1 year old with gross motor delay and poor appetite. Constantly told everything is “fine”

boanerges1989

New member
(I also posted on r/askdocs)

My 12.5-month-old daughter has a gross motor delay (as per the pediatrician) without diagnosis, and a poor appetite.

She was about 1.5 months late to hit each of these milestones: late to roll, crawl, and stand. She stands with support now and just started cruising occasionally along furniture. Whilst she can climb the stairs, she only uses her right foot to push up. Her pediatrician insists on just taking her to physiotherapy and stated she has the delay. I’ve taken her to 3 different physiotherapists. The last one recently said that my daughter is less strong on her left side, and has tension on the right side of her body… she just wants us to do exercises at home to try to strengthen her left side so that she utilizes both sides of her body equally. So far there is lots of resistance with the exercises, and as soon as I’m not doing them with her she reverts back to using mostly the right side. What could the cause be of this? No professional will give me any idea as to a cause or potential issues in the future. Let alone any potential diagnosis.

The second major issue is her appetite. She was born with mouth ties (that were treated) and a poor latch. She has always been tall and thin, and never underweight but always just at the cusp of what is considered “normal” or acceptable for her age. She gains weight very slowly. She refused formula and/or the bottle at 4 months so I couldn’t even top up her feeds anymore.

At around 6 months she started taking teaspoons of food but would turn her head in refusal. By 7.5 months she maybe ate about 1 tablespoon of food per meal. By 9 months there was a slow increase in the amount she would eat, but I had to offer a lot of variety for each meal, presenting her with 5 options so she could only take 1-3 bites of each. Also at 8.5 months I introduced finger foods which took her months to actually eat on her own. By 11 months she’d take a few bites with her hands. All this to say, she eats way under the recommended amount of food per meal for her age. The pediatrician and people at the health food store keep telling me this is “fine” and “normal” but this is starting to seriously worry me. So she isn’t losing weight, but she is not chubby and calm, either. Meal times are rarely happy times for her. Often screaming angrily and throwing the food at the floor, not liking her hands to be dirty, and yet she seems hungry. She does not have a favourite food that she’ll eat any time I offer it. She likes eggs, homemade broth, homemade chicken nuggets, pork ribs, fresh fruit, baby rice crackers, pastas, the occasional steamed veg and the occasional pureed fruit pack, of which she’ll eat half of on a good day… but like I said, she’ll take maybe 10 bites of these foods at most on a really good day. 10 bites being the entire meal. 1/3 of meals per day she eats “decently” (10 bites or so). 2/3 meals per day she has 3 bites of food and it’s over. If I present the same food that she liked more than twice in 2 days she refuses to even have 1 bite of them until a week or so goes by. Yogurt was her favourite at around 8 months, and a month later she literally cries if I try to give her yogurt. She hates it.

She has dark circles under her eyes. Her pediatrician said to not breastfeed her 1-3 hours before each meal, which I have followed since she was 8 months old. Still no real improvement. People at the health-food store do not suggest to give her an appetite boosting syrup.

Could there be a link between the gross motor delay and her poor appetite? What other professional is worth going to see over this? Could there be a medical issue? Should I push for certain testing/bloodwork? Could this be a sensory issue?

For genetic context: I have unexplained severe iron deficiency, and vitamin D deficiency, as well as possible sjogren’s disease. I also have a leg that is 1 cm shorter than the other. My husband is probably lactose intolerant, but never tested for it.

I know people are trying to be kind and telling me everything is fine, but these issues are definitely not typical, nor a good sign (especially the lack of equal strength on both sides of her body). Thank you tremendously for your opinions.
 
@boanerges1989 Get a second opinion. That is the only real answer.

Go to another paediatrician (not a physiotherapist)for a second opinion. Insist on tests. If that 2nd DOCTOR says the same thing then your mind is at rest, if not then you have further steps to take.

Mealtimes should not be the way you describe.
 
@sagat4 I went to a second doctor and it was the same thing. It’s really challenging to find access to pediatricians in Canada right now. The second time I went private and it was 250$ to hear “kids are picky eaters”. Thank you for your comment, I’ll try to find another pediatrician.
 
@boanerges1989 Seems like you have a few valid concerns, but so far nothing so alarming that I'd bet against your kid's current doctor. Still, you should totally get a second opinion, and seek out whatever therapies you think would be helpful (e.g., eating, physio, etc.). Totally not your fault, but it's EXTREMELY easy to expect way too much from an average 12-month-old if you're taking all these milestone lists you find on the internet at face value.
 
@boanerges1989 Keep in mind, sometimes your gut is wrong. If you're worried about a 1.5 month delay, you're too anxious. The imbalance between sides, also seems fine.

The food refusal seems like the only potential issue. But if there's no effect on her weight, and the professionals you've encountered are ok with with, maybe she is just fine.
 
