4 year old - not gaining any weight and super tired

[DaisyChain234]

My just turned 4 year old hasn't gained any weight for 7 months. He was born on 75th, hovered around 50th, steadied at 25th but has now fallen into the 9th bracket (16 to be precise on WHO calc). I raised concerns 6 months ago as he was pale, very tired and I was worried about iron. He had bloods for anemia and coeliac but both came back normal. He had started a steroid inhaler for suspected asthma at the time, which helped energy a bit but now he is back at square one. He really struggles to make it through the day without falling asleep by 4pm, and if he doesn't sleep, he is an absolute mess and either inconsolable or complete menace. I will take him back to GP but interested to see if anyone had a child with similar symptoms? Most of the day he is a happy child, he has no gastro symptoms. He sleeps well, snores with cold but no apnea or anything. He starts school in September and he can barely cope now with 3 days at preschool let alone 5 days at school so im worried about that.

This was exactly like my dc down to the centile scores. He had enlarged adenoids. I suspected it but it took a year to convince the doctors. Eventually diagnosed on an x ray. I didn't actually think he had apnea, he didn't snore, but after the op he slept through and gained height quite quickly.

I would ask for an ENT assessment.

Interesting, my eldest has just been through the ENT route as he is a terrible sleeper but turns out its not an ENT issue. Ill suggest this at GP - thanks.

What about his height? Is he growing taller?
If not I’d be asking to see an endocrinologist in case it’s possibly pituitary related.

I saw a video online from a paediatrician talking about how she identified a friend's son had diabetes from a similar set of symptoms. Does he eat a lot? Does his breath smell sweet? Is he often thirsty etc?

Is his diet good?
Has he had a virus (post viral fatigue?)

Morning,

I know your son has had bloods done but you can request a copy of the results. You can then do your research on the results. Many gps normal blood results can sometimes actually be borderline and they just think that is fine. It isn’t fine if those borderline becomes worse.
This was the case with my daughter who was 12 at the time. She had the exact symptoms as your son, pale, very tired sll the time. No gastro symptoms except very smelly poo. Her bloods showed borderline low iron. Gp gave her iron tablets and then sent away.
A year on with her symptoms getting worse and me going elsewhere to get my daughter sorted she was diagnosed with Crohn’s disease.
I am not suggesting your son has that but no child should be pale, tired and certainly should be growing.
Much too often gps will ignore such symptoms because they have no knowledge of certain illnesses. Therefore us as parents need to be heard when our children are not right in themselves. We need to push until we are listened to and our children’s symptoms investigated.

Really hope you can get your little boy sorted.

Thyroid issues in children show up through lack of growth, another thing to ask to check. I hope you get answers soon , it must be so worrying

Is the asthma properly controlled? My eldest gets v fatigued when it’s not, symptoms aren’t always clear. Coughing after running and in the mornings were one

He is often so tired by dinner time , he cant eat - he is either in full meltdown mode or too silly/overtired - he probably eats dinner about 2 times a week. He does eat breakfast lunch which i try and bulk up but there's always something left. Yes he has grown a bit taller. I know you can't compare kids but i have two other children. My eldest was 4kg bigger at his age, and his sister who is 17m younger is a bit heavier than he is now.

He has never been wheezy, its just a cough that has made GP think asthma, and that is a lot less frequent now so has definitely improved. He very rarely needs blue inhaler luckily.

His breath is normal, he doesn't eat a lot, i wouldn't say he was excessively thirsty.

He has a varied diet but not much of it, a few mouthfuls at meals and rarely dinner, he too tired by that point. Snack wise he will have a couple throughout day. He has had virus recently, so yes post viral fatigue likely but his tiredness has been relatively consistent over the last 12 months - always by 4pm he cant cope anymore.

Celiac? Sounds very difficult OP. I would push for a full health check via a consultant Paediatrician. You need to get to the bottom of this. Get him a good daily multivitamin in the meantime. If he's too tired to eat, will he drink? Maybe a smoothie eith loads of good stuff in it or a healthy meal replacement shake, just to get some calories in.

Mine never wheezed just coughed. If he’s also on a brown inhaler daily he should be ok then

ask them to test for coeliac disease. DD exactly the same and has symptomless coeliac disease

Have a read about cortisol deficiency symptoms & perhaps ask the Dr for an early morning cortisol test.

That said, my son has it so I'm quick to associate these symptoms with low cortisol.

Absolutely push for answers, this isn't normal.

I also wondered about diabetes with my 0 medical training.

Good luck OP, it must be worrying.

So they did a coeliac test about 6 months ago, it was negative. His biological great grandfather and great aunt have it, so there is a slim genetic link but was negative test so 🤷🏻‍♀️ .

was it just the blood test? I’d be pushing for a proper test. My son was also dropping down the centiles and was tired - he was coeliac. Exp as family history.

The problem is it's quite invasive to test beyond a blood test. They won't be inclined to do it with no other gastro symptoms. I went though this with my dc.

Food allergies?
At just under 4 my daughter started losing weight, didn't want food even when we made cupcakes, asked to go to bed early and she never wants to sleep.
She has food allergies and one day came home from nursery telling me she had eaten something I know there was no safe version of and it turned out that the new chef at her nursery hadn't been checking the ingredients in the foods he had been giving her. They were dismissed immediately and within a few weeks she had more life to her. Her usual allergy symptoms were gastric -loose stools or vomitting but we do get some more subtle symptoms too. We did the egg ladder last summer and her only symptom was getting very moody and argumentative like a teen girl, within 2 weeks of stopping she was completely back to normal