Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Worried Constipated Toddler Is Not Growing | | | QUESTION | | | Dear Dr. Needlman,
My 18-month-old son has chronic constipation. At our second appointment with the GI specialist, the doctors discovered that he stopped growing (height, weight, head size) at 12 months. He has been going down in the percentiles from 80 to 30 percent in height and from 40 percent in weight to off the charts. I am very concerned. His doctor told me to feed him high fat dairy products and try to "fatten him up" but he isn't very interested. I can't get him to take milk or Pediasure even with flavorings. My main concern is that there is a problem that caused the growth to stop. I am worried we are missing something. I know that he is not a very big eater. He is not interested in eating and just eats little bits occasionally throughout the day. What should I do? I feel like we should see someone about the growth problem as well as how to make him hungry and thirsty so he will eat and drink normally.— Nicole in Austin, Texas | | | ANSWER |
August 29, 2001 | | | Dear Nicole,
Thank you for asking this question. I, too, would be concerned about any 18-month-old child who had stopped growing at age 12 months. While chronic constipation is a very common complaint, it is uncommon for it to cause such dramatic growth failure.
Also, while many young children have growth failure (also sometimes called failure to thrive), the combination of poor growth and chronic constipation does make me concerned about possible medical causes. It is good that you are seeing a GI (gastrointestinal) specialist. It may be helpful for you to talk with this doctor, to find out all of the medical possibilities he or she has considered, and how these have been tested for. (It would not be helpful for me to give you a list of the diagnoses that might apply here, but there is a pretty long list, and the specialist should be willing to go over it with you.)
At the same time that you are tracking down the medical possibilities, it is also very helpful to look into the behavioral or psychological side of things. Very often, growth problems are the result of both behavioral and medical issues, and both have to be dealt with for children to get better.
A good choice might be a pediatrician who specializes in Behavioral-Developmental Pediatrics. Most university-based medical system have these specialists on staff. Often a large institution will have a team of doctors and other professionals devoted entirely to helping children with growth problems. The GI specialist may well know how to connect you to this team, or your primary care doctor or nurse practitioner can. You could also call the nearest children's hospital yourself.
You can find more information on children's growth in the growth and growth charts section of our site, and also in the overweight and underweight section.— by Robert Needlman, M.D., F.A.A.P. |
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