21 month old not eating dramatic weight loss

[Ankleweights]

Hi everyone. My 21 month old toddler refuses to eat. He goes to nursery Wednesday to Friday and seems to eat ok there most days or so they say but at home he refuses every meal. This started 6 weeks ago and in the middle he had a virus and I hoped his appetite will come back with a bang but it didn't. He lost just over 1kg in weight over the course of 2 weeks between two weigh ins at the HV.

I'm truly at a loss he used to eat so well albeit whilst distraction feeding. His self feeding has been quite slow but we are persevering. He's always been late with his gross motor skills so we just have to give him more time.

He hasn't gotten any taller and infact in the last 4 months hasn't grown in height at all. GP at first said he's a healthy weight and then when I called again after second weigh in and 1kg weight loss ordered some blood tests. Has anyone else experienced this?

He's hungry and his stomach grumbles but when faced with food he can only eat the tiniest bit. I'm offering variety and different textures. And now he's refusing milk during tea. I'm at a loss. He has lost so much weight and dropped nappy sizes.

I want to ask GP to refer him somewhere but I don't know what specialist to ask for. Can anyone please help? I'm distraught with worry. He was never a big boy to begin with and his face has gone in he just looks so malnourished.

Sorry about the long post.

I understand why you're worried- sounds like you're doing everything you can and getting all the right health professionals involved.

Out of curiosity if you gave him everything kids love.... cakes, chocolate etc would he eat them? My toddler is beyond fussy and he will happily not eat for days because he is stubborn enough to hold out for what he wants. Everyone says they will eat when they're hungry but that's not been my experience with my stubborn little so and so. Also does your little one still have milk morning/night? Could you ask nursery to take a photo of the plate before and after so that you can see exactly what it is they make and how much he's having?

Hi @Cactuslove I'm sorry to hear your troubles getting your little one to eat. It's so stressful isn't it?! Like you, I don't believe that when they're hungry they'll eat because I've seen mine first hand not eat so guess it doesn't apply to all.

I've given him everything. Biscuits, cakes, chocolate, cheesecake and crisps healthy and unhealthy versions but nope he'll try some sometimes but most times he will lick his lips then walk away. He'll happily drink tons of water but reducing my offerings hasn't helped his appetite.

Thanks for the suggestion re nursery. I will ask tomorrow. I really hope also they're being honest.

@Cactuslove forgot to add yes, he's still having 2 bottles morning and night. About 180ml of cow milk.

he could have an ENT evaluation to see if he has a swallowing problem, sometimes ear infections can have no symptoms beyond making swallowing painful

next he could have a gastro evaluation to see if he has reflux or other stomach problem that makes having food in his stomach painful

he could have an allergist evaluation to see if a food is triggering pain etc etc

he could have a cardiac evaluation to see if his heart is pumping enough to give him the energy to eat (it takes a surprising amount and eating is often the first thing to go with cardiac problems)

go to the GP and get them to see your LO in person, palpate his stomach, look in his ears and down his throat, check temp, listen to heart and lung sounds. Then ask which specialist path they recommend taking first. It might be a process of ruling things out first

Significant weight loss in a child of this age should never be glossed over. Dont let the GP put you off by seeing how things go. You can do that while on the waiting list for the specialist.

I saw this once a baby which wasn’t growing, the parents took to gp and it was taken seriously and the baby had a hole in heart. Operated and afterwards completely fine

@SeaToSki thank you soo much for such a comprehensive response. I will be looking into this tomorrow.

The last time he saw my child face to face, he had to battle him to get a listen of his chest. I'll go again and again until my GP gets a good initial check on him. Really thank you.

@Notoironing thank goodness the child was treated. It's so hard these days trying to convince the doctor that I'm not a neurotic hypochondriac. I think that seems to be the first hurdle. I will go back again to the GP tomorrow. It's difficult getting a face to face appointment post covid or maybe that's just my GP.

If dc are not happy sitting still for the doctor to check them over, there are a couple of routes that can help

get a toy doctor set for home and play ‘check up’ with the dc. You check them, and they check you.. stethoscope on chest and tummy, scope in the ears and mouth to look. Pretend you are listening for grumbling dragons and looking for potatoes..or whatever will make them giggle and want to try it on you. Then when you are at the doctors, lead the doctor…’oh look dc. The doctor is going to listen for dragons grumbling in your tummy’. Any doctor worth their salt will happily follow your lead so they can get a proper evaluation and have a happy dc

another option is a sucker lolly on a stick…it keeps their hands and mouth occupied and if they only get one at the doctors, it becomes a highly prized treat. Any wiggling or protesting and take it away immediately (might make the doctor raise an eyebrow) and then say dc, you can have your doctor visit sweetie back if you sit still and quiet..if they agree..give it back. The only one it doesnt work well for is looking in the throat, so you might have to get the doctor to do that first and then reward/bribe. Just make sure you talk about it a lot before you go in and are clear that dc can only have one if they are sitting still and quiet. They very quickly get the hang of it. Mine would sit still for injections with one in their mouths. Then dont use those sweets for anything else (ever). It needs to be very exclusive to work reliably

@SeaToSki that's brilliant! I'll try both methods and will defo buy some exclusive doctor visit sweets! Honestly thank you so much. You've made one stressed out mum feel so much better and a plan of action 💛

💐. And if you cant get an in person visit with your GP, try and see if you can get a private GP in person visit to get some direction (might cost a bit though). Then you can call your GP and say that dc has been seen and xyz was recommended and you want referrals..or an in person visit so they can assess appropriately. You shouldnt need to but …

This sounds really stressful! If all physical explanations are exhausted after investigations, you can ask to be referred to a CAMHS psychologist. Some areas have specialist 0-5 parent and child services, which are excellent (but postcode dependant sadly).

