At age one, my Nephew had surpassed my almost- two year old in weight, and looking at his skinny little body, people started to raise eyebrows: Did I feed him?
When asked at his 18- months appointment, our Pediatrician didn't seem concerned: "He's in the 75th percentile in height and head size, the 3rd percentile in weight- Some kids are just skinny."
When he hadn't gained weight at his two year appointment, and still no gains three months later, we decided to have further testing performed. Blood tests such as tGT (tissue transglutaminase), which tests for IgA antibody, when elevated suggest a diagnosis of Celiac Disease. Sometimes, these blood tests can come back normal despite having the illness, especially if you have already placed your child on a gluten free or semi-gluten free diet. Try to have the testing done before switching your tots diet- this will help reduce the possibility of receiving a false negative. The gold Standard in diagnosis, of course, is small bowel biopsy that looks for flattening and thickening of the gut lining. This is an invasive procedure, something I do not necessarily want to put my under-weight two-year old through. I asked our Pediatrician if having such invasive testing is necessary. The quick answer is no. If you suspect your child may have gluten intolerance, blood testing is warranted, but if he or she responds positively to a gluten free diet, it's not necessary to have an invasive procedure performed. It is only if the diet seems not to help that your pediatrician may order follow up testing including but not limited to biopsy.
For now, blood testing will be enough, and we will keep him on a gluten free diet.
This however, is often easier said than done- Gluten, like too much Yo Gaba Gaba, is everywhere.