Advice for Toddler Lab Tests

Updated on January 29, 2009
A.G. asks from Portsmouth, VA
13 answers

My daughter is failure to thrive and needs to have her blood tested for celiac. We already did a stool test since that was less traumatizing, but it indicates that she may have celiac and needs the test. If its not celiac is could be something else so changing the diet won't tell us soon enough.

We have already tried twice to get the test, and my daughter was so brave, barely even cried both times. However she is tiny at only 18 lbs and even the best nurse I have ever used has a really hard time finding a usable vein. Each of the last two times they got it in, but the flow was so slow that he vein collapsed before the tube was 1/3 full. This test REQUIRES a full tube.

Does anyone have anytips for me? Can I improve the flow with diet, or can my Dr use medicine? Last time I did take her when she was well hydrated thinking that would help.

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D.M.

answers from Washington DC on

My son had the blood test for celiac (and later an endoscope) at about a year old. We had the best luck with Children's Hospital lab in Fairfax. They do children and babies all day every day and really know what they are doing. We did have to wait a while for an appt for a gastroenterologist there. Best of luck.

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L.T.

answers from Charlottesville on

My sister use to draw blood all the time. Here's one thing you may want to try. Wrap her arm in a very warm towle to help thin the blood. You know the warmer the thinner the blood thing? Cold slows down the flow.

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C.S.

answers from Washington DC on

Maybe go to the pediatric dept of a major hospital for the blood draw, like University of MD or Johns Hopkins. Ask for someone who draws blood from premature infants. They'll do a great job.

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S.M.

answers from Washington DC on

A.,
I know this might sound silly, but maybe they are trying to get it from too small of a vein. It sounds like you and the doc are doing the right thing (trying to hydrate her first), but the bigger the vein, the faster the flow. I adopted 2 preemie little girls and my oldest was diagnosed with failure to thrive (and no - to the other mother who is worried it is abt weight alone) and they used the big veins in her ankles to draw blood at Hopkins. At the pediatricians office, when they didn't need as much, they did her arm or hand, but the hospital went big. They also left the needle in until they were sure they had a good sample so they didn't need to stick again...The phlebotomist there was amazing. While my darling daughter was resigned and very well behaved at the doctors office, the man at Hopkins got this done with her turning purple and screaming loudly enough to be heard on the next floor. <g>Maybe that helped push some blood too. You can see why they would not want to stick her again...Anyway, it might be worth a shot - using the larger veins. Do it in the ER if possible, so there is no problem. They are more prepared to deal with you if it takes a little while for her to clot up.

S..

PS - We pumped our little girl up with Pediasure. Food that she ate after the Pediasure was a beni - Doctors orders. She is now down to one Pediasure a day (maybe) and growing well. Still not putting on weight, but certainly the inches...

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E.S.

answers from Roanoke on

Hi, A..

Unfortunately, I don't have any advice about the lab tests that differs from what you have already received. A pediatric specialist is definitely your best choice.

That said, I did go through the failure to thrive diagnosis with my daughter around the same age. At birth she was 7 lbs, 13 oz, but she fell off of her growth curve. At 12 months, she weighed about 12 pounds. She is the only child I have ever known to "wear out" her baby clothes! Although she fell off the curve, she was in perfect proportion--just small. Today, at 15 years old, she is still tiny. She is just 5 feet, wears a size 4.5 or 5 shoe and a zero in junior clothes. She can even fit into her little sister's size 10 jeans! She is healthy and athletic--just tiny.

Definitely follow through on having your daughter evaluated, I did. Hopefully, like me, you will find that all is well.

Good luck and keep us posted.

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M.W.

answers from Washington DC on

Taking blood from an infant requires some special skills and experience. Maybe your doctor can order the test from a blood testing lab or from a hospital clinic, and they may have phlebotomists who are expert in infant venopuncture. Hospitals draw blood from infants all the time, that may be the best way to ensure success.

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M.A.

answers from Washington DC on

A.,

My daughter also has a hard time getting any blood out of her veins (she is two now). Here is what I have learnt:
1. Yes, making her drink as much as your baby lets you is a good thing. It helps.
2. There is a prescribed cream that you apply half hour before the test that will make the skin less sensitive to pain.
3. Most important, find the BEST phlebotomist you can find and make sure that this person is the only one that tries with your kid. Some nurses do not have the necessary experience with small babies. When my daughter was one year old, a nurse punctured her 17 times while I was holding my baby crying. The nurse blamed my daughter’s veins. After that experience, I took my daughter to the best phlebotomist I could find in the area and this woman was able to get blood out after the 2nd try.

Best luck!

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S.R.

answers from Washington DC on

I don't know if this is possible but if a pediatric anesthesiologist could help you. Good luck with everything!

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T.H.

answers from Norfolk on

i dont see that her weight is too low for a healthy child. i hope that they have more to go on than just that. if so then try giving her a full meal soon before test and liquids like you did before. but again her weight alone could just be that she is small. does she hit all her milestones on time, does she seem active like her brother and learning at or near his level. either way good luck.

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S.C.

answers from Norfolk on

Talk to your doctor and the lab and see if a pedi tube can be used. My son is not failure to thrive, but he has terrible veins (like his mom). He has had to have finger sticks for some lab work because they can't find a vein. There may be other tubes the lab can use if they do a little research. Good luck.

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R.S.

answers from Denver on

Call your insurance and ask what it would take to get her blood taken at a pediatric hospital (referral from your dr, what not). That can make all the difference. Call the hospital let them know the situation and ask for advice as well. (My son was in a normal hospital and a pediatric the difference was super scary on how easily they drew blood, gave ivs etc.)

Hang in there. (Have they mentioned her having reflux?)

R.

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K.W.

answers from Washington DC on

Making sure that she is well hydrated does help, so try to keep her drinking, preferrably water or something low in sugar. I personally don't know of anything diet related that can improve blood flow. There are anticoagulant medications to keep blood from clotting, but they are not used soley for the purpose of drawing blood. Some hospitals have transilluminators, a device used to illuminate veins that are hard to see/feel (sometimes used on preemies), so maybe you could ask about whether or not your daughter could be sent to a facility that has one. Also, have they tried applying warm packs to her arms before attempting the blood draw? Finally, make sure that you are calm. Anxiety is contagious and if your daughter is tense, it may make it difficult to get blood flowing well. These are just some suggestions- hope it helps!

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M.C.

answers from Washington DC on

I agree with the other posting about hydration. Give your daughter some water or milk about 20mins before you go into the lab. Given wait time, etc., by the time its her turn, her body will be benefitting. I did this with my daughter and it made a big difference.

Another option is to take a cloth to place between your daughter and the needle. Then she won't see it and freak out.
Ask the nurse to check her wrist and ankles for possible injection sites. These viens always work best for me.
I've also taken my daughter when she was asleep to the world. By the time she realized that she was getting blood taken, it was over.

M.

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