April 17, 2011,
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.
D.W. answers from Louisville on August 10, 2010
i completly understand were you are coming from i have a four yr old daughter,that is 33 pounds and have been there for a while.she is very tall for her age and it concerns me because i try everything possible and it dosent seem to work out,her doctor told me that a kid knows when he/she are hungry and never force her to eat if she isn't.now that i have tryed that it seems worst than be for...the only thing that might be helpfull is milk and peanutt butter.make him eat a peanutt butter sandwich every night before bed followed by a glass of whole % milk do that 4 about a week and you should defenitly see a change in his weight! I hope everything works out and i really hope u try my plan it worked for me and i just know it can work for you......GOOD LUCK
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.
K.S. answers from Washington DC on August 23, 2009
Well how on earth is Youth and FAmily services in your business, first off???
I would continue to feed him high calorie healthy foods. Meanwhile find another dr. for another opinion and do some research on the internet. Maybe he is just a super skinny kid?
If he is overall healthy and active and happy and he eats, then I would let him be. I wouldnt worry unless he was sickly, or lethargic or sleeping alot or unhappy.
R.C. answers from Washington DC on August 23, 2009
Take a look at the blood type research. Each blood type has a profile of foods that boost immunity and metabolic efficiency. The Knowledge Base can be reached through my link at www.greenrita.com As noted at the site, other culprits behind your child's issues might be tied to a fungal or bacterial parasite. One is Systemic Candidiasis of which the first inoculation can be conveyed as the child passes through the birth canal. Also, your child may have had an exposure to heavy metals and/or environmental toxins that may have created a metabolic dysfunction. And, there are still other sources for the child's issues that can be addressed with the Microbial Balancing Program available at www.perelandra-ltd.com I have eliminated Lyme Disease, HSV, an intersitial mycoplasm that created convulsions, as well as a constellation of issues including diabetes and arthritis with a combination of protocols that addressed the above listed potentials. Kinesiology can assist in identifying your peculiar course of action to help your child restore metabolic balance and stability.
M.G. answers from Washington DC on August 23, 2009
I would definitely think about putting him on a gluten-free diet. My brother was near death as a toddler from what the doctors diagnosed as Celiac. It turns out that he doesn't test positive for Celiac, but he definitely has a gluten intolerance. If he eats any gluten he is horribly sick for days.
Hopkins is apparently a good place for Celiac. Also, I'd take him to a specialist. If he isn't improving under your doctor's care, you need more.
M.C. answers from Washington DC on August 22, 2009
Have you tried increasing the number of times he eats per day? Like from 3 to 6? Try giving a medium size meal or snack every 2 to 2 1/2 hours. If it is a hyperthyroid, he's burning alot of calories. Eating more frequently will help in the short-term.
M.B. answers from Washington DC on August 22, 2009
Did your doctor run a thyroid test???
R.R. answers from Washington DC on August 23, 2009
Our 2 year old son wasn't even on the charts for his weight, he was so light. We spent almost an entire year seeing different specialists (gastro, endo, nutrition, and 6 others) and they ran a variety of tests, and we had weight checks every other week for months. Our pedatrician finally referred us to the PIE program, a county program that had an Occupational Therapist (and other therapists) evaluate our son for a variety of issues. Turns out he had a sensory issue when it comes to food. Certain texures and temps bother him, causing him not to eat. Can you get him evaulated by the county?
L.R. answers from Washington DC on August 24, 2009
It's frightening that family services is threatening this. Who told them about your son? Does someone out there have a grudge that is being played out by reporting you to family services? If that's the case you should be prepared to document that grudge too...I won't attempt any medical advice as we haven't been through this, but please, as others have said, DOCUMENT EVERYTHING medical, and on paper, not only on the computer (computers do crash) and have multiple copies of everything, with copies in a safe deposit box or other place of safety outside your home. Also keep a written journal of things like phone calls to the doctors, each day's food intake, etc., that don't produce a written record. I also would advise getting an initial consultation with a good family law attorney (see a specialist attorney who is experienced in dealing with family services on behalf of parents) sooner rather than later, so you have an attorney who is already familiar with you and whom you can call immediately if family services actually tries anything. (A friend in another state is a family law attorney and I know that she would tell someone in this situation to document like crazy and have an attorney already on hand.)
E.K. answers from Washington DC on August 24, 2009
I am not sure why someone thinks that a child who eats and runs off the calories thinks that that is child endangerment, but thats an issue that I would ask an attorney about, ASAP! As far as him not gaining weight, my daughter, now 6yrs and 46 lbs, was at 24 -26 pounds from 2yrs to 4.5yrs. Has your doctor done tests for a tape worm? Does he eat pork at all, this could lead to some problems. There are many different physiological problems that could cause a lack of weight gain. You said that you have been talking with your pediatrician, has he/she referred you to an endocrinologist yet? If not, ask for one immediately!!! There is actually a disease that requires the child eat high protein foods EVERY hour, I don't remember the name, but an endocrinologist will know. YFS shouldn't remove any children while you are trying to get a medical diagnosis, they don't want the liability, or bills associated with trying to find out the problem.
