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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 32296
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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My son, aged 2.5, only weighs 10.6 kgs and his weight has been

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My son, aged 2.5, only weighs 10.6 kgs and his weight has been hovering there for about 6 months. He was diagnosed as CMPI a year ago when he weighed just 8.3 kgs and suffered from extreme constipation. It took us a year to get this diagnosis as all the GPs and health visitors just said 'oh it's not unusual just give him some prunes or movicol' and we had to go private to get the diagnosis. He was so weak and thin that he always had a bruise on his forehead where he had fallen over when walking.
My concerns are twofold. One, his weight is static. He sees a dietician who has suggested putting him back on the milk ladder even though his latest bloods still show CMP as a weak positive. His consultant says he is not concerned about his weight because he is developing well now, but I am not convinced.
Two, we took him to an ENT consultant (private again) after a nurse pointed out that he has big tonsils. He gets ill often, I think he is particularly vulnerable because he is so little (the gastroenterologist consultant had him on fortnight lay prophylactic antibiotics to try and protect him from getting ill as he was so thin). It turns out he does have big tonsils and one is prolapsed so another piece of the puzzle became clear with his reluctance to have big mouthfuls, his gag reflex and the fact that he produces lots of mucus that he throws up when he is poorly. The ENT says he is too little to have his tonsils out as a rule, they prefer children to be 15kgs, and said to put him on 5ml piritonto see if it helps his snoring (it does). My concern is that it could take years to get him to 15kg and that he is just too small. Even trousers designed for 12-18 months just fall down his little legs.
I would appreciate any advice you can give us as I feel we are missing something with his health. I am seeing the gastroenterologist on Wednesday this week and am going to ask for a second opinion, which we are happy to pay for as our medical won't cover these issues.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Chip replied 1 year ago.
Hi.First question--what does his diet consist of now?
Customer: replied 1 year ago.
I try to give him a balanced diet, we replace dairy with soya, coconut and almond milks, and he has non-dairy cheese and cream. He loves the yolk of a boiled egg in the morning with toast, but only half or two thirds of a slice. Sometimes he has porridge with maple syrup and apple. Lunch is usually something like pasta with tomato sauce, a non-dairy cheese toastie or sandwiches. Dinner is always a cooked meal of meat with vegetables, or gnocchi with pesto or fish fingers, chips and beans. He almost always has a soya or coconut yoghurt and often a banana or a soya chocolate pudding. He loves stew and dumplings as a rule and we put barley and good quality stock in for calories. His eating can be good and it can be awful, very frustrating. I often follow him round popping bites of food in his mouth just to get him to eat a bit more. He also has a probiotic every day.
Expert:  Dr. Chip replied 1 year ago.
Thanks for the additional information
So what exactly were you told by the first gastroenterologist?
Customer: replied 1 year ago.
He thought my son might be coeliac but said he was almost sure because this all started when I stopped breastfeeding, that it was CMPI or CMPA, which it was as the blood tests showed. He said that his growth was faltering and that if we couldn't turn the weight around he would have to be checked into hospital for a longer term intervention. He prescribed the antibiotics, three-day course every fortnight, along with movicol and a probiotic. We went back two weeks later to be weighed again and to get a referral for the dietician.
Expert:  Dr. Chip replied 1 year ago.
I see
And how are his bowel movements now?
Customer: replied 1 year ago.
Generally pretty good, he goes most days and mostly without straining much. But he still complains of a sore bottom (inside, not outside) sometimes. He is potty trained now so it's pretty easy to see what's what.
Expert:  Dr. Chip replied 1 year ago.
Sorry for all the questions.Definitely doesn't sound like coeliac thenI think for now you are doing a very good job with his diet but it still needs supplementation with something like Ensure--either liquid or puddings He needs more calories for now until his weight and growth pattern begins to catch up to the normal level Let me know what the second gastroenterologist has to say but I think in time he'll be fine. And please let me know if you'd like to continue our conversation
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