What's wrong with my child?

[gourd]

My nearly two year old girl has gone from sunny, bright, happy lively girl to teary, tired and wont settle at night. She is at times full of energy but there is a lot of sitting still staring into space or lying down on the floor and not moving at all at the moment which is unlike her. Is it the heat? Is it teething? Is it because she stopped breastfeeding ? she stopped about a week ago and it seemed to almost coincide with her not being able to get to sleep, and being upset in the night too, which we think has led to unhappy day times as she is so tired.
The last few nights she tries but just can't sleep (she isn?t playing up, she is whinging crying then seems really upset rather than annoyed and will turn away from me cuddling her teddy and trying to sleep but then will cry again minutes later like she is uncomfortable) and then is exhausted the next day after two hours of trying to get to sleep initially and then frequent night time waking.
This is for the third night in a row. Offering breast and her accepting it last night after 5 days of not feeding (her decision, not mine) once she woke in the night seemed to help relax her a bit, but did not prevent her waking again minutes later upset again. Calpol seemed to help initially too, as she went to sleep afterwards but she still woke again later on just the same.

This from child who has slept through night since six week old barring illness. She does not have a temperature and is sporadically like her usual self playing and thumping around the house like a small elephant as usual, but then bursts into tears with no obvious cause and has short periods of sitting looking into space, or lying down on the floor (sometimes silent and sometimes crying) and just looking exhausted. We noticed what looks like heat rash on her leg yesterday ? a tiny patch about the size of 20p plus one spot on her face. No other symptoms, no cough, no snot, no temperature, nothing. She bursts into tears about nothing obvious, (even a picture of a bear walking away from the viewer in a book made her cry) and gets so frustrated at things that she kicks us, but that could be due to lack of sleep too. She doesnt seem ill in any obvious way, does not touch tummy or ear etc to indicate any pain even when asked. No obvious teething signs either- no red cheek or chewing, so what could be wrong?

Have you noticed any weight loss, increased urination or thirst?

Just that my DD aged 16 months had lethargy and sleepless nights prior to her diagnosis with Type One Diabetes. Am sure it isn't but just wanted to make you aware of the symptoms as they often go unnoticed.

Where is she with development - particularly speech?

She does sound like she's got into a spiral of tiredness, and is really tired in the day and overtired at night, but as it is so out of character and sudden I would say she is either fighting something off or coming down with something. How verbal is she? Will she tell you how she's feeling? I would take her to the doc for a check-up anyway.

Thank you all for your replies. LO slept through last night though she still took a bit of settling initially, and CM said she seemed much better in the day time yesterday too. Speech development? Not great. She just doesn't say many words. Teddy was her first word around 12 months but since then she's not made much progress IMO. She "talks" to us using animal noises and imitates cars, trains etc but doesnt use the actual words at all. She only says "Nah-nah" for banana and "Dah dah" for Bye bye! She can say "baa baa" meaning the song Baa baa black sheep and can say Mama and Daddy and will say "No" in a hundred different ways of course, but that's about it. Shakes her head when asked if she can say hello etc and just looks all shy if you ask her to say something. Wont speak unless by accident (when she is excited and forgets that she doesn't do talking - has said "chair", "star" and "geese" whilst pointing at them but that only happened twice per word ever in last 12 months).

Haven't noticed any weight loss, increased wet nappies or thirst though? Actually the opposite, really -she looks a bit chubby at the moment, but is probably due a growth spurt. She doesn?t seem particularly dehydrated, but she probably isn't producing quite as much wee as normal and it's a bit smellier first thing in the morning too, so getting enough water and juicy fruit into her is what we've been trying to do. She ate a whole large mango (plus some more of ours) and two plums for tea last night after half an apple before tea - didn't want the chicken stew (just spooned up and ate all the stew sauce/gravy) but this is normal for her when it's warm weather. She of course ate a frozen yogurt afterwards too. basically will only eat frozen yogurt/ice cream and juicy fruit at the moment. CM said she did eat all her food yesterday though for the first time this week, and that included pastrami sandwiches and two boiled eggs plus more fruit. Prickly heat rash on feet and back of legs yesterday looks better today. It was cooler last night though - which may be why she slept better. Was really beginning to think she had some mystery illness, but it seems it may have just been inability to sweat/cope with warm humid weather after all. The thing is it's not been all that warm for adults really; 22-24 oC-ish I think, but she is probably running around all day getting hot and sticky at the CMs and it is quite humid so maybe that's all it is. Anyway fingers crossed that yesterday's happier daytime and last night's more peaceful sleep weren't a fluke! Thanks again for your replies.

