The Tale of the ‘Poonami,’ and How We Got to the Bottom of It

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by Richard Poulin III |

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I had read a guide for dads before my daughter was born, so I knew what to expect before that first bowel movement.

Called meconium, it comes in the first few days and is typically sticky, thick, and dark green — a mixture of old cells, protein, fats, and bile.

Our daughter’s first bowel movement, however wasn’t typical. It was what is referred to as a “poonami.” An explosive mess, it was funny at first, and my wife and I would signal each other for all hands on deck when one dropped. If a grandparent was nearby, we were quick to pass on the opportunity of changing our daughter.

Is there something in the water?

At that time, we were in China, and we wondered if there was something in the water that was causing issues for Rylae. Our concern wasn’t unfounded. Diarrheal disease is the second leading cause of death in children under 5, according to the World Health Organization, and it results in about 525,000 deaths every year around the world.

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We purchased a comprehensive water filter and even installed a filter on the shower taps to make sure she bathed in clean water. But this didn’t stop the poonami.

digestion issues with AADC deficiency | AADC News | Rylae Poulin grips her spoon after eating some pureed food

Rylae’s digestion issues continued even after she switched to solid foods, and her parents were eventually able to connect the problem to AADC deficiency. (Courtesy of Richard E. Poulin III)

Rylae was still breastfeeding when the poonami was happening, so we ruled out food as the cause. But we had been working through some feeding issues, and because she was underweight, we asked her doctor about giving her formula to make sure she was getting enough nutrients. Our doctor recommended the right one, because she began gaining weight quickly. It didn’t stop the poonami, though.

Neither did progressing to pureed food. When we did this, we were careful about introducing different types of food, and worried that some foods could upset her stomach even worse. But, we continued to monitor her diet, and our daughter was well fed and hydrated.

Digestion issues with AADC deficiency

After Rylae was diagnosed with aromatic l-amino acid decarboxylase (AADC) deficiency, I read everything I could find, but didn’t see anything related to acute diarrhea, and I hadn’t even considered it. My mom believed there had to have been some connection, though.

AADC deficiency manifests in children as an inability to control their motor functions because they don’t have the necessary neurotransmitters to send signals throughout their nervous system. The disease also affects their blood pressure, heart rate, and body temperature.

Eventually, we learned that AADC deficiency is also associated with digestive difficulties in some children, but the symptom has been largely underreported. Not all children in our community had this same issue, and each child will certainly experience different concerns.

Rylae’s digestive issues are still a problem, but the poonami is gone, thankfully, since we continue to work with our pediatrician and monitor her diet.

It is so important to me that there be greater awareness of this symptom, as it can contribute to a severe failure to thrive, and chronic diarrhea can easily lead to dehydration. A child with digestive issues should be seen by a pediatrician to ensure she is getting proper nutrition.

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Note: AADC News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of AADC News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to aromatic l-amino acid decarboxylase deficiency.