking maybe she was perhaps being too rough with him during changes to hurry the process along. I haven't noticed any itching. I have asked the daycare workers to encourage him to use the potty during the course of the day, but they all say when they offer to take him he's not interested. At home with me, he's 50/50 with the potty and pull-ups. Before the move, he was doing very well, almost to the point of using diapers overnight only, but then he regressed afterwards. I haven't noticed any other behaviors out of the ordinary for him.
I would hope and pray that there was no abuse, but I don’t think you can be Too Careful. It may be a transition that he is going through due to new circumstances but keep your guard up. The question about worms was just a second thought. Good
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Good luck to you. I hope this was helpful. This is a difficult situation but it is great that you are an advocate for your child.
Paul
Paul, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 9
Experience: Pediatrician / Owner at Marion
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Paul
Paul, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 9
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Experience: Pediatrician / Owner at Marion

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