not gaining - would you do a blood test?

smiley:)

Sun, Mar 30 2008, 5:35 am

My son hasn't gained more than 3/4 of a kilo in about a yr and a half, and he is only 2 1/2! I am concerned but on the other hand he is getting taller (and skinnier). I was debating if I should go the dr bc the dr will send me for a blood test for him. Let me explain. Why doesn't he gain weight? because he doesn't eat. Simple as that. I dont need a dr to send me for a blood test for that! On the other hand I am concerned that something IN the blood is causing him to not eat... maybe a low iron or something CAUSES that.
He doesn't eat anything unless it looks perfect (like store bought ready made shnitzels etc) but even then often he doesnt eat. He is eating like starvation rations. He is energetic and all so I am not worried about that. I know it sounds silly but I dont know if I should go for the blood test. (yes I did go to the dr... not one I trust just bc I havent found a great one.. and he sent for the blood test). It's a lot of different tubes they need, plus a urine test and knowing his personality he will be traumatized, and I dont say that lightly. He is a really intense kid. What would you do?

Amital

Sun, Mar 30 2008, 5:49 am

I could have written your post!

My older son, also VERY intense, is now 3.5, and his 16 month old brother weighs about the same as he does. He's fallen off the growth charts, and mostly because he isn't interested in eating--he's too busy and involved in other things, like building a block tower, "reading" himself stories, running around, riding his bike, etc.

I just took my son in to have this bloodwork done. BH he's very smart, so we don't think anything was going wrong there, but if there is something physically wrong, we wanted to be able to get it taken care of ASAP. They took some blood, which was a little traumatic, but it was over quickly, and he got a sticker and a cool band-aid, so he felt a little better. (Then he helped calm his brother down after his one year shots, so the attention got off him pretty quickly.)

BH nothing seems to be wrong. He's just going to be a small and skinny kid--for now, at least. There are other tests we could do, which involve a hospital stay, but now that we know that nothing major is wrong, we just want him to be whoever he is going to be.

I think it's worth it to get it checked out, just in case. All kids are built differently, and as long as they are developing normally mentally, your doctor isn't too worried, and your son feels fine, then it is probably simply an aspect of your son. But I felt better after getting the test results. Smile

smiley:)

Sun, Mar 30 2008, 5:57 am

Ah amital I am so happy to hear from you. There is less than 2 kilo difference between this son who is 2 and 8 months, from my 10 yr old son. My son's doesnt have much to do with him being occupied with different things. We make clear that he isnt leaving the table to do x,y and z but he still wont eat.

My son also is smart. I dont see this as interefering with anything that he can or cant do. he is just sooo skinny. I am nervous that not only will he be crazy during hte blood test but it will be in his head for a while after and he wont get over it. He is scared of ppl to begin with so this could make it a lot worse.

I feel like if something is wrong in the blood work I will be grateful I went but if not, I wont forgive myself for going. I know it sounds silly. How much does your son weigh? Was there anything at all in his bloodwork that they are now able to give vitamins, etc?

Tamiri

Sun, Mar 30 2008, 6:04 am

I have 2 very skinny children (we call the 9 yo "see-thru" and the 23 yo has been "skinny-Binny" forever) and I never considered doing a blood test, but I would not tell anyone else to do/not to do one. I don't view their lean bodies as ill-looking. You have to decide for yourself.
My 9 yo eats very, very little. He has a tiny appetite and is very sensitive to what you put on his plate and how food feels in his mouth. So we give him a multi vitamin.
Look at the child: are the eyes bright, the hair reasonably healthy looking? Does he have proper waking hours? Sleep well at night? Good skin? Have enough energy to do what kids his age do? Is he sick more than others (I know, he's not in Gan so that rules out a lot but still) etc.

Amital

Sun, Mar 30 2008, 6:24 am

BH my son who is 3 years and 10 months weighs around 28-29 pounds. My 16 month old is 25-26. The younger one loves to eat, and the older one...he's just too busy and not interested. He will sit at the table as long we require him to, but he won't be eating: he'll build a tower with his food, or fold his napkin into different shapes, or tell a long, long story, or find something to do. He says "I'm full" after what is usually less than his brother eats. And we offer snacks (he prefers fruits and veggies, no joke, while I want to pour cream down him!)

