Health visitor has freaked me out!

[MissTwister]

So the health visitor came today for a 4 month check and has really scared me.

My daughter seems to be developing normally and has had her 8 week check and an earlier discharge check from the hospital by a paediatrician.

She's sitting up (with assistance), grabbing toys etc and is very alert. She has a slight squint which the doctor told me to come back with if its still there in a month.

But the HV started talking about her squint being due to a flat bridge of her nose and then commenting on the fact that she sticks her tongue out a lot.

She then asked about her smiling and I said offhand that she smiles at me and her dad but isn't massively smiley with strangers. She does sometimes smile at strangers but usually reserves smiles for people she recognises.

She's just rung me 6 hours later to tell me I need to get a doctor to properly review her and she's referred her as she's concerned about her squint / tongue and the fact I said she didn't smile (which I didn't say). At least I think this is the reason - she doesn't actually make a huge amount of sense and was just talking without really saying anything.

I think she's hinting at concerns of Down syndrome with the tongue and nasal bridge comments but she has no other markers and I had the harmony test which said it was less than 1 in 10,000 chance. Plus no doctor had mentioned this and she was even in NICU for a night so surely they would have said something?

Am really freaking out. Help!

Highly unlikely to be Down syndrome - it woul have been recognized at birth, as the features are very distinct.
I cannot comment on a squint and tongue. However, an extra check won't do harm. She may just be precautionary and want to be sure she hasn't missed anything.
But I understand your worries - when DS1 was 6 weeks a pediatrician thought his muscle tone was too high. I nearly got conviced he got cerebral pulsy. He is absolutely fine, just a very strong toddler now - maybe more suited to play rugby tgan violin, but who cares.
Hope all resolves well for you too!

Lots,of babies look like they have a squint due to the bridge of their nose being flat and having epicanthic folds which cover the inner part of the eyes. It is called pseudo squint meaning the eyes are straight but give the appearance of an eye turning. Hopefully your GP will be able to put your mind at rest

I think the association of a possible squint to the nasal bridge is called a pseudo squint. It looks like a squint because of the shape of the nose which will change as the baby grows. Often they are difficult to tell apart from a real squint and a referral for vision screening is a good course of action.
Lots of babies only smile at familiar faces at 4 months.
Ask her directly what her concerns are.

She just kept muttering that I should get her reviewed and brought up the smiling. She's quite hard to understand and a bit odd!

Googling it I'm now really worried about the tongue protrusion and link to downs.

At that age my dd had learned to stick out her tongue (had just had a tongue tie snipped )and was doing it constantly. Never does it now.
She was also referred to an optician due to a squint but like pp was told this was a wide bridge .Please don't worry .My public health nurse has me demented finding new faults ..

Thanks all - will take her to docs and see what they say. So worrying having a child!

I personally find HVs useless. Dd1 had an awful squint until about 5 months and is now completely fine.
Dd2 rarely smiled or laughed until around 6 months and now smiles at everyone.
Defo better to get it checked but I wouldn't worry too much. X

The bridge of the nose thing could be a pseudo squint,my 2 year old still has this as he has a wide bridge,the hospital showed me how to check it by including a light source and that the light should be in the same place in the pupils (not explaining very well sorry) but your hv sounds awful xx

My dd has epicanthal folds and my hv scared me about squint but she was send to the hospital and her sight is fine, no squint. I know how anxious you must be feeling, at birth they said dd had a single palmar crease and mentioned downs syndrome she is perfectly healthy and was a case of an inexperienced midwife commenting on something she knew little about, but once it's mentioned you can't help looking for things that aren't there. It's unlikely that your dd has gotten to 4 months and something like down's has been missed. Try not to worry x

My DS4 first smiled at 7 months old, has a sticking out tongue and a flat nasal bridge. He definitely doesn't have downs syndrome. My DS5 has always smiled very sparingly but my DS2 and DS3 would smile at anyone.

Your daughter definitely doesn't have downsyndrome that would have been noticed at birth! Try not to worry I'd ask for a different HV though if she has you this worried.

Hello from the pregnancy boards! Hope you are loving being a mum.

