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Forum Name: Pediatric Topics

Question: 14 month old with multiple infections and motor delay


 kimmad - Sun Oct 14, 2007 4:16 pm

I have a 14 month old son with a history of various illnesses. I have a 'gut feeling' that there is some underlying condition and trying to figure out the best specialist to go to that will help me get some answers. I want to note that this is my 3rd child, so I'm not a nervous new mom.

At birth, he was diagnosed with a severe case of GERD and laryngiomalacia. He's been on 15mg Prevacid per day since 2 months (7.5 mg BID) as well as Zantac 3x/day. This has seemed to control the acid, and he no longer has a stridor.

Consistently, he has been congested, and has been diagnosed with sinusitis & AOM several times. Each time he was put on an antibiotic, the congestion clears, he has less mucus, and I have a happy baby. Consistently each time he completes it, the congestion returns full force.

Other illnesses: pink-eye, which turned into yeast diaper infections, RSV, which turned into bronchiolitis with wheezing and required a nebulizer, severe adenoid hypertrophy which required surgery at 10 months (he also had tubes put in his ears at that time), allergies, gross motor delay (because of the GERD), Gastroparesis, Coxsackievirus, tonsilitis.

He also has dysphagia and can only tolerate and swallow purees.

Today, he developed oral thrush.

I'd like to get an outsider's opinion. Any thoughts would be greatly appreciated.
 Dr. Chan Lowe - Sun Oct 14, 2007 7:15 pm

User avatar Hi Kimmad,

Initially in hearing all these illnesses my first thought was that this sounds like a normal 1 year old. 1 year olds get an average of 12-15 infections per year. The infections you are describing sound like typical child illnesses.

You may want to consider having him evaluated by a developmental pediatrician for his gross motor delay to see if there is anything more to this.

The surgeries he's had (tonsillectomy and ear tubes) are quite uncommon for a child of this age. Because of this I am presuming that these infections have been fairly severe. If there is concern about a possible immune problem I would recommend he see an immunologist.

Also, if your child's primary care doctor is not a pediatrician I would suggest you consider changing to a pediatrician if possible. Pediatricians have more experience treating chronic illnesses in children. In general, my recommendations are to be conservative with children at this age since most problems they'll grow out of. We don't want to do harm to them while treating something that will go away eventually anyway.

Best wishes.
 kimmad - Sun Oct 14, 2007 9:50 pm

Dr. Lowe,
Thank you for your quick reply.

We do see a pediatrician only, believe me, I've seen more of them than I care to! I probably should have mentioned that he received PT for the motor delay and is now right on track, and beginning to walk. We are working on OT for the swallowing problems.

He only had adenoidectomy/tubes because his adenoids were completely blocking his airway, causing him to have problems breathing through his nose. He also had a great deal of fluid in his ears, and the infections were becoming antibiotic resistant. Obviously, we saw a pediatric ENT for that, and did agree that while he was young, it would help. Unfortunately, haven't seen much help yet (although he has only had one ear infection since the tubes).

The thrush bothers me because I know it's uncommon for babies over 6 months or so to get it. I have always associated this with an immune deficiency. We just had some blood drawn for RAST testing and immune testing, after seeing the allergist/immunologist. We're waiting for the results.

His file at the pediatricians is larger than both of my other boys combined. I have been in and out of all kinds of specialists offices trying to figure out why he is always sick - ENT, GI, Allergy, etc. He's been poked and prodded so many times, he's actually used to it. I didn't know if there was something I'm missing.

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