Another follow-up with the GI doc last week and it seems that our miniature man is still miniature. To be precise, a full ounce lighter than our last appointment. And now we find ourselves at a bit of a crossroads.
We entered this super-high-tech medical world with the goal of ruling out any crazy, rare disease which might explain his rather unusual growth chart (8 lbs at birth, 12 lbs at 4 weeks, 20 lbs 4 oz at 17 months). JD and I are not basketball players, but neither of us is tiny. I'd wager that we're both about average height and weight. The fusspot has always held steady somewhere between 30th-50th percentile (after her rough first month) and in general has very normal toddler eating patterns: nothing new unless it's coated in cheese or chocolate, but very happily eats a wide range of food (Seriously, my oldest turned down maple syrup at the diner because it was "new" but loves her lassis and hundred year old eggs).
We have thus far ruled out a variety of rare diseases: celiac, allergies (no rashes, and he tests negative via blood test, although obviously he could still have something, also no family history of food allergies), juvenile diabetes, thyroid, cancer, parasites ... basically his labwork all looks good and he meets all developmental benchmarks. He is also super active (except for one test, and doctor thinks it's a false positive. Needless to say we'll be testing again for C.rohns at his next appointment but not scheduling the scope until he's bigger/older because of the anaesthesia).
And here's where things get dicey. Anytime you mention toddler failure to thrive, questions are going to be raised about the family/environment. Stress? Abuse? Poor food habits? I know they need to ask these questions, and I know that they are relevant for many families, but I am truly confident that the dumpling has no sensory issues/no anxiety related to food. He will very happily eat about 3 bites of anything and then he's done, lips pursed, not another calorie going to enter his body. We -always- let him self-feed, two hands into the food no matter what it is. He is allowed to run around and snack no matter how messy (something I would never allow except for above weight issues). And I am tired of being questioned, of having dumb doctors and even nutritionists suggest "new high calorie foods for him." No, he has never eaten an avocado even when doused in brown sugar and blended with cream. No, he does not like peanut butter or butter or cream or whole milk. I mean, this toddler declined warm chocolate chip cookies last weekend, even when I left a plate on the floor next to the blocks so that he could approach them on his own schedule ... resulting in chocolate smeared all over my carpet but not a single bite in his mouth.
And in order to get calories into him, my previously organic-home-made-meals baby's diet looks like something out of a toddler-version of SuperSize Me. He has either string cheese or hot dogs for breakfast. Cream added to his whole milk. Peanut sauce doused on his pasta. Goldfish for snacks instead of fruit. Fruit roll-ups, egg yolks but no whites. It is the type of diet that would give anyone a stomach ache. And I'd like to stop. To step back and say there is nothing medically wrong, and he's just small. But now the seed has been planted: the fear that this will affect brain development if we don't ply him with high calorie processed foods. Or that he'll land up needing growth hormones in the near future. Let alone the fact that we are now thoroughly under medical surveillance and repeat 3-day food diaries are in high demand.
For a condition where stress can easily be a trigger, it is scary how easily all of this can fall into blaming the mother. I am tired of chasing my toddler around the apartment with forkfuls of high fat hot dogs while he shakes his head no and runs away. I'd like to have the perspective to say we ruled out the really scary stuff, now it's time to get back to normal, but I'm not sure I'll be able to. And yes, I am deeply thankful that all test results were normal. But now that the fear has been planted, I certainly feel more concerned than I did pre-testing.
ps -and for those wondering about the next medical step, there is a new consult with a new allergist for the end of the month and I'd like to try a lactose-free diet for a week or two. I know lactose intolerance is rare this young, but so is everything else we looked at. It does not make sense that an otherwise healthy toddler would deliberately starve himself, so my suspicion is that he may have some discomfort from food, although who knows if we could ever isolate that?
We entered this super-high-tech medical world with the goal of ruling out any crazy, rare disease which might explain his rather unusual growth chart (8 lbs at birth, 12 lbs at 4 weeks, 20 lbs 4 oz at 17 months). JD and I are not basketball players, but neither of us is tiny. I'd wager that we're both about average height and weight. The fusspot has always held steady somewhere between 30th-50th percentile (after her rough first month) and in general has very normal toddler eating patterns: nothing new unless it's coated in cheese or chocolate, but very happily eats a wide range of food (Seriously, my oldest turned down maple syrup at the diner because it was "new" but loves her lassis and hundred year old eggs).
We have thus far ruled out a variety of rare diseases: celiac, allergies (no rashes, and he tests negative via blood test, although obviously he could still have something, also no family history of food allergies), juvenile diabetes, thyroid, cancer, parasites ... basically his labwork all looks good and he meets all developmental benchmarks. He is also super active (except for one test, and doctor thinks it's a false positive. Needless to say we'll be testing again for C.rohns at his next appointment but not scheduling the scope until he's bigger/older because of the anaesthesia).