@boanerges1989 My son was what we called a drive by eater. He was too busy to sit down and eat a meal. I just fed him all the time. He comes trotting by. ..here is an apple slice. Trot by again here is a cracker with cheese on it. He eventually grew out of this, but honestly the constant little snacks were probably better for him anyway. As for the right side dominance, maybe try the excercises as more of a game. Babies don't really understand required excercises.
 
@boanerges1989 This may be completely irrelevant, but my dentist picked up on my kid’s eye bags and said “I reckon she can’t breathe out her nose. Am I right?” He was, chronic mouth breather. Turns out, swollen adenoids were the culprit. So much better since surgery.

I’m not sure how young this can become an issue, but I didn’t even know that mouth breathing caused dark eye circles! Due to it being a clear fix, I feel it’s the type of info parents should know.

If the eye bags continue into childhood and you notice she snores or mouth breathes a lot, it’s worth having her checked out by an ENT to be sure she isn’t blocked.
 
@boanerges1989 No advice but to continue following your gut. You know your kiddo better than anyone else. Personally I would keep up with the exercises, even if she reverts back to using her right side more you can still try to build up the muscles in the left side. Have you tried offering meals more often to see if you can get more food into her? If she’s still nursing I would keep up with that too, her brain really needs a lot of fat and nutrients right now. Good luck, I hope you get some answers soon.
 
@boanerges1989 You can also set them in play areas. Sometimes eating at the table is boring to young children. It's the only time they're expected to sit still for half an hour at a time.
 
@boanerges1989 My youngest was one of the drive by eaters. Still kinda is. She eats best if her food is on the side table and she can “snack” while she plays. Now at 15 months she will sit down for dinner, but everything else is “snack” all day.

At this age it’s breakfast, snack, lunch, snack, dinner, then maybe another snack. They need the constant replenishment often, it’s possible that she’s just “too” angsty/hungry/overwhelmed with everything to actually sit and eat.
 
@boanerges1989 My son didn't walk until 14 months. At 8, he is still less coordinated than his peers. He also never had much of an appetite and has always been tall and skinny. Some kids are just not naturally well developed and don't have a huge appetite. If multiple doctors and therapists have told you that your daughter is fine, she is likely within developmental norms. She may be close to being an outlier, but the range of development and growth is huge. As long as she is growing and seems to have enough energy, she is probably fine.

You can supplement her with vitamin D drops and other vitamins with fortified cereals and ask for an anemia test, but some kids just have dark coloring under their eyes, especially if they are pale in skin tone.
 
@maryln I agree with you that some children are less well developed than others. But the question remains, how much better could these seemingly “fine” children be doing with earlier interventions and support.
 
@boanerges1989 I have no real advice for your particular problem, but I will say, with small children it seemed to me that doctors are unwilling to pursue much unless there is something drastically wrong.

My experience with this is my son: he didn’t sleep. He would wake up screaming in pain. I would listen to his stomach gargling and found that after the bubbles passed a certain spot in his tummy, he would fall back asleep instantly. After a year of hearing “it’s just gas” “some kids don’t sleep” “it’s colic” (I tried dietary changes when he was exclusively nursing, when solids were introduced it changed nothing (no improvement, no worsening, just more of the same)) etc etc etc my husband put his foot down and we brought him to the children’s hospital.

Because my son was developing fine in all other aspects, they tried to also turn us away with the same responses.

In the end we argued further and he received an ultrasound. There were no obvious issues. The pediatricians there openly told us that because there were no obvious indications of illness, it would be unethical to subject my son to any further investigation; and essentially, just deal with it. We are also in Canada.

I think they want to let a lot of these issues resolve themselves, if they can, before they will insert themselves into the process. Maybe they’re right, and in my sons case he did grow out of it eventually, but in the interim it is very stressful when you suspect there is a real cause to a problem your child is having, and no one will help you solve it.

Good luck to you
 
@dontajohnson Wow, sorry to hear this. Glad your son is ok now. The scary part is that some children actually have very nuanced symptoms of a serious issue. They are turned away until something goes horribly wrong and then it’s either too late or at best the child is doing alright but could have been doing better had it been for earlier interventions. I’m so sick of what’s happening in Canadian healthcare, it’s a tragedy.
 
@boanerges1989 Agreed. It’s very challenging to even see a specialist, let alone get a second opinion, so take heart that you are doing the best you can.
I hope in your case she outgrows these issues too… as that is best case scenario I think.
 
@boanerges1989 Request a neurology consultation and genetic bloods (microarray). My now 1 year old did not hit 6 month milestones. This assessment and bloods ultimately diagnosed her with a genetic disorder which was the cause of her hypotonia and developmental delay, most of which are gross motor.
 
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