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Wednesday, December 29th, 2010

Failure to Thrive

Charlie has not been gaining weight since this summer. At his 12 month well check, he was just over 21 lbs. In July, he was about 22. Then he started walking (running) and his weight dropped. At his 15 month check up in August, he was back to his 12 month weight. At 18 months, he was 21 lb 14 oz. Looking back at his baby book, he was 20 lb 2 oz last January. So we decided to do a weight re-check in a month, which brings us to today. Side note--on Christmas Eve, he wore the same pants he wore last year on Christmas Eve. They were too long then, but fit him around the waist. Fit him perfectly this year.

21 lb 14 oz. No weight gain at all. He is off the charts for weight, meaning below the 0 percentile (if there is even such a thing.)

His main doctor kind of blew it off last month, saying he thought maybe he had a high metabolism. The doctor we saw today took things much more seriously, which concerned me, but I'm grateful too--that she wants to get to the bottom of this.

Her first suggestion was to take him to the hospital for some blood work. She wrote out all of the tests she wanted done and in the space for "reason" she wrote "failure to thrive." I don't think any mother ever wants to hear those words said about her child. If the blood work comes back normal, we'll see a pediatric nutritionist.

I decided to take him right over to the lab, since we were already out and about. It was awful. I had to hold him so tight and still he struggled and screamed the whole time. The nurse who was drawing the blood was calling him "Hercules" because his writhing caused the needle to slip out of his arm...she said "he blew the vein." I don't know exactly what that means, but it didn't sound good. She had to then start over in his left arm. She took 6 vials of blood total.

As soon as she was done, I put his coat on and got him in the stroller. He took his bottle (yes, he still uses a bottle, at this point that is the least of my worries) and calmed down immediately. He almost fell asleep in the car--about a 10 minute drive--but held off until we got home. So much trauma.

He's also had an issue with fluid in his ears since April. Every time we go in, his ears have fluid in them. His main doctor wasn't all that concerned (I like him, but wtf?) but today the new doc. gave me a list of pediatric ENTs--so we'll tackle that issue next. Just fluid--no infection.

The good news (thank God there was good news) is that he's been battling a cold since last week, with a pretty chesty cough. This time last year we were having tons of breathing issues, and he was diagnosed with asthma last summer. He's been on Singulair and Flovent (two puffs, twice per day) since July and his lungs sounded fine today. No wheezing. So we're controlling one thing.

I'm worried about my little man. I don't know why he isn't gaining weight. He eats like a horse, and he eats ALL THE TIME. He has 3 meals a day, and snacks whenever he wants them. He'll eat 2 whole eggs mixed with whole milk, dry cereal and a piece of fruit for breakfast, or oatmeal made with whole milk and fruit, or full fat yogurt. Lunch is typically an all beef hot dog (no preservatives), turkey or ham, a slice or 2 of cheese, another piece of fruit and a cookie. Dinner--chicken and mashed potatoes, or mac and cheese made with butter and whole milk, with 2 veggies and dessert. During the day he snacks on fruit with peanut butter, dry cereal, pirates booty, fruit snacks, nutragrain bars--really, whatever he wants (within reason!)

So now I wait for the results, and hope that everything comes back normal.

My issues (teeth and stomach, still) pale in comparison. I just want him to be okay.