And here's where things get dicey. Anytime you mention toddler failure to thrive, questions are going to be raised about the family/environment. Stress? Abuse? Poor food habits? I know they need to ask these questions, and I know that they are relevant for many families, but I am truly confident that the dumpling has no sensory issues/no anxiety related to food. He will very happily eat about 3 bites of anything and then he's done, lips pursed, not another calorie going to enter his body. We -always- let him self-feed, two hands into the food no matter what it is. He is allowed to run around and snack no matter how messy (something I would never allow except for above weight issues). And I am tired of being questioned, of having dumb doctors and even nutritionists suggest "new high calorie foods for him." No, he has never eaten an avocado even when doused in brown sugar and blended with cream. No, he does not like peanut butter or butter or cream or whole milk. I mean, this toddler declined warm chocolate chip cookies last weekend, even when I left a plate on the floor next to the blocks so that he could approach them on his own schedule ... resulting in chocolate smeared all over my carpet but not a single bite in his mouth.
And in order to get calories into him, my previously organic-home-made-meals baby's diet looks like something out of a toddler-version of SuperSize Me. He has either string cheese or hot dogs for breakfast. Cream added to his whole milk. Peanut sauce doused on his pasta. Goldfish for snacks instead of fruit. Fruit roll-ups, egg yolks but no whites. It is the type of diet that would give anyone a stomach ache. And I'd like to stop. To step back and say there is nothing medically wrong, and he's just small. But now the seed has been planted: the fear that this will affect brain development if we don't ply him with high calorie processed foods. Or that he'll land up needing growth hormones in the near future. Let alone the fact that we are now thoroughly under medical surveillance and repeat 3-day food diaries are in high demand.
For a condition where stress can easily be a trigger, it is scary how easily all of this can fall into blaming the mother. I am tired of chasing my toddler around the apartment with forkfuls of high fat hot dogs while he shakes his head no and runs away. I'd like to have the perspective to say we ruled out the really scary stuff, now it's time to get back to normal, but I'm not sure I'll be able to. And yes, I am deeply thankful that all test results were normal. But now that the fear has been planted, I certainly feel more concerned than I did pre-testing.
ps -and for those wondering about the next medical step, there is a new consult with a new allergist for the end of the month and I'd like to try a lactose-free diet for a week or two. I know lactose intolerance is rare this young, but so is everything else we looked at. It does not make sense that an otherwise healthy toddler would deliberately starve himself, so my suspicion is that he may have some discomfort from food, although who knows if we could ever isolate that?
3 comments:
Has he been tested for Eosinophilic Esophagitis? Long story short, when my husband was diagnosed at thirty three, it really helped his eating issues that stemmed from childhood. I hope you find some answers soon!
I hope you hit upon something that helps. Losing weight (however little) can't be helping the stress factor. I know I just become a picky eater around that age. Focusing on food that much could also be putting him off eating (just my own experience) I can't imagine how stressful this is on you- if he was growing Id be the first to say he's just small. My bear is unusually large for our family. My husband and I are both under 5'3, but Bear seems to be headed to outgrowing older sister within the year. He's healthy- solid not fat.
I think Dumpling is just a little guy. Maybe with an intolerance that makes him not want to eat a lot which adds to it. Trying the lactose free will at least rule out one of the biggies...
On an unrelated note...I've finished a knitting project and am looking for another- I love having a huge pool of mini-guinea pigs...Anything the kiddos could use for winter?
I think eyeing the allergies is a good idea. Michael has food allergies. Sometimes I feel like I can't call them allergies because they don't result in trips to the emergency room and shots of adrenaline, but that doesn't mean that they aren't real allergies. And they absolutely made a difference in his eating... except in his case he ate more. The way he dealt with his discomfort was to eat more, which made things worse, but we had to figure that out for him. So to me it makes absolute sense that maybe that's why the Dumpling eats less.
Hunting down allergies is a very difficult process. Remember as long as you are breastfeeding, anything you eat may be getting to him as well and you really have to pay attention to when you eat something and the delay time for it to reach your breastmilk (4-12 hours for me) and then several days for it to get flushed out of your system. And frozen and stored milk just creates and extra level of complication. It isn't easy, you really have to have your head in the game.
I think dairy is a great place to start since that is very common. But if you need more clues as to what to test, from my experience, Michael ended up with allergies to nearly every food that I really loved and ate the most often when I was pregnant... beans, chickpeas, soy, etc. So perhaps think back to your pregnancy and if you were finishing off a tub of hummus every couple of days, be suspicious of it. It was sad giving up my favorite foods, but at least it helped him. Not that I want this to be the case for you and the dumpling, but better that than Chrons.
Post a Comment