Aibu to pull my child out of nursery

[Kanfuzed123]

So my daughter was SGA 2.3kg at 37 weeks. No signs of iugr or fgr, we were told constitutionally small, but who knows. Enter lots of mum guilt and blame.

She caught up to approx 15th centile by 6 months and floated in that range, got up to 25th for weight but then fell to 15th after she became more mobile. That’s fine our mid parental range is from 9-91st.

She started nursery and it’s big after big after bug, she held out ok still floating around that centile and before 2, her length fell between 2nd and 9th centile, weight stayed the same and then at a check a few months ago her weight has fallen to the same centile range and she’s now faltering growth. I feel like the worlds worst parent and like I’ve failed her. She’s got another cold and a sickness bug now again so she’ll drop further. I don’t know what to do for her. She’s been prescribed weight gain drinks but she won’t drink them. I think she eats enough to keep her ticking over (we do all the tricks to make her food higher calorie) but not enough to gain and her appetite gets affected by being constantly unwell. I’m concerned because she’s not eating enough it will impact her catch up growth. Her dietician who prescribed the shakes has said calories are required for growth and at a young age growth is largely nutrition related.

I’m at a loss, DH is depressed from it and ends up inadvertently putting pressure on her which makes it worse, I’ve stopped this as soon as i noticed, but it is a very desperate situation because we are so worried about her.

At this point, what would you do? Take her out of nursery? I’m considering it, just so her health can recover. I know she might get Ill then at school but since sep 20 she’s probably had 2 weeks cumulative of good health. She’s had 2 lots of blood tests because of how unwell she gets but they’re all normal. Are there any other tests? I do think she must be more ill than the average child.

Should I just pull her out of nursery? I’m on mat leave so I’m at home? Is it unreasonable to pull her out? Dh isn’t sure I’ll cope alone with both of this (kind of insulting but that’s another post).

She’s off her food with every sickness bug or every time she gets phlegm in her throat which is a regular occurrence with the amount of colds she has. She also passes it on to her brother who’s a newborn and I’ve already been chastised by our GP as he’s had bronchilitis twice.

Wwyd?

@Metallicalover I’ve tried counselling for it but they’re very dismissive, dh holds me partly responsible and I get a lot of grief from my own mother about it. Yesterday was just an awful day because she’d suffering, yet again. She can’t even keep water down so she’ll probably have to go to hospital. Made me spiral a bit as it feels like she’s not even getting the chance to catch up.

I know centiles and guidelines are just data but ultimately it’s the best that’s available and those guidelines exist for a reason. The concern is that her growth velocity is falling

I’m on maternity leave @RobotValkyrie so I’m off for a year. Dh can’t reduce his hours or take unpaid leave as we just won’t be able to afford to live

Update: she’s just been taken to hospital. Won’t drink hydration drinks and was up sick in the night and has the runs too. She’s struggling to keep water down.
I can’t work out if this is normal because in my head it seems to be affecting her more than any other children.

It seems like she’s always suffering, my knee jerk reaction is to pull her out but I still don’t know as from comments here it’s quite divided on what the best thing to do is.

If we take her out we’ll lose her place but as she’ll be 3 and a bit when I go back to work she’ll be entitled to free hours so we can send her to a nursery school attached to the school she’ll attend. I think I need some professional input on what’s the best for her.

I’m going to post for anyone in medicine to see if there are any other tests for immune systems

My little one was born on 25% centile and over the next year dropped to the 1st. The health visitors and paediatrician thought I was obsessing over these centiles which on reflection I was. However the big indicator was that in her first two years, she was constantly ill. Bug after bug and multiple admissions for bronchiolitis and viral wheeze. She knew when the nebuliser was coming! She rarely ate. Was so skinny and short in height. All my other children are very tall, as is dad. In the end, they worked out she had sleep apnea. Had adenoids and tonsils out just before she was two and we have never looked backed. Within a month, she grew in height and weight. She has asthma but this has got better as she got older but finding the cause was life changing for her. She also went to nursery 3 days a week between 1-4. I hope you find some answers as I remember the stress so feel for what you are going through.

