If your child is fidgeting in their seat, grouchy, or on edge, it’s easy to assume that they need a sensory fix to regulate themselves. However, if this happens on a regular basis, there could be more to it.

Interoception is our sense that handles the internal body sensations coming from our organs (including our skin). As our organs deliver signals to the brain (stomach growling, dry mouth, droopy eyes, etc), the brain gives meaning to these indicators (hunger, thirst, fatigue) and addresses them appropriately (eat, drink, sleep). These sensations and responses can vary from person to person.

How we feel internally can affect our emotions, homeostasis, and how we perceive the world around us.  Some kids may not show the traditional signs for concern when it comes to how their body is feeling, often going unaddressed as they get older. They may assume their body’s cry for help may be typical and that can influence how they handle daily situations, from self-care skills to peer interactions.

For this post, we’ll be diving into some common issues with the four areas associated with kids’ interoception: eat, sleep, poop, and pain.

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Eat

We must eat to survive, but as adults, we know from past experiences what foods don’t sit well with us. For babies, they are just now going through this trial-and-error process.

How would you know? If you breast feed, your diet may not be one your baby can tolerate. Your infant may constantly spit up, develop eczema or rashes, or have interesting stools. You may have to eliminate certain products, like soy or dairy, until you no longer provide them your own milk. Formula is an alternative to breast milk that also caters to food sensitivities and intolerances; however, it can cause constipation for some babies. For toddlers, food sensitivities may look like indigestion/constipation, gastrointestinal pain, itching or skin irritation. Patti’s 3-year-old just had a run in with some ripe pineapple and couldn’t understand why her mouth started itching very badly.

Why is this important to recognize these symptoms? If they aren’t addressed, feeding over time can become difficult and not enjoyable for you or your child. Food may be seen as a threat which can lead to picky eating, seeking items that are safe and predictable. If rashes continue, it could result in tactile sensitivities as clothing may irritate their skin.

What can be done? Generally, a detox of suspected food culprits for 6 weeks while monitoring any change in symptoms is recommended for children under the age of 3. Unfortunately, food allergy testing isn’t a go-to for little ones as they may not have enough of a certain protein in their system, making it tricky to pinpoint what foods are causing the negative effects. If it’s really a problem, discuss the issues with your pediatrician who may refer you to a gastroenterologist.

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Sleep

Sleep is an indicator for self-regulation. If your child gets a good night’s rest, then they’re more likely to regulate themselves appropriately throughout the day. That sleep-regulation relationship starts as babies. Newborns snooze in 1- to 2-hour cycles, averaging about 17 hours of sleep a day. As they begin to move and explore their environment, they develop better self-soothing patterns (falling asleep easier, sleeping longer, fussing less, etc). By the time they’re about 5-6 months old, they are able to sleep through the night without a feeding.

What can happen if your child doesn’t get enough sleep?  Research has found that:

• Sleep issues seen at 6-12 months of age is correlated with behavioral problems in 3- to 4-year-olds.
• 8-year-old children who have sleeping difficulties are more likely to have depression when they reach the age of 10.
• Children with limited sleep have a higher incidence of sensory over responsiveness to light, sound, and touch, hindering their engagement in daily activities.
• Atopic dermatitis (eczema) between 3-10 years of age has been associated with shorter sleep durations.

What can we do? 

• Allow your little ones to move around. When movement is limited, like frequently carrying your baby around or allowing them to stay in their jumper/rocker to extended periods of time, it can result in difficulties self-soothing that can affect sleep.  
• Consider factors that can hinder your child’s sleep, such as noise, lighting, sleep location, temperature, textures against their skin, etc.
• Check their diet. For babies to sleep through the night, they should at least weigh about 12lbs. Once littles are moving around, they are metabolizing as much calories as they are consuming, so ensuring your child is getting enough nutrients is key. For older kids, be cautious of the kinds of foods they are eating before bed. Heavy meals or snacks prior to bedtime can keep them awake for most of the night.
• Snoring or sleep apnea are not typical for a healthy child to have. If your child is frequently experiencing breathing difficulties while sleeping, especially on their back, check if they have a tongue-tie (a malformation that restricts movement of the tongue).

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Poop

You can tell a lot about what’s going on inside your kid’s body based off their poop. Yeah, we know it can be gross. Healthy stool, for the most part, will have the same consistency, smell, and color. If something is off, whether that is a change in diet or if your child is sick, any one of these stool characteristics will change. For example, floating poop indicates difficulties absorbing fats (who knew?).

The one type of stool that implies an issue in babies and young children is constipation. Why? Because it is painful to pass. If this is a constant feeling for your child, it can result in difficulties with toilet training. If they regularly have bad, painful poops, they may try to hold it in. This can cause a vicious cycle of painful bowel movements and attempts to withhold going to the bathroom. I speak from experience from potty training our son.

What can we do to help?

• Diet change is a big one, especially if there’s any food sensitivities present. Studies show 80% of chronic constipation is linked to an allergy to cow’s milk. Working alongside your pediatrician and a pediatric dietitian may help.
• Some sitting postures are better than others when it comes to eliminating. Have your child lean slightly forward on the toilet to help them poop. Consider the size of the toilet as your kid may be more concerned about falling in/off than trying to go. You can also try positioners like the Squatty Potty if your child needs a passive method to get into appropriate alignment.
• Belly massages using gentle circular motions on your little one’s abdomen can relieve constipation (and gas) as do assisted knee tucks (bringing their knees to their chest).

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Pain

Here’s a fun fact. Pain is not a signal sent by our organs, but rather, manifested by the brain when it is assigning meaning to these internal sensations.

Why is this important? If caregivers misread the pain cues their little one is giving them (which can happen when interpreting a baby’s cries), it may cause the child to develop a higher pain tolerance over time and assume this feeling to be normal. Two situations come to mind when discussing pain in young children: ear infections and eczema.

Ear infections are very common, characterized by ear pain, fever, and crying at night. About 35% of preschool children experience them with 83% of those resolving on their own. However, if your child is consistently getting these, it can impact their hearing (listening to verbal instructions) and balance (like participating in PE class). It can also limit their ability to swim or travel by plane because they can’t handle the pressure change. Tympanostomy tubes are the recommendation when infections persist, draining excess fluid out of the ear. If fluid still continues with the tubes, that means it’s allergies.

Eczema and similar skin irritations are the body’s response to noxious stimuli that may be harmful. Children with allergies, whether from food or the environment, can develop rashes on the skin which can affect participation in activities requiring touch, like dressing, bathing, or even receiving a hug from loved ones. What can you do to handle this? Aside from examining their diet, find and eliminate what your child may be allergic to. Talk to your pediatrician who may refer you to an allergist to determine any environmental triggers (like laundry detergent or pollen).

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Interoception lets us know the internal state of our body. However, it’s not always easy to puzzle out these signals compared to the other sensory systems. Try your best, help your child lean into their own body sensations, and give them the vocabulary they need to help them communicate these needs.

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