My son, aged 3½, seems to have no sense of smell. I recently asked him to compare some smells, but he got frustrated and gave inconclusive answers. Should I be concerned? Or is smell simply something that develops more slowly in some children than others? Name and address supplied
I’d be surprised if your son had no sense of smell at all. It’s unusual for a child to be born without a sense of smell. How this sense develops through childhood though is not fully understood and may vary from child to child.
Smell is carried via the lining of the nose to small nerves sitting at the top of the nose, which in turn are carried through tiny holes in the base of the skull to the areas of the brain responsible for controlling smell. There can be physical reasons for not being able to smell properly. As anyone with a cold will know, smell can be affected when the nose is blocked. Any swelling of the nasal lining will affect its ability to carry messages to the nerves responsible for conducting smell.
I suspect that your son can smell but finds it difficult to describe what he’s smelling. For adults, there is a standard method of formally assessing smell using a variety of “scratch and sniff” type cards. But there is nothing of this sort available for children.
You could test him at home by tracking down a strong smell, such as coffee, and seeing how he responds.
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There are some rare conditions linked with no sense of smell; your GP will be able to discuss these with you further.
Baby’s weight
My seven-month-old baby is failing to gain weight and since she was one month old she has been gradually dropping down the weight charts. She was 7lb 1oz at birth and now weighs 13lb. I have been advised to put cream in her solids to provide extra calories but feel uneasy about it. Would you advise this? Jan Hannant, Sheffield
It’s normal for babies to cross the weight centile charts in the red child-health record book. A small movement up or down the centile charts is not uncommon. Your daughter, though, at 7lb 1oz, was on the 50th centile, an average birth weight. She has now fallen to below the bottom line of the charts so I think this is a cause for concern. Ask your GP to refer her to a paediatrician to rule out any underlying medical problem that could be causing her poor growth.
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In most cases though there isn’t a medical reason for poor growth. Most babies, however, gain weight slowly because of a low dietary energy intake. Perhaps your daughter is a poor feeder? At seven months she should be taking either five to six breast feeds a day or about 700ml (24oz) of infant formula plus two to three small meals.
For her weaning diet it’s important not to give foods that are too low in fat. Babies who are growing fast need quite a bit of fat in their diets and it would be inappropriate to give her only plain fruits, vegetables and potatoes, low-fat yoghurts or desserts. If the foods that you would like to give your baby are naturally low in fat, add cream, butter, margarine or a vegetable oil such as olive oil for extra energy. This is often recommended and is perfectly safe.
There are also two highenergy baby milks on the market in the UK which contain more energy and additional nutrients, compared with standard formulas, and have been designed for babies whose growth is slow. They are available on prescription but can also be bought over the counter on the recommendation of a healthcare professional.
Inherited colitis?
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I recently lost my husband at the age of 28 from cancer, which developed as a complication of his ulcerative colitis. As far as I am aware he is the only member of his family to have had this. I am concerned about whether our children, aged 2 and 4, might be at higher risk of developing this disease. Should they be tested? Name and address supplied
I am sorry to hear about your loss. Ulcerative colitis is a disease of the large bowel in which the lining of the intestine becomes inflamed. Rectal bleeding, bloody diarrhoea and abdominal pain are the most common symptoms. It can be fairly mild, or severe, as was the case for your husband.
While ulcerative colitis can run in families, it doesn’t tend to follow a predictable pattern. It would be impossible to give you a statistic as to how likely your children are to develop the condition. Also, unfortunately, the precise genetic cause has not yet been identified. There is a great deal of research in this area though. For other related conditions, such as Crohn’s disease, genetic causes have been identified but work in these is still in its infancy.
The majority of childhood cases do not develop any symptoms until at least the age of 8. There aren’t any tests they could have now, but if symptoms develop later, a blood test might give a clue if the condition is present, which could be confirmed with an endoscopy.
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Jane Collins is the chief executive and honorary consultant paediatrician at Great Ormond Street Hospital
OVER TO YOU
E-mail Dr Jane Collins at drjane@thetimes.co.uk or write to her at Body&Soul, The Times, 1 Pennington Street, E98 ITT. Please include your name, address and telephone number. Dr Collins cannot enter into individual correspondence.