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Premature child has asthma, lazy eye and developmental delay. Which specialist should I consult?

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I have a concern about a child at the preschool where I work. He's not presently in my class, but I've worked with him in the past, and I have a lot of history with him. I've been tracking his progress even now. He was born very premature, 24 weeks. He is much smaller than other children his age, he has asthma, lazy eye, and some delays in his development. He's been progressing really well on that last one. All of last year, none of these health issues ever seemed to be an issue. He never missed a day of school, and he was always highly active. LNow, his health seems to be declining. Last fall, he had an asthmatic cough that dragged on a while. More recently, he's been out a few times for illnesses in the past month and a half. He's had a few short illnesses that help him out a day or two in that time. I've been concerned about the frequency. Also, he had a cold sore that quickly developed into a cluster of cold sores (not his first incident with cold sores) Most recently he missed school Friday. I inquired, because I'm concerned about the frequent absences that are so out of the ordinary for him. I was told he was out because he had an appointment with a neurologist. Apparent;y, there was some recent incident (don't know specifics) and when his Mom described it to the Doctor, the doctor said it might have been a seizure and referred them to the neurologist. He was doing so well, now his health is declining. When he is in school, I can't put my finger on it, but he seems diminished somehow, not quite himself. What could be happening to him? Could it be cancer? What could he have? Is there any chance he could survive and be his old healthy active self again? I've been beside myself with worry.
Posted Sat, 23 Mar 2013 in Growth and Development in Children
Answered by Dr. Sumit Bhatti 58 minutes later

Thank you for your query.

1. I am assuming that the child is over 3 years old as he is attending preschool classes.

2. It would be worthwhile to exclude adenoid hypertrophy as a cause for the frequent respiratory infections, cough and asthma.

3. The exact cause and conditions (whether maternal, fetal or related to the pregnancy) leading to his premature birth and any associated syndrome will determine the prognosis.

4. There is a ongoing development of the brain and nervous system in the first three years. Premature children are prone to neurological changes and many other problems. Brain scans and other tests will help the Neurologist to locate the cause, a common one being fresh bleeding in the brain.

5. The exact cause and type of the seizure (drug related is a possibility) will determine the treatment (which is usually medical) and the subsequent control of the epilepsy.

6. The chances of cancer are low. The list of possible problems with preterm babies is exhaustive and beyond the scope of this answer.

7. Since he has done well over the years, his chances of survival and becoming well again are bright.

Hope this answers your query. Should you have any additional concerns, I will be glad to assist you further.

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