Something that you may be doing, but not mentioned, is vitamins. Not all vitamins are created alike, and none of the ones that you get from the store get absorbed to work the way that we want them too. Missing vitamins and nutrients, or the inability to properly absorb them from the normal diet, can cause a lack of weight gain. I know of a company that has DOCUMENTED absorption of vitamins and nutrients, that may help to gain at least a little weight.
Have you tried protein supplements? The same company has good protein shakes and snacks.
How often does he eat? My kids eat an average of every 3 hours, when at home, at school, I fill them up with fiber filled foods and pack one in the lunch box to keep them not soo hungry at school.
Please let us know what happens
A.F. answers from Washington DC on August 23, 2009
Can you ask your doctor to refer you to a specialist? AF
Children grow in their own programmed way. if the doctor finds no medical reason for the size of the child, he should write a statement of health. I say this because when I was 13 years old I only weighed 60 pounds and was 4 feet tall. In my teen years I had a growth spurt. I grew to my adult height of 5ft 4in. and adult weight of 110.
J.K. answers from Washington DC on August 24, 2009
Have you checked his thyroid?
ALso, have you gotten a second opinion? from an endocrinologist, etc?
keep him on full fat milk for sure, and lots of it.
My nephews are similar- very tall but toothpicks.
The doc made their mom make them use olive oil liberally. to pack on healthy fat.
I would get a second and third opinion but bring copies of the results to the new docs so tests aren't copied repeatedly.
R.H. answers from Norfolk on August 23, 2009
According to my Ped. she always said (And WIC office) As long as he's thriving things are ok. We would go to our Dr. appointments and i would go But look at her she's so small. (my daughter is nearly 7yrs old and only 35lb) they would ask is she not eating to stay thin, and i would say "No" she would say well she looks actives. (she was happy and playing in the office) and she would say "As long as she's not trying to stay thin and she's happy and active things are good"
M.B. answers from Washington DC on August 23, 2009
Hi. My name is M. Bunker. I am a chiropractor whose focus is natural therapies. I work with all age types helping people get healthier. It sounds like you child may have food allergies or underlying infections or other challenges. What I do is test the body to determine why it is having problems and what it needs to get healthier. I don't do anything invasive so you don't need to worry about that. What I do is called Nutrition Response Testing. I feel as though I may be able to help you and your son. I try to not post things soliciting my business on here, although I feel like I can help a lot of people on the website, but your post caught my eye. If you are willing to try something out of the mainstream, as it seems as though they are having trouble finding anything, let me know. I am willing to do the initial exam and evaluation and give you my recommendations at no charge. If I find that I cannot help you, of course I will tell you that as well. There is absolutely no obligation whatsoever. At any rate, I hope that you find the answers that you are looking for. Please let me know if I can be of any help.
M. Bunker, DC
M.M. answers from Washington DC on August 30, 2009
I am no doctor but could it be tapeworm?
J.F. answers from Washington DC on August 23, 2009
Sounds like a food intolerance. Unfortunately there is no real test for anything except Ig* types of allergies which most aren't.
This has been reprinted with permission from Monica at FoodLab--the
ultimate support and resource spot for living with and cooking for food
This group is mostly about food, so I'm going to talk now about how you
identify potential problem foods. There's several things to consider
when deciding what you want to test for:
* The "Big 8" and other common allergens: The "Big 8" list are foods
that add up to 90% of clinically-diagnosed food allergies in the US.
They are: Wheat, Dairy, Soy, Eggs, Peanuts, Tree Nuts, Fish, Shellfish.
Corn and Sesame get honorable mentions. When you get "allergy
testing," they usually start there.
* Stuff you eat ALL THE TIME. If you eat rice every day, it's more
likely to be a culprit than if you never eat it. Allergies start with
exposure; more exposure increases the risk that you'll develop a reaction.
* Stuff you CAN'T LIVE WITHOUT. Yeah, this is the hard one. That food
that you just can't IMAGINE cutting out of your/your child's diet?
That's a good one to start with. Wheat/gluten and dairy are known to
trigger addictive responses in the brains of susceptible individuals.
Other foods may work the same way (but are less well-studied).
* Stuff your mommy-gut just tells you might be a problem. Listen to
that voice. It's often noticing things your conscious brain hasn't put
* Stuff other family members are allergic to, or foods that "don't agree
with" them, etc. This isn't usually that useful, since it's mostly a
tendency toward reactions that's inherited rather than a specific
reaction, and many people go through life blissfully ignorant of their
reactions. But sometimes it makes you think of things that you wouldn't
have suspected otherwise.