I wouldn't worry until they tell you there's actually something to worry about. He might just have a high metabolism or something. Brennan has always been small. When she was born she was 8 lbs 10 oz, pretty big for a baby. Now she is over 3 and a half and is just now wearing a 3T in pants. Did I mention she only weighs about 30 lbs and Layne was 32 lbs at his 18 month visit? The doc hasn't been worried about her because her growth chart has shown increases over time in both height and weight. Translation: she's growing at her own pace and not the growth chart's pace.
soundchick   Wednesday, December 29, 2010
Good to know. He's going up on the height chart, but down in the weight. I'm holding on to that hope that it's just his metabolism. If he's not eating, he's running. And sometimes he eats while he runs. And when he's in his high chair, he's rocking. I think I may try the toddler formula or pediasure.
Jules   Wednesday, December 29, 2010
I would be worried to, what Mom wouldn't, but Soundchick is right. All kids grow at their own rate, a good friend of mine has an 11 month old that is still in 3 month clothes, Reagan already weighs the same as that almst one year old! I hope everything is okay and that the results come back quickly.
Moore Crazies   Wednesday, December 29, 2010
Though I'm sure all will be OK, I'll say a little prayer for Charlie...hugs!!
Angi   Wednesday, December 29, 2010
I understand why you are worried and any mother would be. It does make sense that if he's running all the time that he'd lose weight. I hope that you find out what it going on very soon. On the ear issue, I'm with you on wtf. Why wouldn't you want that fluid out? I hope that the ENT can help you out!
Merritt   Wednesday, December 29, 2010
ugh Merritt, he is one of my FB friends, which is cool ( he's on chat all the time so I can ask him questions whenever) but not cool, because I can't complain about him there!!!

I messaged him around Thanksgiving about the ears--this is our conversation:

Hey Dr. C,

I was speaking to a friend of mine the other day and mentioned 6's head banging, how he does it all the time, especially when he goes to sleep. She said she was just talking to a coworker about the same thing--her son (coworker) was doing that as well--turned out he had fluid in his ears (like 6)...he ended up getting tubes and stopped the head banging immediately. Do you think it's worth seeing an ENT?

Hope you all had a great Thanksgiving!


Hmmmm. It's definitely a possibility. It's probably not very likely, but possible. Did I see fluid in his ears last time I saw 6?

yes, and the time before that, and the time before that. Really, I think at least the last 3 appointments you have seen fluid but said no infection. When we were there last week you said you'd check them when we came in for the weight check later this month.

OK. If it's really been that longstanding, then I should probably try antibiotics if it isn't clear by next visit. And we can try Zyrtec or Claritin or Benadryl too. If we still can't clear it, then I'd say go to ENT.
Sound good?

ok. The banging doesn't bother me, but I have to wonder if he's doing it because of the fluid bothering him. He slept in the pack n play while we were in MI and he was banging against the mesh side...if you look at my pics from Thanksgiving (and even the ones I posted today), you can see mesh burns on his little forehead. Poor boo.

Poor kid! He's soooooooooooooooooooooooooooooooooooooooo cute. Sorry haven't seen any pics in months. Too swamped with my night job the last few weeks. It's been nuts.
Jules   Wednesday, December 29, 2010
I'm hoping with you, Jules.
!   Wednesday, December 29, 2010
(((Jules))) Take a deep breath and try to remain calm, you will be doing that ALOT in the next 18 yrs. lol All three of my children are "small" for their ages. They have like 1% BMI. My oldest though is by far the smallest. She was 5lb 14oz at birth. At one she was 16 lbs. she is now 12 and only weighs 72 lbs. She has NEVER been on the growth curve thingy for weight. she has, however, always followed her OWN curve. My six yr old only weighs 35ish lbs and is still in 4T pants. All three of my children are constantly on the go. I hear this alot: Your children are so well behaved but do they EVER stop?!?! lol No they sure don't. The most "normal" sized is my son. He is 8 and weighs like 67 pds.
runt   Wednesday, December 29, 2010
Thanks everyone. I'm feeling much better about things now (the xanax and your comments are helping). We'll just wait and see what the blood test results say and go from there...in the meantime I'm going to continue feeding him good fats/high caloric foods and maybe add in some pediasure.
Jules   Wednesday, December 29, 2010
Might want to check out a book called "Eating for your Metabolism". Had some really good stuff about what is the right kind of food for the right kind of person. I learned a lot of good things in it.
LGrant   Wednesday, December 29, 2010
Hey Jules, you know you can hide a FB post from specific people? I use that to talk about our potential move and hide it from Isaiah's family!
girlcarew   Thursday, December 30, 2010
Hope everything is ok. My guess would just be his metabolism too. My best friend told me the other day that her pediatrician told her that if he did not know my friend and how much they fed their son they would be worried about him. He is in the less than 5% and is 18 months. He eats a ton and is just really active.
niki   Thursday, December 30, 2010
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