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Premature baby with respiratory issues, eating problem, delayed speech, leg deformity while walking, had cellulitis of eye

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hi my son was born prematurely at 35 weeks. He only stayed for a day in special care and weighed at 5lbs. At 4 months he had wheezing and was hospitalised he was given inhalers and over time he has been using them he was hospitalised at least 15 times since then he also had cellulitis of the eye, which was treated with antibiotics. He also had problems with sleeping a lot from around a year old he would stay awake for an hour a day tests came with nothing. He also has problems eating we have tried supplements from the doctor but nothing works. He was under the peadiatrician for a year but recently discharged because he was putting on weight. Now we are back to square one he wont eat and and when he does he gags. He seems to be in pain but because his speech is not clear and he sees a speech therapist cant tell me whats wrong. It seems his bones are weak because of the way he walks. His right leg seems to come out of place and he screams in pain. Is this all linked. I have attached a picture of him today and really worried on what to do.
Posted Fri, 13 Apr 2012 in Child Health
 
 
Answered by Dr. Santosh Kondekar 7 hours later
Hi,

Thanks for the query.

Let me enlist your worries:
1.frequent respiratoiry issues,may be asthma
2.cellulitis
3.problem of eating .. excess? or less
4. speech delayed
5. right leg deformity in walking?

I shall address these concerns. The picture you sent doesn't display him in full, please send a picture of him in standing position. You may upload the picture of him in the standing position if possible again.

I am worried about his current weight. It would be better if you can let me know his growth parameters at present including height and weight. I am also seriously worried about child's development. Delayed development has many issues related to feeding, nutrition, movements etc. Please specify if he has any such concerns too.

Now to address the issues-

1. Frequent respiratoiry issues,may be asthma -
Since it has started very early in life, it may be related to birth history or any other chest condition. i would like to see any old chest x-rays if you have them. If he was on repeated inhalers, its likely that he has some chronic condition, though unlikely to be asthma.

2. Cellulitis -
It was just one time incident. Many a times, this is probably caused by lack of hygeine in the respective area. "It is unlikely to be related to other concerns".

3. Problem of eating .. excess? or less
Was the increase in weight following medicines?
You reported that your son was "discharged". Was he hospitalised? If yes, may I also know the reason?

"Child not eating for long without any acute issues is related to throat infections or poor oral hygeine". You need to discuss this with your pediatrician.

4. Speech delayed
A proper evaluation and perhaps audiometry test such as ABER or BERA test will help to predict the cause. With intense therapy, his speech would improve.

5. Right leg deformity in walking?
I request you to discuss with your doctor regarding small head size if any and / or any chance of deformities since birth that may be close to cerebral palsy.

I apologies for not answering your query here - if they are all interlinked. It is hard to predict the link between the various problems without complete details. But I am worried. Your detailed information will help me arrive at precise advice and diagnosis.

I shall look for these details from you at the earliest.

Awaiting your reply.

Regards
Dr. Santosh kondekar

Above answer was peer-reviewed by
 
Follow-up: Premature baby with respiratory issues, eating problem, delayed speech, leg deformity while walking, had cellulitis of eye 3 hours later
Thank you for your reply. He doesn't have deformities on his leg its only that he constantly says it hurts him. The only thing is his thumbs ,he was born with no creases on both of them and doctors said it was linked to hypo-mobility. As far as the speech he saw an audiologist who said he had glue ear and he had the operation to put grommets in both ears in January this year and also had his adenoids taken out.
He was discharged because he was starting to eat after the op for adenoids and grommets. He had put on a kilo.
The eating issue started early he never wanted solids until way after he was a year old. He also had continues runny nose which the doctor said was also linked to his respiratory problems hence the asthma.
 
 
Answered by Dr. Santosh Kondekar 8 hours later
Hi,
Thanks for the follow up.

1.He doesn't have deformities on his leg its only that he constantly says it hurts him. Hurts knees? every day?
Can be associated with vitamin C deficiency.


2.The only thing is his thumbs ,he was born with no creases on both of them and doctors said it was linked to hypo-mobility.
Hypomobility isn't a simple issue, did the doctor workup for hypomobility by say EMG(electromyography) study or was he shown to an occupational therapist for the same. Creases cant be changed but may point to a genetic reason.

3.As far as the speech he saw an audiologist who said he had glue ear and he had the operation to put grommets in both ears in January this year and also had his adenoids taken out.
Its good that adenoids are out, that may clear the ear too and to a great extent it will control fever related runny noses.


4.He was discharged because he was starting to eat after the operation for adenoids and grommets. He had put on a kilo.
That's exactly what happens after adenoid surgery, good for him.

5.The eating issue started early he never wanted solids until way after he was a year old.
Not eating only solids may also be related to tonsils or repeated throat infections or any swallowing issues related to hypomobility.

6.He also had continous runny nose which the doctor said was also linked to his respiratory problems hence the asthma.
Not exactly asthma, when adenoids are removed and runny nose persists we call it as allergic rhinitis which is often with asthma. I wish the child to respond well, as the medicines and therapy especially speech or occupational therapy in such cases are required for long periods.

Hope i have answered your query.I will be available for follow up.
Above answer was peer-reviewed by
 
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