Toddler Has Celiacs?

[JJmom]

my 2 yr old has always been small. she was born at 37 wks 4 lbs never on the growth chart. She's 27 mos and weighs 20 lbs and is 30 inches tall. Her general pediatrician sent her first to endocrinology PEDs - all those tests came back normal, then they sent her to a gastro ped and they did an endoscopy and found "minimal blunting" of villi but all bloodwork came back negative which I know is not reliable at this age. We have gone gluten free for almost 4 months now but have not noticed ANY improvement in her weight gain or appetite. She never had any classic celiac GI symptoms like diarrhea or vomiting, only constipation and poor weight gain (again she's always been small) and was never a good eater even with her formula as a baby. Other than the "minimal" blunting of villi, the endoscopy did not show anything out of ordinary (like reflux or anatomical obstruction that would cause pain for to not like eating which is what they were originally thinking). My question is could there be a mis-reading of the biopsy by pathologist/gastro dr? Also can something else have caused the minimal blunting? Shouldn't we SEE some improvement by now if gluten is the culprit for her lack of weight gain and meager appetite?

[tarnalberry]

Assuming you have removed all sources of contamination (sneaking crackers from other kids, other care providers inadvertently feeding gluten, commercial playdoh, access to grain-based pet foods, shared kitchen equipment like toasters, shared condiments like peanut butter, and so on), then yes, I would expect to see improvement (not necessarily complete, of course) in a 2 year old. Are you certain there is no cross contamination?

Rarely, casein can cause the same problem - damaged villi and weight issues. Unless you used a special, expensive, formula that broke down the casein, or used a soy based formula instead, and if she's now consuming dairy, that is a (again, rare) possibility. As a parent of a toddler, it'd probably be the next thing I try, myself. And then other food and environmental issues.

But I wouldn't stop working with the doctors in case there is something else going on.

Is there any family history of celiac disease?

[JJmom]

We have removed all gluten in our house. Daycare confirms all gluten-free and they are super careful when it comes to food allergies because of the legal liability that's what they told me and I have observed them during their lunch times it is gluten free. Toddler still has constipation and not a great eater. She's been at 19-20 lb mark for almost three months (she fluctuates when she gets a cold and doesn't want to eat).

Gastro PEDs dr wants to do another scope to see if there's been any healing but how can there be if no symptons have improved?

[Ollie's Mom]

I know the daycare is saying they're being careful (and I am sure they're trying) but trust me, your daughter is definitely being exposed to cross contamination. If there are other kids in the same room eating gluten foods, there are crmbs everywhere. And my son has been known to snatch bits of crackers and cookies off the floor and pop them in his mouth in a few nanoseconds. And playdough is a staple at those places.

If we have him home for a week or more, we see significant improvement in his bowel movements.

Could you take a week or two and keep her home to completely control her food intake and environment?