8 yr old girl with hypotension?

[Anonymous]

My DD woke and after about 20 minutes was trying to eat breakfast.
"Why do I always feel bad in the mornings" she asked me.

Low blood sugar? No, she had milk and a small cookie before this.
Dehydration? She didn't look dehydrated and had drank about 8oz of milk.
high blood sugar? maybe

Then I took her blood pressure and it was 76/49. That's really low.

I looked and there's really nothing to do for low blood pressure. Should I see her ped? what could they do?

[Anonymous]

How did you measure it? Manually? Or with a digital automatic one?

I would question the accuracy at home if not manually with a child size cuff.

[Anonymous]

Did you take the blood pressure with a pediatric cuff? And blood pressure normal ranges are different by age. So if you are concerned I would take her to the pediatrician's office for an accurate measurement- I prefer if a manual BP is checked by an experienced nurse/tech along with a machine measurement.

https://pediatricassociates.com/parenting-tips/what-is-the-normal-blood-pressure-for-a-child/

Feeling "bad" in the morning is reasonable to investigate with your peds but I would not attribute it to low BP off a home cuff measurement- it could be allergies, apnea from tonsils/adenoids causing poor sleep, anemia, etc - it's a vague complaint with a broad differential diagnosis.

[Anonymous]

Has she had covid?

[Anonymous]

Anonymous wrote:Did you take the blood pressure with a pediatric cuff? And blood pressure normal ranges are different by age. So if you are concerned I would take her to the pediatrician's office for an accurate measurement- I prefer if a manual BP is checked by an experienced nurse/tech along with a machine measurement.

https://pediatricassociates.com/parenting-tips/what-is-the-normal-blood-pressure-for-a-child/

Feeling "bad" in the morning is reasonable to investigate with your peds but I would not attribute it to low BP off a home cuff measurement- it could be allergies, apnea from tonsils/adenoids causing poor sleep, anemia, etc - it's a vague complaint with a broad differential diagnosis.

Thanks for this. She is also very thin (in the teens on the weight chart).

The BP was with an at-home adult wrist cuff that I "normed" at the doctor's office with my other child who takes ADHD meds. I am going to track it and am also going to reach out. If she's got an endocrine issue, that could explain a few things.

Thanks all.

[Anonymous]

My DD told her ped about sometimes feeling dizzy when she gets up quickly, and her doctor said that benign, orthostatic hypotension is very common in prepubescent girls for a variety of reasons, one of which was that their BP is usually already low. Not sure if that helps since you seem to be dealing with different symptoms, but figured I would add.

[Anonymous]

Anonymous wrote:My DD told her ped about sometimes feeling dizzy when she gets up quickly, and her doctor said that benign, orthostatic hypotension is very common in prepubescent girls for a variety of reasons, one of which was that their BP is usually already low. Not sure if that helps since you seem to be dealing with different symptoms, but figured I would add.

Yes. I fainted quite a bit as a teen...12-16 and got a pretty bad concussion once, broke a glass in a bathroom another time...but 8 seems too young for that. I think the reason is that the body grows faster than the vascular system and the blood flow can't keep up for awhile. She's not growing super-fast as far as I can tell. In fact, she was "tall" at the beginning of the school year but is now "short" compared to the same classmates.

Thank you for noting that though. Maybe she is growing and the spurt just started.

[Anonymous]

Anonymous wrote:My DD told her ped about sometimes feeling dizzy when she gets up quickly, and her doctor said that benign, orthostatic hypotension is very common in prepubescent girls for a variety of reasons, one of which was that their BP is usually already low. Not sure if that helps since you seem to be dealing with different symptoms, but figured I would add.

Was coming to post this. Is she growing a lot? When they grow their blood pressure goes down because their bodies have outgrown the volume of blood. (Clearly I am not a doctor but that’s the gist.)

[Anonymous]

I had significant orthstatic hypotension as a teen girl and through my 20s. What helped was seeing a cardiologist who actually recommended I eat more salt.

By the way, the growth spurt thing is not real. It's an urban myth. Think about you giving blood. Your blood volume returns to normal fairly quickly--usually around 24 hours. Your child is not growing fast enough to outpace that.

[Anonymous]

Anonymous wrote:I had significant orthstatic hypotension as a teen girl and through my 20s. What helped was seeing a cardiologist who actually recommended I eat more salt.

By the way, the growth spurt thing is not real. It's an urban myth. Think about you giving blood. Your blood volume returns to normal fairly quickly--usually around 24 hours. Your child is not growing fast enough to outpace that.

OP here;

I've started upping the salt in her diet. Clearly can't hurt.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had significant orthstatic hypotension as a teen girl and through my 20s. What helped was seeing a cardiologist who actually recommended I eat more salt.

By the way, the growth spurt thing is not real. It's an urban myth. Think about you giving blood. Your blood volume returns to normal fairly quickly--usually around 24 hours. Your child is not growing fast enough to outpace that.

OP here;

I've started upping the salt in her diet. Clearly can't hurt.

WHAT? It can hurt. Salt is very bad for you.

[Anonymous]

Anonymous wrote:I had significant orthstatic hypotension as a teen girl and through my 20s. What helped was seeing a cardiologist who actually recommended I eat more salt.

By the way, the growth spurt thing is not real. It's an urban myth. Think about you giving blood. Your blood volume returns to normal fairly quickly--usually around 24 hours. Your child is not growing fast enough to outpace that.

Multiple pediatricians and specialists have told us this; it is not a myth.

[Anonymous]

My BP is usually around 80/40 and I feel great in the mornings. I am an early riser. I don't see a connection here.

[Anonymous]

Anonymous wrote:My BP is usually around 80/40 and I feel great in the mornings. I am an early riser. I don't see a connection here.

Maybe she's not a morning person and you are trying to medicalize this.

[Anonymous]

I am a pediatrician and I can tell you there is no medical science behind hypotension and a growth spurt. Without being seen by a doctor there is no way to diagnose if there is a medical issue. It could also be a lifestyle issue, or she simply isn’t a morning person! However, I have several colleagues whom I hear float the idea of tiredness and low BP related to a growth spurt. Even though there is no medical science to prove it, there are still lots of unknowns. Some doctors believe this theory to be true, others believe it eases parents minds in the absence of an actual medical diagnosis.

If she feels this way every day, it’s worth an evaluation to potentially rule out a medical issue, and for piece of mind.

P.S. - There is medical science behind the negative affects of too much sodium in the diet, especially in children. Do not purposely increase sodium intake without a medical recommendation.