We had some tests done at about 2 years for him, which found out he was iron deficient, so we've addressed that. There really is no problem this time: they did a CBC, checked for deficiencies, and expecially checked his hormone levels, including thyroid and growth hormones. BH he seems healthy.

The next step seems to be to hospitalize the child for a half day or so and monitor how the growth hormone is metabolised, but we decided against that. Since BH everything else is going well with him, and several doctors are not very worried, we are watching. For now. If something changes, we'll adapt as needed.

It sounds like your biggest fear for going would be your son's reaction. What would the worst case scenario be? How bad is it? And what would most likely happen? Only you can weigh it and see how it falls out for you. For us, even though BH nothing seems to be wrong, I'm glad we went, and subjecting him to that hard few minutes, because I was extremely worried about him, and that has lessened for me. I feel like I checked it out, and he's just bound to be a skinnier and shorter kid.

BTW, this is also somewhat genetic. Apparently I was like this, and one of my brothers when he was young (who is now over 6 feet tall and normal sized.) And it's not necessarily a constant - just what's happening now. If nothing is physically wrong, it could change as he gets older.

I'm trying to be mindful that G-d has a plan and has entrusted me with a unique individual, and this is apparently how he is built. I've done my part, and will continue to watch to see if there is anything else I can do, but for now...

smiley:)

Sun, Mar 30 2008, 6:57 am

amital - ok now I dont feel as bad! My 2 yr 8 month son is around the same as your 3 yr 10 month. He is surely at least 27 pounds but I think he is a bit over 28. My 10 month old is over 23 pounds.
I totally hear what you say about finding something to do other than eat. Mine does that all the time.

So after you addressed the iron problem this situation didnt improve still?

I dont know what worst case scenario is. I guess he screams his head off and is scared to go near drs, to go near ppl etc. That he wont trust us? I am not sure.

I guess I just feel stupid going. He isnt gaining bc he doesnt eat. And just as you said it could be a genetic thing. I am relatively tall and not skinny but my husband is pretty short and skinny. I dont know he was when he grew up but let's just say most guys are taller than him. So it could totally be genetics, and why put him through all this?

Sorry I know this is relatively silly bc it is "just" a blood test. But I am the same person that got sick the days of my son's brissim. I just hate knowing that I am the one who put them in pain. It literally makes me sick.

Clarissa

Sun, Mar 30 2008, 8:29 am

My son has been tested for numerous things, because he's so small and gains so slowly. He's had blood and urine tests. Neither have been a big deal. My pediatrician, as well as the hospital phlebotomists, are used to dealing with little arms and tiny, barely visible veins. The urine test was really nothing to worry about -- they put this little bag over his p*nis, and we hung out and played until the bag was full and was taken off. Initially they thought it was a kidney problem, but that's been ruled out. Now they're going to look into endocrine issues. We're also going to see a nutritionist who specializes in children. Once we've ruled out anything physiological, we're just going to go with the idea that he's a really little guy, and just focus on getting him to eat.

One last thing, unrelated -- I'm nervous about Pesach. It's hard enough to get him to eat a big meal these days. Adding restrictions as far as what I can offer will make it even more complicated.

Amital

Sun, Mar 30 2008, 8:33 am

Hey Smiley-

Glad I could help! Very Happy

I used to get pretty worked up about my oldest's weight. He hit 20 lbs at about 18 months and has slowly been working his "weigh" up since then (sorry, pun intended. LOL

) He's on the very bottom of the weight chart, and has been for over 2 years, so it seems like that's where he's supposed to be. To be honest, I still worry, but I've done what I can without going overboard. What can I do? I have put it into G-d's hands.

I also bawled like a baby myself at each little boys' brit, and had visions of running away with my precious little one, but that is also out of my hands. It's not fun, but we parents find a way to cope. And our little ones don't remember anything, but they are forever marked by our choices for them.

We had no real change in weight after addressing his iron deficiency. He seemed to feel better, so we're glad we did!

To address your worst case situation, can you take only your older little boy? I told my son flat out that we were going to the doctor and probably going to get some shots--but only after he was in his carseat on the way. He would ruminate and work himself up every extra minute he knew before hand. I also told him his little brother would have to get shots, too, and that I needed his help him feel bettter. My older boy wasn't happy, but he cooperated, and he wasn't calm when they did his blood draw, but he got over it relatively quickly. You could make a special outing of it if that works for you, like out for ice cream after...whatever works for your kids.

