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Quick reference medical handouts used by Pediatric offices

My two year old has developed really dark circles under his eyes recently. My mother suggested that maybe he's not getting enough sleep, and he is a poor sleeper, but no matter what I do he won't sleep more. I've also heard that they could be caused by allergies, but I'm not sure if a child can have allergies at two. He's also not a great eater and I wondered if it could be nutritionally related. Is it something I should be really concerned about and get checked out? Thank you!
Children (and adults too) may develop circles under their eyes for a number of reasons. Allergies certainly can cause one to look somewhat like a "raccoon" if the allergic symptoms are associated with a lot of nasal congestion and runny, itchy eyes; circles under the eyes sometimes become apparent with a sinus infection. Two year old children can have allergies: food allergies, medication allergies, pet allergies,contact allergies, and environmental allergies. Testing for specific allergies in this age group may be difficult as the procedure is somewhat uncomfortable and may not be very predictive at this age; blood testing (RAST testing) might be considered, but a positive blood test does not always mean a child actually has that particular food allergy, unless the child actually has allergic symptoms when he consumes that particular food. If your family has a strong family history for allergies, eczema, or asthma, and if your child has already shown any symptoms of eczema or wheezing, then allergies may be playing a part in your child's "dark circles" symptoms.

Your child's irregular sleeping patterns may be playing more of a part in adults having circles under their eyes that in a two year old child. Irregular sleep patterns are very common among two year olds. There are some wonderful behavior modification techniques that can be used to improve your child's sleeping patterns. You should discuss your child's sleep problems with your pediatrician; the American Academy of Pediatrics just published a wonderful book about childhood sleep problems, which your pediatrician might have, or your could look into getting this book through the AAP web page (, and look under their publications list). Dr. Richard Ferber's book on how to solve your child's sleep problems also is a very useful and popular paperback book which may offer you some help in normalizing your child's sleep problems. Improving his sleep patterns may not get rid of the circles under the eyes, though.

Nutritional problems, such as iron deficiency anemia, could be a possibility. Two year olds may be very picky eaters, and if your child is still not off the bottle and if he is consuming more that 24oz./day of cow's milk and is not eating much else, iron deficiency becomes a distinct possibility. Many pediatricians routinely screen all two year olds for iron deficiency (and lead exposure) at the two year old well child visit (a blood test). If your child has not yet had his two year old well child visit, your concerns about the circles under the eyes, the disturbed sleep patterns, and his nutrition are all matters that should be discussed at that visit. If these issues did not get discussed at that visit, or were forgotten to be mentioned, then book a follow-up appointment to discuss these concerns.


As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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