So, you go through that list, you see the foods that match on two, or
three, points, you get to the bottom, you realize that you really should
probably look into ____________ because now your mommy gut is telling
you to... you make a list. Then you go about deciding how to eliminate
those foods for testing (and, if you really want to, you request allergy
tests for them too, though the results of an elimination/addition test
are going to be more conclusive). Once you're there, then you say
"HELP! How do I make dinner without_______________?" and then we jump
back in. ;-)
C.D. answers from Washington DC on August 23, 2009
You have received some great responses!! Here is my 2 cents worth.....
I have two girls who had very hard times gaining weight when they were younger (and one still does, she is 11). Neither one was on the weight chart for many years.. With my oldest, she spent 4 to 5 years not even on the weight chart. When she was 1.5 years old, she seemed to stop gaining weight so our pediatrician suggested keeping a food diary for two months and continuing our weekly visits for weight checks. Well, after keeping the food diary, we discovered she has an extremely high metabolism. She was eating more than a normal child her age but in two months gained a whopping 3 ounces in two months!!! Between her activity level and her high metabolism, she had a lot of trouble gaining weight. She is now a beautiful 14 year old 120 lb teenage girl. With my second girl, she is still in the 5th percentile for weight (at 11 years of age). Our current pediatrician suggested a bone scan and some blood tests. The blood work was normal and the bone scan told us that physiologically, she was about 2.4 years behind in development. Thus, she will eventually grow but just at a slower rate than other kids her age. She is super active ( a gymnast ) and eats very healthy and of course some junk. When she was smaller, we gave her half and half on her cereal and loaded her up on fatty foods. Really, she preferred fruits and healthier foods, thus she didn't really gain a lot of weight.
My point is to keep searching for the answer to your son's difficulty to gain weight but maybe he is just small and/or has a fast metabolism. Document everything to show social services that you are trying to find an answer.
E.P. answers from Washington DC on August 23, 2009
Three things come to mind:
First is I agree with a previous poster that he should see a pediatric gastroenterologist. If nothing else comes of it, at least you have documentation that you are working on the problem with medical specialists.
Second is, have you had a Comprehensive Metabolic Panel done? It is a simple blood draw for your son. Lastly, a friend had both of her children on the low end of the weight charts. It turns out that both her children had GERD. The oldest 8 always complained her belly hurt after eating. Now both her kids are on Zantac and eating much better...just a thought. After dealing with a medical problem with our son I learned you need to be pushy with the Drs. to get what you want. Don't take no for an answer if in your heart you feel there is a medical explanation for his weight. Best of luck to you!
P.G. answers from Washington DC on August 23, 2009
As said earlier: you need a pediatric gastroenterologist IMMEDIATELY! And I would also hazard to say, a new pediatrician once things get normalized again. You need a major set of blood work and metabolic panel and likely a few GI tests. Gluten allergies and other chronic genetic mucosal absorption issues come to mind. These require specialists to sort out along with possible genetic testing. Did your pediatrician actually recommend feeding with potatoes, ice cream and other starchy and sugar-laden foods????! Please RUN to another doctor if so. And family services has no place in your situation if you can document that you at least sought and followed what you thought was appropriate medical intervention. Call Childrens Hospital in DC for an emergency gastro appt, explain the situation clearly to the receptionist, or better yet, present your child to their ER for more rapid evaluation. This situation does seem to warrant such action. Best luck to all of you.
R.B. answers from Washington DC on August 23, 2009
As long as a doctor is involved and has been working with you to find a solution, I can't see why fam. services should want to take all your children. Try another doctor and maybe a nutritional specialist. Make sure that they do blood work. Is he healthy and active in every other way?
B.M. answers from Washington DC on August 23, 2009
A., I pray that you find a solution to this problem soon. I am sure he knows he is the subject of a lot of concern. Please don't give up seeking solutions.
D.S. answers from Milwaukee on April 17, 2011
I know it is too late. But might be useful to someone. My son went down from 95th to 25th percentile in weight at 11 months and kept getting a new bout of flu every 2 weeks for about 5 months. His teeth started decaying rampantly and I felt helpless. Then things came under control after I a smoking neighbor moved out. I added ghee and cod liver oil to his diet. He is allergic to milk. I wonder if he could have had malabsorption when I was giving yogurt for a while that time. Now he has not come up in his percentile, but doesn't get sick often and teeth decay is under control. Once he stopped eating for a while and I found threadworms in his stool and started eating after deworming. Just a few possibilities for not gaining weight.
J.C. answers from Lynchburg on August 25, 2009
I know you already got a lot of answers, and I haven't read through them. I'd check for hyperthyroidism, if that hasn't been done already. I have hypo, and from my understanding, most people develop thyroid problems in teens and older, but I'd check it all the same, if they're threatening to take away your kids. Also, my son is right at 40 lbs and turned 4 in May. He was also right at 40 lbs when he turned 3 last year, and for most of the year after he turned 2. He hasn't really gained weight in a while. I think he will soon b/c he's been eating like there's no tomorrow-I'm certain a growth spurt is on it's way. But, his last growth spurt didn't add any weight-and he grew almost 2 inches in just 2 weeks earlier this summer.