@Trying2310 what were the signs about adenoids and tonsils? Dh is at a and e now with her on the advice of 111, her blood sugar is v low so they are keeping her. Could they check her adenoids and tonsils there?

@Kanfuzed123, suppose they could check if she has unusually large tonsils. Is she regularly unusually tired during the day?, snore? Our wee one snored like a trooper buy we thought it was normal and she was a mouth breather . We didn't join any dots until she was napping on me and suddenly stopped breathing for a long period of time. We went to A&E and she was booked in for a sleep study. We then monitored her sleeping which resulted in two very exhausted parents. We got loads of video footage to gather evidence and the sleep study showed her oxygen levels dropped dramatically when sleeping and when she stopped breathing. They operated on this evidence alone. I hope you get some help at hospital and she feels better soon.

It's totally normal for them to get every illness going when they are in Nursery. If you take her out at this he you are just postponing the issue until she is school age.

Your GP sounds bonkers. You can't realistically do anything about your child getting bronchiolitis 😕. It's usually caused by RSV which is just everywhere! My 2nd DD spent 2 winters with pretty much constant bronchiolitis which is a PITA - constant time off work and OOO's Dr appointments but some kids just seem prone to it.

Has your GP done any further investigations as to why your daughter is losing weight? Have they looked into allergies or underlying absorption issues?

My LO was the same weight and percentile, she has also had one bug after another at Nursery. She has gained weight- I’ll let her eat anything - a wee icecream every evening, I’ve also laced her food with ricotta when she was on purées. I found rinsing here hair every night in the bath helped - it was the suggestion of my GP, just in case all of these coughed and colds were actually hay fever or an allergy and it has helped a bit. I was also told that once they get to 2 years old her immune system would improve. Do what works for you,

She’s not losing weight @Doggydreaming, her growth velocity has slowed down. The GP is useless so she sees a paediatrician and dietitian and it’s their opinion weight wise it’s due to constant illness. They aren’t sure height wise, they’ve emphasised that growth at this age is largely nutrition based if that’s hampered then her growth will be stunted. She’ll see endocrinology and it’s their area but step one they suggest is to increase calories hence the shakes.

No one has mentioned allergies, she does have dark circles though so I’ll ask the GP to do an allergy screening. No clue about absorption issues or what that even means, it’s only the past 4 months her weight fell before that she tracked the same centile for 18 months

@Thevoiceofreason2021

My LO was the same weight and percentile, she has also had one bug after another at Nursery. She has gained weight- I’ll let her eat anything - a wee icecream every evening, I’ve also laced her food with ricotta when she was on purées. I found rinsing here hair every night in the bath helped - it was the suggestion of my GP, just in case all of these coughed and colds were actually hay fever or an allergy and it has helped a bit. I was also told that once they get to 2 years old her immune system would improve. Do what works for you,

Oh we let her eat whatever she wants, she typically likes healthy things though which I know lots of parents must be jealous over. Her one weakness is chocolate and biscuits though, always tries to get those lol

None of this is your "fault". It just is what it is and no one is to blame for that .

Sorry to hear she's in hospital again. It must be tremendously stressful. My youngest was in and out of hospital a lot up until about 2 and then one day things seemed to just get better.

Regardless of cleaning practices nurseries are a hub of germs. It's in the air and of course young children mouth toys/books/each other. Lockdown and various measures have made children's resilience to germs less. My husband works in a Nursery and says children are always off ill. I'm a Childminder and between our own children and mindees, there is always someone off. I've never known it to be this bad. My 5yo has mild hearing loss and due to repeated colds has lost so much hearing now that she's got hearing aids. Tbh it makes me want to pull her from school but she also has speech delay and they support they've given has been great. Our children were at home over Christmas for 3 weeks and weren't ill at all. First time for ages.

If you were to pull her from nursery then she'd probably be well for longer and you could have a real good go at feeding her up. Entirely depends on if she'll eat of course. Does she eat more at nursery or at home? If she does better at nursery then it might be better to keep her there. Does your nursery consult with their own Dietician (some do to design the menus)? You could ask for their input. In term of nutrition there I would be thinking about asking them to provide extra healthy fats, protein and carbs, or even if you can send your own food in.