If the short term wrath of your little boy is all that is holding you back, and this is something you are really worried about, why not test and see if it is something? If so, you'll be able to fix it, and if not, you'll know it's normal for your little guy. It's no fun to do things your kids don't like but it's part of our job when it's for their own good. Again, only you can weigh your situation and decide! Smile

Good luck!

smiley:)

Sun, Mar 30 2008, 8:43 am

Until he was 1 he grew so quickly. Till 1 1/2 a bit more. Since then it is all height and no weight.

I guess it is mostly how he will react in the moment, though also I dont want it to add to his distrust in ppl or in me.

In any case I or my husband would take him while the other one of us stays with the baby.

I am worried about it - sometimes more and sometimes less but in my heart of hearts I bet it is nothing. But I wont even feel responsible having gone. I will feel bad.

Amital

Sun, Mar 30 2008, 8:43 am

Clarissa wrote:

One last thing, unrelated -- I'm nervous about Pesach. It's hard enough to get him to eat a big meal these days. Adding restrictions as far as what I can offer will make it even more complicated.

Hi Clarissa-

I know what you mean! I can say this has played a big role in planning for Passover for me for the past few years.

We got lots of Pesachdig noodles, and BN I will be making some of their other favorite foods. My kids love ketchup, so I made sure to get that, which apparently makes all sorts of things edible for my sons, and cranberry sauce for meatballs, plus a bazillion eggs or so, and will get cream cheese and jam for matzah, etc. My kids also seem to like matzah "rolls," which have oil and eggs, so maybe that's a good thing!

Plus the seder(s), with all the treats, and his Savta has sent a big package with treats I've been told, so although normally we don't allow too much of that stuff, he'll probably be eating more. (My husband has memories of being deprived and hungry over Pesach, and I don't want that! Plus, the holiday should be special and fun! Oy, justification...)

In any case it's only 8-9 days (with Shabbos this year.) I hope that maybe mine will even gain weight? Here's to hope! Smile

Amital

liora

Sun, Mar 30 2008, 8:46 am

my son is 5 and he weights 34 pounds, so he is the skinniest and when he was younger they did every test under the sun and B"H nothing.
he is very skinny and he is running around all day long.
his brothers are skinny but nothing like him so now we let him be, because the DR. could give you iron so it gives him more appetite also if you go to a nutritionist they will tell you to increase the calories with mayo and oils and a lot of cheese things like I cann't do for everyone so is almost imposible.
good luck

Amital

Sun, Mar 30 2008, 8:55 am

But you can make sure to offer higher cal foods. My almost 4 year old (and almost 1.5 year old) still drink whole milk. We have only full fat cheeses for them, we eat eggs (he gets an extra yolk sometimes), no low cal drinks (like Crystal light--he gets real lemonade!) or syrup or anything like that. I give him full fat cream cheese when he eats it, let him lick my frosting beaters, and don't blot the grease off of his pizza, etc... I try not to give him too many treats, but whatever I do give him, I make sure it's got fat and calories when appropriate!

morahg

Sun, Mar 30 2008, 8:58 am

I would ask for a referral to a speech therapist (yup, an SLP) who has experience with feeding issues. There may very well be sensory integration issues going on here. An OT may be able to help you recognize some of the other signs as well (kids with SI issues are often described by their parents as "intense"). I have an MA in a related field, though I am not a therapist, and see a lot of sensory issues that have reprecussions in many areas (eating, behavior, which clothes the child will wear, etc.).

MahPitom

Sun, Mar 30 2008, 10:20 am

morahg wrote:

This is very obviously a sensory issue. If you can get a really great therapist to help him navigate his frustrations with specific foods, you can modify his issues from early one.

Kids with sensory issues might love OR hate something like mashed potatoes. I also suggest you keep a close look at his hair and nails (and somebody mentioned eyes). A sickly vitamin-deficient child will lose the luster in the hair and nails quickly, and hair will thin out with time.

Make sure he gets a multi vitamin daily, so you know you are doing your part. See if you can sneak in a protein shake in his drinks.