3 year old dd with poor appetite very pale and gone back to day time napping. Help

[suiledonne]

DD1 is just over 3 1/2. She has never been a good eater. She rarely consumes the number of calories a child her age needs.

Since the winter began she is very pale. She gave up napping months ago apart from the odd catch up nap every few weeks but is now needing a nap every few days.
She is usually asleep by 7 and sleeps 12 hours with occasional wakes in the night.

She has asthma and was quite ill in Sept/Oct and I have discussed her eating with the paed. He is not concerned. She is small for her age but within acceptable range.

Today so far she ate 1/4 slice wholemeal toast, drank the milk but didn't eat her cereal for breakfast

and ate half a slice of french toast and a small apple for lunch.

I gave her a cup of warm milk a little while ago as she was so pale and she is now asleep on the couch.

I don't think I am worrying too much, I think she needs help.

What do you think?

If you're still concerned go to your GP and ask to be referred to a dietician.
My DS(4)has a small appetite too. He used to live off bread products, bananas, milk and weetabix. He ate no meat or vegetables. Over the last 6 months his range of foods has improved but he still has the appetite of a bird and is very long and lean! A child can live quite healthily on a very restricted diet suprisingly. However as you feel your DD's health is suffering I would definitely take her to the GP's again. Have you thought of adding multivitimins to her milk? We used to do that. Also if she is eating very little make every mouthful healthy. Does she eat meat? She needs a source of protein as if she's pale she could be anaemic. Lentils are full of protein if she would eat a lentil soup or similar.

Aneamia? Can be a vicious circle as it causes a poor appetite too.

I don't think you're giving her food that contains enough calories for the amount she is prepared to eat. Will she eat cheese? Peanut butter?

Rather than wholemeal toast and cereal for breakfast (which is perfectly appropriate for a child who eats well, or an adult) try her with half a slice of toast with cheese or peanut butter on. Give her something fried in olive oil for lunch, rather than an apple which is filling and practically devoid of calories. Swap her milk for Guernsey milk, which is higher in fat, or add some cream to it.

If you have tried all these and she won't accept it (I have a three year old, I understand) then I don't really know what to suggest

She really hates cheese. She can taste it even if I add to things without her knowing so I have given up on that one.

I haven't tried peanut butter yet as I am stupidly nervous of allergies as she has asthma and eczema and had a bad reaction to egg. She had RAST tests done again recently and her egg allergy has reduced thus trying her with the french toast today.

Her allergy tests didn't show a peanut allergy but she has never had peanuts so not sure if it would show on the tests.

To be honest today has not been a good day. I have roast chicken, mash with lots of butter and carrots for her dinner but she has just woken up so won't eat for a while.

I make homemade soups which she used to love particulary leek and potato to which I added lots of milk and some cream but she is not keen lately. The only meal she seems to enjoy is a homemade chicken soup with loads of veg that that I blend into a creamy soup but these days she only manages a few spoonfuls.

It is her total lack of interest that defeats me. She shows the same lack of interest in 'junk' food as in healthy food and doesn't like the usual kid's fallbacks like yogurt, white bread, pasta, chips etc.

anyone any ideas?

I agree with the anaemia suggestion - usually I don't think supplements are necessary for children but maybe try some sort of childrens iron supplement? I think Floradix do a liquid one for children. Anaemia can cause children to be pale, tired, and short of breath, as well as affecting their appetite.

Thanks for the replies.

Before I give her the iron supplement would I need to get her iron levels checked?

She suffered badly from constipation and this has recently improved a lot so I am war of anything that could cause problems again.

My DS was eating like a bird, he had (and still has) a problem putting on weight,so he was referred to a pediatrician; indeed, his iron level was low. Apart from iron supplement, he was prescribed a special "fattening" milk called Fortini, 200 kl (or was it 300) in a glass. We also had a consultation with a dietician who basically told us to give him anything he would eat - chips, pastry, chocolate, anything.

My advise (apart from trying to convince your GP to refer her to be seen by a specialist, or at least do blood test), try to add oil/butter to everything, avocado is also good. Bananas are good.

As to the iron supplement, consider Spatone, they claim not to have any side effects (ie constipation).

Good luck, it's not easy, but you can do it.

suiledonne, How about taking her to the gp, having a chat about her iron levels and seeing what they say. I totally understand your concerns about making her constipated again. If the gp thinks that it would benefit her to take an iron supplement you could try spa tone they sell it in boots and it comes as sachets of naturally iron rich water, because its soluble it doesn't have a lot of the negative side effects of the usual iron tablets that get doled out. It can be given to children according to the packaging, I am a bit wary with children and iron because of the risks of overdose, but low iron was my 1st thought on reading your thread. Hope she's feeling better soon.