May be totally unrelated but have you had his blood sugar checked? My eldest was diagnosed at 2 and his weight loss was one of the first symptoms. Not trying to freak you out but if you haven't I would - Type 1 Diabetes can get very serious very quickly if not treated. Hope you get to the bottom of it soon, OP

@SeaToSki i didn't know that that was even an option. I'll look into if my GP can't get anything to help start a first referral.

@octoberfarm goodness i hadn't even thought of that. I hope your son is ok. Doctor has ordered some blood tests. I'm not sure he's specifically requested one for type 1 diabetes. Would you by any chance remember which blood test it is and whether fasting or non fasting? Thank you.

@Blossomed it really is. What makes it more so is that doctors easily fob off parents thinking we're being paranoid. If my child could talk properly he could tell me.

Thank you for the suggestion. I'll ask the doctor if that's available for us. I know from second hand experience that the waiting list for CAMHs can be incredibly long. If nothing comes of the other avenues then that is a definite route to go down if available.

You could try adding Complan or Pedeasure to his milk in the meantime

When mine had a weight issue I was advised against this while investigations were going on as it may artificially boost weight and disguise the underlying issue, if there is one.

I know it’s hard o/p but the blood tests are a start. Take him for regular weighing, and keep doing what you’re doing.

it may be useful to keep a food diary- get nursery to fill it in on their days too. It may show patterns or an issue over days/weeks.

@Ankleweights all they'd need to do is a blood glucose test - it's a simple finger prick (usually non fasting unless they were trying to gauge how his levels were when he first wakes up, but for this I'd expect non fasting) rather than anything fancy, and they'd test for ketones after that if his numbers were high. I'm not sure if they'd do it at the blood test place so might be worth calling the doctors back and asking if they can do it there.

My son's now 7 and doing brilliantly, thanks ❤️ It's meant a lot of changes but he's still leading a normal, happy life.

@Badgersonthedoorstep i was giving him crushed vitamin tablets for infants in his milk because i started panicking about it all but now that I've seen @Usernamenotavailab comment i think I'll stop until after blood test is done. Incase results are masked.

@Usernamenotavailab nursery keep a record but i will start doing it at home as well. Thank you.

@octoberfarm i spoke to GP today and he said he's asked for HB1AC which checks for diabetes type 2 and I've asked him for type 1 test. He said he'll call me tomorrow. Thank you.

Hba1c will also show type 1. To be exact: it will show what the blood sugar levels were over the last 2-3 months. If they're elevated it is diabetes, could be 1 or 2.

But the gp could also do a finger prick test, if your kid has type 1 it will be massively elevated. Takes 30 seconds. He could do that tomorrow.

Was just about to say exactly this. HBA1C is a great start for T1 too, and will give the GP an idea of average blood sugars over the last 3 months, but a finger prick will be much quicker and able to indicate if there's an immediate concern. Good luck OP, your little one is so lucky to have you in their corner

While this won't help with any underlying medical issues, can you offer more milk? DD got the vast majority of her calories from milk at that age (she struggles with food and didn't want to wean); she was drinking over a litre a day. You mentioned he doesn't want it at tea - can you offer it at other times? Would he drink more morning and evening? DD could polish off an 8oz (240ml) bottle without difficulty. This is only a suggestion for getting more calories in if you're really worried about the weight loss in and of itself rather than as a symptom of something else.

I can only imagine. I think the thing to remember is that although professionals may be experts in a particular area more generally, you are the expert in your specific child. These days, most professionals are (or should) be as collaborative with patients/carers as possible, but if you know something isn’t right and continue to feel unheard, keep going until you are.

You are absolutely right about CAMHS waiting lists, so I think it’s always best to get on the waiting list sooner rather than later. You can always cancel later on should things change.

Wishing you all the best.

I thought i would update this thread. My toddler had a full blood test and everything else except for iron levels were fine. His iron was extremely low despite me supplementing him and giving him red meat 3 times a week and vegetable sources rest of time. GP said if iron levels become low around 15 then children's behaviour, energy levels, sleep and eating will be affected.

My son was prescribed high strength iron and within a week of him taking it he's been so energetic and running around again and importantly he's been eating. Just as a precaution we had him looked at by an ENT and aside slightly large tonsils he's fine.

The change in his eating has been dramatic from not eating anything to eating anything he can. If anyone else is looking for answers please get a blood test as low iron can affect development as well xx

Thank you everyone for your helpful suggestions. I've taken note should we come to this again xx