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Child does not eat, feels tired, and has white spots on body

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
hi my child doesnt eat and feeling always tired ,have white spots on his body
Wed, 26 Sep 2012 in Child Health
Answered by Dr. Hema Yadav 45 minutes later
Thanks for posting your query.
Eating habbits vary from child to child and faulty eating habbits often commonly lead to anemia ( low level of iron/ hemoglobin in blood ) which can cause weakness, growth faltering , white dry spots on skin, pallor of skin and mucosa of eyes tongue etc .
The best way to confirm the diagnosis is to get a complete blood count test done and your pediatrician may also be rule out any other significant causes like infection, malignancy , blood disorders etc .
Once the cause is confirmed treatment is possible and very effective .
A three to six month course of hematinics depending on the severity of illness along with other multivitamin supplements may improve the child's appetite and growth.
In case the child eats very very less a trial of synthetic appetizers ( cyproheptadine ) might be given for a short term in the beginning.

Apart from this deworming tablets ( Albendazole) as a single dose might be required as per need.
Though the problem might seem insignificant to you it's best to get it checked and treated as long term deficiencies can cause significant growth and health problems to the child in future .
Meanwhile you should try to give him small frequent meals 3-4 hourly , give plenty of fluids , XXXXXXX leafy vegetables , red meat , fish and dairy ( if non vegetarian ) and fruits like apples and dates .
So please consult your doctor for a thorough physical examination & investigation to confirm the problem and start treatment .
Hope I have answered your query.
Kindly accept my answer if you have no further queries.
Above answer was peer-reviewed by
Follow-up: Child does not eat, feels tired, and has white spots on body 13 minutes later
hello again this is the complete blood count test :

wbc-9.77 lym-4.56 mıd-0.56 gra-4.70 ly-46.1 mı-5.8 gr 48.1 rbc-4.85 hgb-123 hct-39.5 mcv-81 mch-25.4 mchc-312 rdwc 13.4 plt-430 pct0.37
Answered by Dr. Hema Yadav 19 minutes later
Thanks for the follow up.
The report you have posted is within the normal limits and does not indicate any anemia or infection in the child assuming it is a recent report and the child is asymptomatic .
The next best course of action would be to rule out any cardio respiratory illness ( breathlessness weakness on exertion) or a behavioural problem ( picky eating).
This must have been ruled out by your doctor in case the child has been thoroughly examined physically.
If there are any other symptoms like mild fever or pain in abdomen or constipation kindly mention in detail .
Also mention the onset , duration and dimensions of the white spots as many such spots of hypo pigmentation on trunk may be due to a fungal skin condition like tinea apart from the more common nutritional deficiency causes.
Hope I have answered your query.
Awaiting your response.
Above answer was peer-reviewed by
Follow-up: Child does not eat, feels tired, and has white spots on body 13 hours later
hello again these are the picutres of the rashes

Answered by Dr. Hema Yadav 1 hour later
Thanks for the follow up.
According to the appearance and distribution of the hypopigmented spots on the child's skin the differential diagnosis could be
1.Inflammatory hypomelanosis like pityriasis XXXXXXX .
2. Atopy or skin manifestations of allergy or other immune related disorder.
3. Unlikely , rare but significant problems like fungal infection( tinea ), mycosis fungoides or mycobacterium leprae infection need to be ruled out by thorough physical examination and tests ( eg woods lamp examination ).

Considering your child has a faulty diet habbit , dry skin , atopy or p. XXXXXXX are likely diagnoses which are not very serious problems and might be cured with appropriate treatment . The treatment includes ,
1. Using moisturizers and sunscreens regularly as per dermatologists prescription ( after examining skin type)
2.Local application of prescription strength hydrocortisone ( steroid )cream/ lotion to the white spots .
3. Deworming the child and avoiding any known allergens in diet ( especially eggs , nuts etc)
4. Having a nutritious diet XXXXXXX in iron , and fatty acids and zinc or taking supplements for the same ( like tab mega 3 , cap autrin, fefol , Syp zincovit etc)

I would suggest you consult a dermatologist for the physical examination , confirmation of diagnosis and treatment .
If after a month or two of such treatment if the lesions persist then a skin biopsy would be recommended to know the exact pathology.
Please do not worry , such hypopigmented disorders are common in childhood and many cases resolve on their own over the years with growing age .however considering the widespread distribution of the lesions I suggest it would be beneficial for the child to get it treated right away .

Hope I have answered your query.
Kindly accept my answer in case you have no further queries.
Above answer was peer-reviewed by
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