A.A. asks from Reston, VA on August 22, 2009
My 4 Year Old Son Is 24 Pounds and Wont Gain Weight.
My 4 year old son has not gained weight in 8 months. He currently weights 25 lbs and is all bones ribs breast bone and nobby elbows..The doctor ran every test he could and put him on every diet he could....pedia drinks ice cream......potatoes but nothing helps...Youth and family services threatens to take all 5 of our healthy kids because one wont gain weight....I am searching for a medical condition that might fit his symptoms....If anyone has an idea please help!!!!!We are desperate!!!!
3 moms found this helpful
S.M. answers from Washington DC on August 22, 2009
Postscript - Following on some others who suggested Celiancs. I wouldn't change his diet without a specialist's care. I have read that if you go off gluten on your own, the doctors won't be able to find the enzymes produced in celiac's that need to be presnet for the diagnosis. They look for enzymes in the blood, but can also look for intestinal "damage" from the gluton with a biopsy. There is certainly the chance that the blood tests could have missed it or that he has a sensitivity to gluten that is not celiac's, but you want the doctors to actually be able to test for it, and if you take away gluten on your own, they won't find it.
Haven't you seen a gastrointerologist? Something like this is not something to be dealt with by a pediatrician or a family primary care doctor.
Here is my limited experience and thoughts.
I have an 18 month old whos is 23 pounds and has fallen form 90th to 25th percentile. She is maintaining height and head circumferance, but the doctor is quite concerned. She just ran a full blood and urine panel looking at the THYROID and looking for INFECTION affecting liver and kidney function. They had been thinking thar there is something going on to prevent absorbtion of nutrients. They were in particular looking for a urinary tract infection which she said could be underlying/lingering and using up excess calories.
The workup came up fine, so now they want to work on her diet for a few weeks. And if she doesn't gain they want her to see a gastro doctor. They mentioned in particular CELIAC'S DISEASE(gluton intolerance).
A friend of mine also has a similar problem with her 2 and a half year old - he weighs 25 pounds, but has always been small. They are currently testing him for MAPLE SYRUP DISEASE which is some sort of metabolic disorder.
I wish I had some more ideas for you, but I strongly strongly suggest you get to a different doctor and get a second opinion. Your doctor is not seeing the problem and a new set of eyes is needed. And if you haven't, you must get to a specialist.
Has your son been classified as "failure to thrive"? Has he always been small or has his groth pattern changed? Does he have other developmental symptoms? Does he have (or had as an infant) digestive/GI upset? Is there any GI problem or other problem in the family? Ask yourself all these questions and write down your thoughts.
I also suggest you keep a diary of his eating, activity levels, and urine and bowel movements. Also note how he feels after he eats - both discomfort but also behavioral changes. This can help identify what foods "work" and if any don't. Not only oculd this helps a doctor with a diagnosis but it will also help you deal with anyone who makes accuusations regarding parenting. I really feel for you as this must be very scary, and I hope you will post as to the outcome. Good luck.
1 mom found this helpful
E.F. answers from Washington DC on August 23, 2009
Have him tested for Celiac Disease (gluten intolerance). Gluten is a protein in wheat, barley, oats, & rye. It has a variety of symptoms, including "failure to thrive" in children. I have Celiac, and was diagnosed in 2003 by an allergist, but I think the pediatrician can do the test also. It is a simple blood test, which looks for 3 indicators. My symptoms are different, but I've heard about miracles in children who switch to a gluten free diet.
L.E. answers from Washington DC on August 23, 2009
By using probiotics and enzymes to help her digest the food better, she finally began to retain and use all the nutrients she was eating and is now on the normal growth chart and thriving.
I'm not sure where you're located but our doctor (who is also an MD and a pediatrician) is Dr. Margaret Gennaro -- www.neckbackandbeyond.com. She's in Fairfax, VA and I highly recommend her. There's a long waitlist for an appt (2-3 months) so if you're at all interested contact her immediately. She might also be able to recommend someone else who is closer to you or who has an earlier appt.