Childcare settings are great for child development but so can being at home. Don't under estimate the benefit of children being at home. At the same time, when you have another child at home it's harder. I had a 2.3yo and newborn at home and my 2.3yo missed out on a lot of activities when I was on maternity leave. I found it very hard.

I think you probably need a pros and cons list tbh. Even as a visual thing it will help you to think it all through.

Have you actually been in touch with your HV for advice? Some can be reallt good and offer extra help and support. I know she's under a Dietician but I found (with my youngest) that they focus mainly of nutrition, rather than practical advice on getting them to eat. What about getting her to make the food? Peanut butter brownies etc? You might find that she won't eat the finished product (or she might) but will want to lick the bowl as she makes it. Warm milk before bed with a bit of honey in. Weetabix before bed etc. I'm sure you're already doing all of this. Chopped nuts for snacks in a little snack pot maybe with some cheerios. I make energy balls that my 3yo loves - they're made with peanut butter, chocolate chips, coconut, oats, flaxseed, agave and chia seeds. Full of healthy fats and goodness. I make a batch and keep them in the fridge. Might be worth a try?

It's totally normal for them to get every illness going when they are in Nursery. If you take her out at this he you are just postponing the issue until she is school age.

My paediatrician doesn't agree.

Very callous.

Your GP is correctly assuming the newborn would be around you and your DH most of the time and as such you need to wash hands & insist your elder dc wash ends before touching him / her. I work in a nursery DS attends another nursery & to avoid spreading bugs everywhere I have become exteemely strict about handwashing. I was hands at strict intervals and as I’m heading out. I also requested my DS’ nursery to follow the same schedule. We then wash our hands again as we get home. It’s the only way to contain preventable illness. Another thing to do is to gently disuade her from things like biting nails / thumbsuckimg / nosepicking if she does it. Other than that the only thing you can do is just make sure hygiene is impeccable.

@Beowulfthethird

It's totally normal for them to get every illness going when they are in Nursery. If you take her out at this he you are just postponing the issue until she is school age.

My paediatrician doesn't agree.

Very callous.

Pediatricians only really have experience with higher risk /unwell kids. Not kids who are healthy and growing well. So for sick kids who aren’t growing properly, as balance of risk, them attending /doing badly in school and not having friends or being lonely as a result is not even a consideration. That’s where HV come into it. This is why pediatricians will have HVs as gatekeepers - to ensure advice is kept relevant and porportionate to each child.

We don’t have a HV for her, it’s only up to 1 in this area. I’m very reluctant to engage with them over her and they are part of the reason we have a dietitian. We were relentlessly given a hard time by them about her size, not enough weight gain even though she crossed 2 centile lines up, it wasn’t enough wasn’t fast enough. They advocated force feeding and said being on the 9th centile is cause for concern and a sign of neglect. That’s why we went to a dietitian. The dietitian was outraged.

The dietitian did give us suggestions on how to encourage eating, it’s primarily getting her engaged and taking the pressure off, but still she’ll eat what she’ll eat and it’s not enough for her to rebound.

We do all the tips and tricks, jersey milk with a dollop for cream, nuts and seeds for a snack. Getting invoked with cooking, she’s done cookies, brownies, pizza, nachos, pasta bakes (she was iffy on the bake before but ate it well after cooking it) and egg based dishes she used to eat the pizza after cooking it but not anymore. We do interactive foods at least once a week like fajitas and tacos or build your own wraps, she likes that. Any suggestions on anything else a toddler can make will be appreciated!

Typically she eats well at nursery, 3/4 or all of everything and occasionally seconds and occasionally half of something and she does it independently whereas at home she needs more encouragement. They fortify all her food, as per our dietitians instructions. Child won’t eat desserts

They said at hospital not to take her out today but I don’t know if they are seeing the full picture here.

She was 10.35kg at naked at hospital today after V&D for over 48 hrs and not keeping anything down even water. She was wretching up bile and her blood sugar was down to 3, BP was low due to dehydration. So mostly likely in normal circumstances her weight is around 300g higher they said.

