Hard Lumps on Your Baby's Legs: When to Seek Help

The baby has hard lumps below the knees on both calves?

Hello, Dr.
Hsiao.
My baby is currently 11 months old and I have noticed hard lumps on both sides of his feet.
Sometimes, after mosquito bites, there is an additional swollen lump, and there are also dark pigmented spots where the mosquito bit him.
Should I take him to see a doctor? There are also lymph nodes behind his ears.
When will these disappear? His sleep has been poor; he wakes up crying several times at night and only goes back to sleep after nursing.
Why is this happening? His milk intake has always been low, only about 150 ml, and recently it has decreased even more, but he is eating solid foods correctly.
Is this a sign of milk aversion? Thank you, doctor.

Joyce, 20~29 year old female. Ask Date: 2013/11/30

Dr. Xiao Kaiwen reply Pediatrics

If there are hard lumps below the knees on both sides of the calves and they are symmetrically located, it is usually considered normal.
Consultation with a pediatric orthopedic specialist or pediatric rehabilitation specialist is advisable.
Infants have relatively more sensitive skin compared to adults, and they may have a stronger reaction to insect bites.
Lymphatic tissue will gradually increase until puberty and then will naturally decrease and disappear; the absence of inflammation or malignancy is normal.
An 11-month-old infant has reached a certain level of neurological development and may experience nightmares during sleep, which primarily requires reassurance.
A decrease in milk intake alongside the introduction of solid foods is normal; if the infant's activity level and growth are normal, it is likely just a benign phase of milk aversion, and observation is sufficient.

Reply Date: 2013/11/30

More Info

When it comes to hard lumps on your baby's legs, it's essential to approach the situation with caution and awareness. At 11 months old, your baby is still in a critical developmental stage, and any unusual physical symptoms should be monitored closely.
From your description, it seems that the hard lumps you feel on your baby's legs could be a result of various factors. One possibility is that these lumps are lymph nodes, which can become swollen in response to infections, such as a mosquito bite or other minor infections. Swollen lymph nodes are common in infants and usually indicate that the body is responding to an infection. They can feel firm or hard and may be accompanied by other symptoms, such as redness or warmth in the area.
If the lumps persist, grow larger, or are accompanied by other concerning symptoms—such as fever, persistent crying, or changes in behavior—it would be wise to consult a pediatrician. They can perform a thorough examination and determine whether further investigation is necessary.
Regarding the dark pigmentation you mentioned after mosquito bites, this is often a normal response to skin trauma. The skin may darken as it heals, and while it can be alarming, it typically resolves over time. However, if you notice any changes in the color or texture of the skin that seem unusual or if the area becomes increasingly painful, seeking medical advice is recommended.

As for the lymph nodes behind your baby's ears, these can also swell for similar reasons. They may take some time to return to their normal size after an infection has resolved. If they remain swollen for an extended period or if you notice any other symptoms, such as difficulty swallowing or breathing, it is essential to consult a healthcare professional.

Regarding your baby's sleep issues and feeding habits, it is not uncommon for infants to experience sleep disturbances, especially around this age. Babies often go through phases of sleep regression, which can be triggered by developmental milestones, teething, or changes in routine. If your baby is waking frequently at night and only settles down with a bottle, it could indicate a reliance on feeding for comfort.
It's also worth noting that a decrease in milk intake can be concerning, especially if your baby is also eating less solid food. This could be a sign of a feeding aversion or "nursing strike," which can occur for various reasons, including teething discomfort or illness. If your baby is refusing to eat or drink adequately, it is crucial to consult a pediatrician to rule out any underlying issues.

In summary, while some of the symptoms you describe may be common in infants, it is always best to err on the side of caution. If you have any concerns about the hard lumps, changes in your baby's feeding habits, or sleep disturbances, do not hesitate to reach out to your pediatrician. They can provide guidance tailored to your baby's specific situation and help ensure that your little one remains healthy and happy.

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