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Underweight child not eating properly. Black dots on the tongue. How to increase the appetite?

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Hello Doctor,

My 2yr old daughter is not eating well for past one week. She is rejecting all the food and eats only few servings of cheese and egg (she likes them). She is underweight baby from birth itself and now she weighs around 9.5KG. We took her to doctor 4 days back for vaccination and asked about her fasting. He checked her throat, ear, chest and stomach and said everything is normal.

Today I saw some black dots on her tongue and I am not sure about cuase of it.
1. Is black dot on tongue normal?
2. What could be the cause of loss of appettie? How to improve her appetite?
Another question regarding black/dark dot.
Could this be caused by yeast infection? She has about 5-6 dots.
XXXXXXX XXXXXXX
Bangalore
Posted Tue, 22 May 2012 in Child Health
 
 
Answered by Dr. Santosh Kondekar 1 hour later
Hi XXXXXXX
recent onset selective reduced intake of a child is often due to subclinical throat infection or ear infection or adenoid infection which need not manifest with symptoms, but swallowing rough solids often causes throat discomfort and children prefer to take water in such conditions.
Its not uncommon to have viral sores over tongue, often they may be pink or white. Tongue may appear white or grey if solids are fed for more than 3 days. aS you could doubt it (black dots) may be yeast like growth, but if it can be easily wiped from tongue, no worries.
Loss of appetite being selective, one needs to call it swallowing discomfort than true loss of appetite. In such situations often children need to fed the diet that is more acceptable in a given child XXXXXXX in fats. also liberal water intake needs to be insisted to prevent dehydration.

please let me know if her weight gain is good, passes urine at least 6-8 no of times in a day and activity is not affected. In such case, special attention and close feeding supervision may be needed including advice for rehydration.

i hope this answers your query. feel free to write back. Thanks.
Above answer was peer-reviewed by
 
Follow-up: Underweight child not eating properly. Black dots on the tongue. How to increase the appetite? 1 hour later
Thanks for your reply.

Though her weight is not upto the standard chart, but her weight gain is decent. When we had taken to doctor a week back she gained some weight after that fever episode. She is also urinating 6-8 times per day. I am not sure if I can try to wipe those black dots, they are present in inner part of tonque and not easily accessible without causing discomfort to my daughter.

What is your suggestion for her symptoms? Does it need any medication? or Do you feel that I should visit my local perdiatircian again (I visited him 4 days back and he checked her throat & ear and said she is normal and loss of appetite could be due to growth of tooth also).or Shoud I just wait for few more days and feed her liquid diet (if she eats :-)) and not force her to eat usual food? Me and my wife are really concerned since she is off the usual weight chart and not eating well.

Thanks again. XXXXXXX XXXXXXX

 
 
Answered by Dr. Santosh Kondekar 6 hours later
Dear XXXXXXX
thanks for prompt reply.
here are my answers for your concerns:

What is your suggestion for her symptoms?
- current one is mild and as long as she is gaining good weight and passes adequate urine every day.
Does it need any medication?
== brush her tongue with a soft tooth brush. if intake not improved in a week. a doctor may start short course of antibiotics.

or Do you feel that I should visit my local perdiatircian again ==
==== legally i cant refuse such a leading question.

(I visited him 4 days back and he checked her throat & ear and said she is normal and loss of appetite could be due to growth of tooth also)
== ok
.or Shoud I just wait for few more days and feed her liquid diet (if she eats :-)) and not force her to eat usual food?
== insist good calorie liquid diet with intermittent solid offerings like medicines, 6-10 times a day.. may be small quantity in beginning.


Me and my wife are really concerned since she is off the usual weight chart and not eating well.
=== please provide exact weights at ages to address this concern.

Thanks

I hope this addresses your queries, do compile your question if you wish to ask any further.
Above answer was peer-reviewed by
 
Follow-up: Underweight child not eating properly. Black dots on the tongue. How to increase the appetite? 1 hour later
Hello Doctor,

Thanks a lot for your replies.

Here is the her weight history.
On birth - 1.6KG (little premature)
6 Months - 5.KG
1Yr-7.5KG
1.5 Yr-8.5 KG
2 Yr - 9.6 KG

Thanks
 
 
Answered by Dr. Santosh Kondekar 57 minutes later
Thank you so much. Despite being a premature baby, he has shown a good catch up growth. Growth spurt does get slowed after 1 year age and so weight gain will be slow. The kid needs small feeds more often for better outcomes. Protein powders may help gain good weight too

Thanks again for details. Hope this satisfies your query.
Above answer was peer-reviewed by
 
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