i think i would get her checked if i were you-you know your child best and if she is not right then i think it's worth getting looked at.

have you spoken to anyone about her speech??

No haven't mentioned speech to anyone, but only 'cos others with kids (and CM who has five of her own (3 are now adults) and has been CM-ing for 17 years) say she is normal. CM often writes in book about her saying new "words" but we haven't heard any, not real ones anyway. My parents also think her speech is quite good! However we have seen another child at the park a month younger than her who clearly and distinctly said "One, two, three... ten", so that's what made me wonder if she isn't very good with speech after all. Then again, there are also kids older than her who seem to have fewer words too, so it's hard to know. She will say "Duh" pointing at letter D and "Guh" pointing at letter G in a book etc, but not many actual words. I recall her saying quite distinctly and in tone of voice just like an adult "Oh dear" on two seperate occasions when she was about 15-16 MO, but she's never said it again. I nearly fell over with surprise when she did it though, as she'd never shown any inclination to talk properly before! Her cousin who is 3 months younger than her has even fewer signs of real talking than ours did at the same age though, and no concern seems to have been expressed about that by anyone. LO will be due 2yr check soon anyway (next month) so hope I will find out if there's a real issue there. May take to GPs tomorrow (my day off) if she seems unwell or doesnt sleep again tonight, but she seemed fine yesterday from what we saw in the evening and from what CM reported and was fine again last night and this morning.

The crying at pictures in books thing has happened before actually - it seemed to co-inincide last time with similar sleeplessness too, but that turned out to be teething (red cheek always appears AFTER the pain, so it seems).

Maybe she misses the breastfeeding but obviously is unable to articulate it. What have you replaced the BM with?

With my DD, now 4, I replaced her formula milk with cows milk when she was just over 1. Her behaviour changed entirely, she was hyper-alert so didn't sleep well at all. When I stopped giving her so much cows milk, she began to sleep through and was much calmer. She can tolerate a little dairy now but does much better without it. I give her vitamins so she's not missing out on anything.

Why don't you try replacing cows milk with a) goats milk or channel island as this has more digestible proteins than Holstein milk... or b) try coconut milk, it's nice and creamy and contains a healthy amount of fat for a growing brain.

Supplement with vitamins and minerals, kindervital is a good brand and eye-q omega 3. They're available from chemist direct online.

And definitely make sure she is well hydrated, its easy to miss dehydration in a young child..

Totally untelated to the sleep, I would recommend that you speak to your HV/GP. At the very least they should be offering you a referral to speech and language therapy. At best you can expect a referral to the community paed so they can investigate issues which others have raised here as well. In some areas you can self refer to the local SALT so can bypass here HV/GP.

I might get flamed but I am going to go out on a limb here having spoken to an expert in speech and language therapy on Tuesday this week re my DD who is two next week and not saying much but babbling away and very happy.

So. Sleep regression is common around two. Its more common just before learning to walk and to talk, she has also stopped her known sleep comforter. I'd say its pretty normal - children are walkers or talker - mine was a walker at 13mo. My child also hasn't slept more than 3 hours since she was born so I cannot say we have the same issues - but a friend whose dd HAS slept through since tiny (and FF not BF) has recently had her sleep go to hell in a handbasket so I'd say its fairly common. I'd go out on a limb and say your DD is just on the verge of talking and its causing some sleep issues.