My understanding is that children with downs have low muscle tone so can be floppy. I am sure that would have noticed months ago. My diagnosis - daft HV!!

Hope the dr sets your mind at rest

Saw the doctor. He said down syndrome was unlikely but that she does have a protruding tongue and perhaps a flattish bridge so he is referring me to a paediatrician to double check. Am so worried. Cried in the surgery...

Holding on to fact that the Harmony test said it would be under 1 in 10,000 chance......

When my youngest was 2, and at the eye clinic in hospital, a trainee optician casually threw in that he might have Down Syndrome then walked off. Given he had been expected to have a disability when scanned, I completely freaked out. Thank goodness my lovely husband calmed me down and said he was fine in that he had been well looked after and seen by health professionals regularly so I hadn't denied him any extra care.

No point telling you not to worry, it's a parents job, but plan to get all the information you need should there be any issue.

My daughter was diagnosed with a pseudo squint as well - it's pretty common.

You must be so worried, but the chances of Downs going unnoticed must be tiny.

It is a tiny chance, but it is possible to have mosaic Downs Syndrome (ie only some of the cells have an extra chromosome) - and this can go un-noticed at birth, and even into adult hood.

Ds was tested for this, but has another genetic condition, which has markers of protruding tongue and flat nasal bridge (there are many genetic conditions with these markers).

There is also of course the possibility that it is nothing.

I am glad that your Dr has referred you on, because even if it is a tiny possibility that something else is going on, it is definitely worth getting it checked out.

Good luck and I hope you don't have too much waiting for tests etc.

I can't comment on your child - but try to take what HVs say with a pinch of salt.

So sorry you are going through this.

When my NT daughter was a baby another mum at a toddler group just assumed she had Down's Syndrome.

I was a very at the time, but looking back on photos I can see what they saw.

Hope the results come back quickly and that there is nothing to worry about.

They're telling me it's a 6-8 week wait to see a paediatrician about it. What am I meant to do in meantime?! What about practicalities if she did have it such as weaning?

The results should be back before you need to worry about weaning so hopefully that's one less thing to be concerned about. Horrible having to wait though. Can you ask to speak to a GP or a different HV in the meantime to ease your mind? X

If it's 8 weeks until the appointment and then I need a blood test this would takes well over 6 months.....

Sorry thought you had said baby was 4 months and would take 6-8 weeks so would have thought taht would be around the 6 month mark. If you have your appointment with paed around then could you not discuss any weaning worries then?

There should be no differences in weaning, just follow your child's lead (this would be true whether a child has a genetic condition or not) - is she sitting well? is she able to move food around in her mouth? Swallow without gagging? if she struggles with more solid foods, stick to purees, your HV sounds sensible, so she should be able to help with advice.

Ds was unable to sit until he was nearly 15 months, and struggled with weaning, so we stuck to milk and thin purees, gradually thickening them up a bit.

It is horrible waiting, but (and I know this is easier said than done) try to enjoy your little girl and do all the things with her that you would do if you din't have this horrible wait. As you said in your op, she seems to be hitting her milestones (apart from concerns about smiling), and is developing well. Plus there are no health concerns - apart from her possible squint - so this is good.

Hi MissTwister my dd2 has Down's Syndrome, it is quite unlikely that it wouldn't be picked up at birth, but hazeyjane is right that mosaic Down's is only some cells with the extra chromasome. Dd2 was given a provisional diagnosis at birth and then comfirmed with a blood test. Dp and I were pretty sure she had ds as she looked so different to Dd1. The blood test took a couple of days. You should not need to wait so long for the paed, though, not sure why your gp cannot send your dd for the blood test straight away.

Dd2 was quite floppy with poor muscle tone and could not sit up without a special chair at 4 months. Other markers they looked for at birth were single line on the palm, long tongue, epicanthic folds on eyelids, sandal toes - big toe has a big space. Dd2 also did not have that "walking" or startle reflex newborns have.

Dd2 is a gorgeous little monkey, now though!

Hth, I really feel for you as I know how upsetting it can be to hear the possibility that your baby might have Down's.

Oh, actually, the one thing dd2 did do early was to smile at all and sundry.