Very underweight 3 yo asthma enlarged tonsils advice pls

[mummyto2boysandagirl3]

Had ds2 weighed this morning and he's lost weight again is now down to 11.3kg Hv is understandably no longer happy to monitor for gp and thinks gp needs to refer I agree question is do I push for general referral to paeds or ent? We recently discovered his tonsils r humongous gp thinks ent will want them out ASAP (her dh is ent surgeon) but wanted me to record him sleeping so we can c how it was effecting that. Iv recorded day time naps as ds1 snores vv loudly and also has sleep apnoea and they r in same room prob how I hadn't noticed ds2s snoring as can't hear anything over my oldest. He has been dropping centiles since 12 months as his weight gain has been v v slow he started off on 75th for height and 50th for weight now 9th for height and 0.4 for weight as of this morning. He's not got taller for a yr and his feet haven't grown in the last 12 months either. He generally eats quite well and has 6 small meals a day with snacks in between if he asks for them. He's always v tired (but doesn't sleep v at night generally up at least once but sometimes as many at 5/6 times) he has had blood test recently and all came back clear. Developmentally I think he's fine but he's got v whingey since sept when the weight loss started. Could this really b just big tonsils?! He's had his heart checked out at 16 months old as his growth slowed and he'd started going blue round the mouth. His asthma is now well controlled 100mg clenil twice morning and night (I'm also asthmatic so got a good feel for when it's not right) he also has a mild dairy allergy and has Benadryl during the summer for hay fever and the pollen also is a trigger for his asthma. I'm not sure if there's more to it and he needs to c paeds or if just ent and take tonsils/adenoids out? Sorry if this is all waffle but I'm v worried and especially worried about him catching something Hv has said this is her concern too that a chest infection or tummy bug could easily hospitalise him. :( he has gp Friday I'd already booked it just incase just wish I could take him today

Also iv heard of something called pediasure? Anyone any experience of it? The term failure to thrive has been used since he was 14 months but they haven't wanted to treat as thought he'd grow out of it/was just small feeling v frustrated :( so sorry if iv bored u to tears

How is his diet? What does he eat on a typical day? Did he ever complain of tummy ache? I'm asking, because if he has a good diet rich in protein, carb. fresh fruits and veg, dairy... then he may not be absorbing any nutrient because of a gluten intolerance. Failure to thrive (and fatigue) is one of the symptoms of coeliac disease. Maybe, as you are seeing the GP on Friday it is worth mentioning coeliac disease.
And you didn't bore me at all !

He's been tested for coeliacs and was negative. He has a mild intolerance to dairy so we for the most part r dairy free but he eats well has 6 "meals" breakfast - cereal with oat milk, oat milk strawberry and banana smoothie and a whole slice of toast with olive oil spread. Mid morning snack will b fruit of some description toast and jam if at preschool or rice cakes homemade chicken goujons or similar hummus or guacamole if at home. Lunch at preschool he has jam sandwich or crackers with dairy free cheese chopped chicken breast soya yoghurt banana raisins apple juice at home baked potato & beans/ chicken or tuna mayo sandwich omelette fish finger sandwich etc with fruit and a soya yoghurt. Afternoon snack is normally something quick after picking ds1 up from school so toast and jam pancakes etc with fruit or if I have any left over meat from a roast they have that and a mug of hot chocolate oat milk. Dinners r normal family meals cottage pie chilli roast dinners fish pie etc etc then supper is normally a dairy free yoghurt/dessert bread sticks & dip toast or occasionally scones or similar if I've been baking. They drink water throughout the day and with meals. We have done a food diary and dr is happy with his diet only thing she can think if is he's giving up before he's full bcos his tonsils r so big he can't swallow.

Thank u for replying tho Gordon :) and if u have any ideas on anything else I could give him food wise I'm always grateful of suggestions. He also loves my home made soups which r my go to of his chest is bad as I know even if he's wheezy he'll gobble it up. Lentil & veg is his fav and he will eat it at least twice a wk. he's also on a good multi vitamin & mineral supplement it's just been going on for so long I don't know wot else to do for him :(

Maybe ask for a referral to both. As far as I know waiting lists for ent are long so it would be good to get on list ASAP. You could then see the paediatric Dr for the other issues.
My son has weight issues and was well below the .4 centile area eventually he reached it at 2.5yrs but was still grossly underweight up to now (12) he is 34kg now. In saying that he hasn't lost any weight since they got his medication(for his ongoing condition) under control but his low weight has never been too much concern cor Dr as it wasn't affecting his quality of life.

Thanks blue talk I didn't realise I could ask for both :) ent waiting lists r ridiculous I had to pay for ds1 to b seen so suspect we will end up paying for ds2 also. But would b good to know if paeds think ent is def the way to go as it's a lot of money I can't really afford but I'll find it if that's what he needs