3-1/2 Twin Son Looks Anorexic

[Nikki]

My name is Nichole and I have 3-1/2 year old twins.  My daughter eats like there's no tomorrow, but my son refuses to eat 90% of the time. He chews his food a hundred times before swallowing and likes to play with his clothes, shoes, silverware, etc., rather than eat.  He does need to have his tonsils taken out, according to his pediatrician, as the opening in his throat is so small.  Could this be why he doesn't eat?  When he was at the pediatricians office, a couple weeks ago, she said he is 75 percentile for his height and only 25 percentile for his weight.  You can see literally see his bones sticking out everywhere on his body.  The doctor said he looked malnourished and wants him to be seen by an Ear, Nose & Throat specialist.  Shouldn't he have some sort of blood work done or some extra testing?  He always looks very pale and acts lethargic.  Please help me.

[janet]

When our daughter was 2 she weighed in at 21 pounds.  She would not eat anything unless it was soft, and even then she preferred to drink her meals.  We took her to an ear, nose & throat specialist because her tonsils were always swollen, she had five episodes of strep in seven months plus she had sleep apnea (snorting & breathing problems).  He recomended her tonsils and adenoids be taken out.  She is now four years old and is eating like a trooper.  Taking her tonsils out was the best thing we ever did.  Before she would not talk and now she talking nonstop.  
Go with what you Dr. is suggesting.  You will notice a big change in him within weeks.

[Kevin Kennedy, Ph.D.]

Dear Nikki,

Children vary considerably in relation to appetite and eating. There's no 'one way' to be normal in this regard.

There's no doubt that your son's physical condition can be contributing to his lack of interest in eating. The act of swallowing is not easy for him. It sounds like your pediatrician is doing a wise thing by referring him to the specialist. He's likely on the right track.

Relative to the lab work, ask your doctor about it. Tell him about your worry; see what he recommends. But remember, he's not ignoring your concern. Rather, he is responding to it in what sounds like a sensible fashion.