Good luck. If you want more info feel free to email me -- L., mom to 2 girls, 9 and 3
J.G. answers from Washington DC on August 23, 2009
You've received alot of good advice--please weed through it and follow through with what you think is necessary. My daughter is 6 1/2 and weighs 34 lbs. I worry constantly. A few things I've learned:
She gets very constipated and then feels full and won't eat. I give her Miralax (at the doctor's suggestion) every other day which keeps her regular and I find that she eats better.
At the doctor's suggestion we did a bone age scan. They x-ray the hand and look at the growth of the bone. It turns out my daughter is behind about 2 years from where she should be, but this is GOOD according to the docs. They say she will grow at puberty.
They also look at whether the child is growing taller. We saw a pediatric endocrinologist who makes sure she is growing UPWARD at a good rate which is a good indication of thriving.
Look at his physical health and activity. Is he healthy? Does he get sick alot? Is he active like a kid should be? I find my daughter is very healthy and active so I don't worry too much. Your gut will tell you if something is wrong or not.
Keep good documentation of all of your doctor visits. Make copies of all doctor visits and physical exams then follow through with the recommendations. As long as you are on top of everything and can document how you are trying to help your son then there shouldn't be any question.
M.C. answers from Washington DC on August 23, 2009
Hi, I don't usually respond to these things, but it sounds similar to my sister's situation (with out family services getting involved). My niece would not eat, was pale, and lethargic. She had lots of testing done, that found nothing, and several bouts with tonsillitis. She finally had her tonsils removed to uncover a terrible abscess!! Since that has cleared up she is eating everything in site and has soo much energy and is totally normal. She was slowly dying from the abscess and the Dr.s couldn't find out what was wrong. So keep looking for what is bothering your son.
Megan (mom to 3 yr old girl, and 1 yr old boy)
D.R. answers from Washington DC on August 23, 2009
It sounds like you have a received a lot of great advice.
I would ask you doctor to also check for Celiac's disease as well. Although Celiac's has a lot of symptoms. One in particular is failure to thrive/gain weight.
The other disease which would have probably been diagnosed by now but there are always the atypical patients'. The other disease I would check for is cystic fibrosis, it is very commmon with that to also not thrive, however, there are a lot of othe symptoms that go along with it as well.
I hope you find out what is wrong.
P.s. if CPS tries to take your kids away and you end up finding out what was medically wrong boy are they going to be a boat load of trouble. You will have one serious lawsuit on your hands!
R.S. answers from Washington DC on August 23, 2009
If you're working with a pediatrician (and you may want to talk to a second one to see if they have any more/different ideas), CPS generally has nothing to argue. There is non-organic failure to thrive, which comes from emotional neglect even when the child is being fed (not saying that is the issue, just saying that is what CPS could argue). I would consider that, and see if the pediatrician suggests therapy (just so it's on record). I'm guessing they checked his endocrine system, thyroid, pituitary, etc?
If they didn't run a LOT of blood tests, you should be changing doctors, and even if they did, I'd suggest a second opinion.
J.C. answers from Richmond on August 23, 2009
I don't think Celiac disease always shows up accurately in testing-- if they've already checked your little guy for it, and it indicated he doesn't have it, you might consider taking him off all gluten anyway, to see if he begins to gain weight. My uncle had Celiac undiagnosed for years, and nearly died from it, until he came off wheat and all gluten products on his own. He finally began to gain weight again, and is completely healthy now. You can go online and learn from some good websites how to completely rid your son's diet of gluten-- it hides in all kinds of foods, so you may not realize you're still feeding it to him-- things like rice, if processed a certain way, or caramel color in foods, etc.. I'd also go for a good long while completely gluten-free before letting him have more of it; months and months. If at first you see no signs of change, it could be that he is so completely sensitive to it that he, for instance, needs a separate toaster from everyone else's, because the regular bread would leave traces of gluten in the toaster, and then his gluten-free bread would become contaminated.
My dad also has Celiac disease, so I've been around all the rules and regs forever!! You have to be so vigilent if you're going to try taking him off gluten, or you may never know for real if he's sensitive to it. Some experts in the field say that really the only definitive way to know if some folks have Celiac is to go gluten-free for a good long while....
Good luck to you, A.. This must be so hard for you. I hope you'll let us know how it all turns out.
PS- I would get a second and third opinion post-haste, as well.