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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8808
Experience:  Doctor of Medicine
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My grandson is 31 months old. He has long term problems with

Customer Question

My grandson is 31 months old. He has long term problems with eating & constipation. Suffers from anaemia & has difficulty putting on weight. He was late reaching physical milestones, but speech & understanding are average/ possibly above for age. His limbs are very thin & always had a protruding stomach. Lifting him from a prone position to standing (in just a nappy) I recently noticed that the skin on his stomach was shrivelled when he tightened his muscles. Is this a cause for concern? I worry about him more than his parents as he is an only child & they have nothing to compare him to. He is also quite an anxious & fractious child who is starting to get distressed if routines are not followed. Any insight ours be most welcome.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 years ago.
Hi there.
Thank you for your question.
I will be helping you out with your concerns today.
I am sorry to hear about your grandson.
Can you please let me know how severe the anemia is? I mean what is the level of the hemoglobin?
Also you mentioned that he was late in reaching milestones, can you please let me know which milestones were late to reach and when exactly did he reach those milestones?
Please let me know.
Kind regards
Customer: replied 2 years ago.
Sorry I can't be exact with information, but I'll do my best. Anaemia - his iron stores are good, but the iron in his blood stream seems to become easily depleted. He had good head control from birth, was slightly late sitting unaided, but didn't crawl until around 16 moths. Took his first steps around 22months, but continued to crawl for many months. Very stiff when walking. Has overprinting on both feet. Climbs steps/ stairs, but needs to hold onto someone/ something, or will crawl. Hope this is useful?
Customer: replied 2 years ago.
That should read over pronation on both feet.
Expert:  Dr. SH replied 2 years ago.
Those milestones are slightly late but nothing that I would worry about a lot.
I think that as he grows older he should be absolutely fine.
I would just continue monitoring him and keep checking his hemoglobin at every two to three months time to make sure that is around the 12 mark at least.
Just to reassure you, my own brother walked when he was 24 months old and now he is in the army running and is in fact a very good athlete.
So I think that he just requires monitoring for the time being and good healthy diet that is rich in iron and folic acid.
Let me know if you have more questions.
Please rate me by clicking on one of the stars at your end.
Kind regards
Customer: replied 2 years ago.
Thanks for your reply. The good healthy diet is a problem as he eats only small amounts of very limited foods. Can you explain why the skin oh his stomach would be shrivelled?
Expert:  Dr. SH replied 2 years ago.
The main thing is the diet which could be leading to the skin problem as well.
I think that a consultation with a dietitian to help formulate a diet plan would help greatly and will also likely help his skin as well.
I would not worry too much about his skin which should improve as he grows older and his skin matures and his diet improves.
Let me know if you have more questions.
Please rate me by clicking on one of the stars.
Kind regards
Customer: replied 2 years ago.
I think his eating difficulties are now behavioural (he eats some foods one day & not the next, or eats certain foods for a period of time & then refuses them). It is also linked to constipation. Dietitian initially refused to see & labelled him a fussy eater. At what point would you recommend food supplements or specialist support with 'food phobias' ... or however you would class it?
Expert:  Dr. SH replied 2 years ago.
I think that food supplements should be added to what he likes to eat.
Constipation must be treated with stool softeners and making the kid take lots of fluids.
Adding benefiber to his diet will help in relieving constipation as well.
Let me know if you have more questions.
Kind regards