Now - onto the bit where I will get flamed. DD has 4 words. She has 12 or so signs which she uses. She has a strong bond with me and her key worker and we understand her nuances and she doesn't actually need to talk. The Salt agreed with me (non NHS) that parents are asking for speech therapy earlier and earlier, because of the worry about their child not talking, and the decreed number of words a child should say - the key is whether the child understands what you are asking of them and whether you child can point at what they want and whether they are babbling. An assessment of DD's understanding and reasoning put her at 3yo, and her emotional and social skills are also beyond many of those in her 2-3yr room at nursery. But yet because she is pretty much non verbal people in my antenatal class describe her as delayed, yet she walked and rolled, and crawled weeks before their children

every child is different but i would expect a child to be talking by 2-non verbal is quite unusual.

Of course she's "talking" baby talk - it;s just not words anyone else would understand, but we do!
Havent replaced BM with anything other than yogurt which she's had since 6 months and milk and cream in porridge which she's also had since 6 months. She has never drunk cows milk, have tried but she's never wanted it and have been advised that she doesn't need to since she eats so well. We replaced mummy snuggle and breastfeed with bedtime story and snuggle but she isn't keen on snuggling with me at that time - I think she thinks I am trying to feed her if I lift her or cuddle her on the bed where we read the story (and where BF took place) so she wants Daddy to lift her and put her into her cot instead! I always follow and kiss her goodnight and stroke her hair till she closes her eyes though.
Anyway she took a while to settle again last night but then slept through so big improvement for all of us!

Her speech sounds normal to me from what you've said- much the same as a friends little girl just the same age. The only reason I asked is that speech varies such a lot , and I had two really freakishly early talkers who could have chatted about how they were feeling at two- I asked just in case your dd was the same. Prickly heat is so horrible and itchy-I have it right now and am exhausted as I got no sleep last night, so that will be having a big impact on how she feels in the daytime.

Her urine is smelly? She could have a UTI- these can present very differently in children to adults, and IIRC, lethargy is one of the symptoms. It could also account for the sleeplessness.

It could be worth taking a urine sample to the GP to test, even just to rule it out... A UTI can be very serious for a child if left untreated.

Yes a bit, but that maybe something to do with disposable nappies though - we used washables till 18 MO but she grew out of them. To me the disposables stink when wet and i always notice, but partner cant smell anything so it is probably just me. I think her speech is probably normal as it seems to vary a lot from child to child, she certainly never shuts up usually, it's just that no-one except us and CM really understand what she's saying so when you hear clear words form another child it does make you wonder. I don't actually know anyone with similar aged child, but only friends with older kids who cant remember what theirs did so i can only go off what people on forums say! Must say that another kid almost 2 years older than LO at CMs never appeared to say much more than ours. He's left now though. Today LO was fine all day and full of beans but it was much, much cooler all day. Ate a massive amount at tea time too so appetite is back. Prickly heat rash gone in morning then did appear briefly again this afternoon but faded again as the evening cooled. She hasn't scratched it at all so I don't even know if it bothers her at all, it doesn't seem to in the day time, but perhaps she notices it more at night when there are no other distractions. She slept ok last night after taking a while to settle initially, and she had a good day time nap today - went straight to sleep, no tears, so we'll just have to see how it goes tonight.

Just to update that LO has started to settle a lot easier and slept through last night again. Looks like it may have been mixture of heat related fatigue/irritability and difficulty adjusting to new bedtime routine without the BF before sleep. For some reason it didn't occur to me that she would find that difficult as she decided for hereself to stop the bedtime BF and also she settles for daytime naps without it, but it does look like that change in routine may have been the culprit. She was OK last night after a week of the new non-bf-ing routine, so hoping that she is going to be OK from now on. We also used the opportunity (of her already being a pain to settle/sleep through etc) to remove the cot side (so she is now in cot-sized bed) and she was unphased - she enjoyed getting in and out in the day time, and putting toys in and out, then had her 2 hour nap in there fine, loved it! She went to bed OK too - If anything it was better than last week. She didn't get out of bed all night and actually settled easier (we only went in twice in first 20 minutes, as opposed to every ten minutes for two hours last week), then she slept through. Problems solved? Hmm, we'll see.. It'll take us parents a week to catch up on sleep anyway - we're shattered!