First off, Thank you for all that you do here at IRD!

My son is almost 4. He was born with a birthmark on his right shoulder circular in shape. It was about 2-3 cm at birth. It has grown with him and since become hairy (with darker coarse hairs). It is about 1/2-3/4 in in diameter. I did some research and found something about a hairy Nevi. Do these need to be removed? Is there risk in not having them removed? If removed, is it more of a superficial removal or is it deeper? I know this picture isn't the best but it's the only one I can find on my computer.

Also, Caden has always been pretty petite. He had IUGR but "caught up" the last two weeks in utero and ended up being born at 6 lbs. 12 oz. He is SKINNY though. You can literally see his bones. He has some sensory issues and is high functioning autistic so he goes through some VERY picky eating periods. Would it be okay to supplement with pediasure or boost during these times? If so, how much should he have a day. He is 33 lbs and had waiver between 32-34 lbs for over a year now. Is this normal?

Thanks in advance!

http://img.photobucket.com/albums/v225/munkeesmama/carsparty005.jpg?t=1169021594

Hi,

The hairy nevus should be examined by a dermatologist at some point in the next few years and consideration given to its removal, due to the low possibility of it over the many years having a malignant transformation. How deep, how extensive and what type of removal, if any, would be a question that the derm person could answer.

Pediasure would be OK and a can a day would be acceptable. Does he really need this? If he is healthy in general, he should be fine with the regular food. He is, if he is average for height, in the 23% for weight, making him slender. Over the long haul of life, this is probably a good thing.

Good luck, Dr. Olson