As soon as she’s home from nursery and before being around baby she washes her hands and sanitizers them too, she loves it. (Tell me you have a pandemic child without telling me you have a pandemic child). We do the same but the GP even said a lot of things are airborne so it will only do so much.

OfstedOffred took DS a while to catch up -he seemed to have a growth spurt when he was 3, and again in yr2, but each time all his friends overtook him again. it’s really only been this last year-18months where he’s grown loads and is finally taller than some of his friends, and he’s 10 now. Interestingly, I remember a couple of kids in school who were always small and slight who absolutely rocketed in their teenage years, so although they say your height at age 2 can be a predictor of final adult height its worth remembering this is not an absolute.

DS also had obstructive sleep apnoea and had tonsils and adenoids removed age 3 - shortly after which he had the first growth spurt. His symptoms were mainly snoring with pauses in breathing, after which he would gasp and start breathing again. He had frequent bouts of tonsillitis and other throat infections. By the time he started school he had largely stopped catching every bug going, and now is a fit and healthy lad.

So the facts are:

She's reaching all her milestones
She's involved, active and interested
She's happy
She likes healthy food
She keeps catching bugs/virus's
She loses weight when sick
She has had bloods/tests done and nothing untoward found

Based on that information only she sounds exactly the same as millions of other 2-4 year olds. All the above is well with normal ranges. It sounds like your anxiety and the need to blame yourself if clouding your judgement a bit here. You appear to be fixated on her size.

If she's meeting all her milestones and enjoying nursery and eating well overall (most children have limited diets) her size should not be an issue. I have seen 7 year olds smaller than my own 3yr old and my 3yr old made other children his age look like babies he was so tall.

In terms of the illnesses again it's perfectly within normal parameters for some children to catch everything going. My oldest who is now 23 has only been to the Drs 2-3 times in his life. My youngest is now 19 and I can't remember how many antibiotics he had, how many Drs involved, how many trips to A&E in the middle of the night for the first 7 yrs of his life. He caught just about everything going or worse, he didn't catch 'the thing' (ie chickenpox) but he became ill with NSV whenever people around him had something. Temp spikes, hallucinations, turning blue, so much stuff it was exhausting and scary at times but all tests were negative and I was told he would grow out of it and eventually he did. Although he still catches things now his immune system kicks in pretty quickly.

Personally I think you need to stop thinking about her weight, height, food and just let her get on with being her. She might be tiny all her life, she might have a big growth spurt and be taller than everyone. She might always have a crap immune system or she might not. But I wouldn't take her out of nursery, she's happy there, they help with food issues and you get a break all good stuff. And hopefully her immune system will catch up soon.

Oh, and any Dr stupid enough to tell you off because your child has Rsv needs getting rid of, get a new one.

@nokidshere I’m not fixated on her size. She’s monitored by a paediatrician for her growth. She meets the NICE criteria for faltering growth and failed catch up growth due to being sga. There is a difference. 90% of sga children catch up within the first 2 years, the remaining 10% will not catch up without medical intervention. I think from your comment (forgive me if I’m wrong, that you’ve not had an iugr/ sga baby- catch up is important, it’s not a vanity thing, it’s a barometer for their overall health, failed catch up growth is usually the result of something (rss, allergies, genetic conditions, ghd or insufficient gh to catch up). Her paed said it is very very unlikely she’ll ever have a growth spurt. Her bout of illnesses always raises eyebrows but no cause has been found

[quote Kanfuzed123]@JanuaryBluehoo you’ve not upset me don’t worry, I’ve had a little cry just about my daughter in general, I’m just worried about her and blame myself for all that she’s going through. Seems so unfair she has to live with the consequences of my mistakes. Your post made me a little worried about her nursery, and definitely worried about residential care homes (but I don’t know anyone in them, and if I do, definitely will drop by unannounced)[/quote]
Just commenting on this, if ur daughter is developmentally thriving and just keep getting illnesses then she , she isnt failing and u r not failing her. U mentioned u had anxiety, could u be feeling more anxious than u need to be? I know ive been there!
Children and adults r getting more sickness bugs now as we were in lockdown for 18 months so no bugs were passed around, and its natural for children to get bugs to strengthen their immune system.