I was curious about anyone's history with failure to thrive. What course of action did you take once diagnosed? Was there a hospital stay involved? Assuming time has gone on how are they doing know? Or how long were they continued to be labeled as failure to thrive?
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So I haven't had a child with FTT, but I used to be a pediatric RN in a children's hospital and we frequently had children with this. Basically what we did was have scheduled feedings with higher calorie formula mixtures, usually 22kcal or 24 kcal, sometimes with oatmeal and sometimes with coconut oil. If it were an older child, we would have to use an NG tube to infuse tube feedings to the child continuously or as a bolus feeding. This was after doing a 3 day calorie count of everything they ate with high calorie foods. How old is your LO? What is going on with them, if you don't mind my asking?
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Failure to thrive is more of a label than anything else. It took my son nearly 4 years to get on the growth chart but he's there now, although still not 30 lbs! The doc was more concern d with progress than the actual number. We did try pdiadurr around age 1 but it made him puke so we quit and added addional powdered milk to his regular milk for a long time. We've done occasional protein drinks or mills but too much is constipating. Overall our son is totally fine. (FTT) probably due to being a micropreemie, 25-weeker.
As a baby he ate 24cal fortified milk. We used a combo of breast milk and formula.
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Ok! I have just gone through this. My daughter was 7 pounds at full term birth. I exclusively breastfed her, and I had no trouble with my supply. At 6 months she had dramatically fallen off the charts for weight. My doctor knew me, and knew that I wasn't depressed, or abusing her, or anything like that, so he mostly focused on organic causes.
They did a lot of expensive testing and never found anything wrong. I was encouraged to feed overnight and to push high fat foods, but not discouraged from breastfeeding.At 9 and 12 months she was still off the bottom of the chart, but she was growing somewhat. At 14 months I decided that I was sick of nursing her, and we weaned. After that, her food intake predictable increased, and she started drinking several cups of whole milk each day. And that was it - she got back on the curve, and now weighs more at 20 months than my older daughter did at 2. She's still very petite, but so am I.
I can see now that it was a problem with breastfeeding. She was a bad nurser, and I hated nursing her. I don't think she was ever getting quite as much as she really needed, even though she never complained. She's also very, very active, so she was clearly just burning more calories than she was taking in. But even now at 20 months she still drinks 2 cups of milk between bedtime and waking in the night, so she's clearly still catching up. And she's still highly active.
FTT is hard, because there is usually something the parent is doing to contribute, even when they're trying their best. So you just feel awful, even when you're doing your best. I was lucky to have a great doctor who knew my family well, but I would not have hesitated to find a better one if I hadn't cared for the way I was being treated. Be sure to advocate for yourself if you feel like you need to.
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My oldest was considered FTT. He was born under 6 lbs and by 4 months has fallen off the chart. It took a while to figure out but he has MSPI and started refusing to nurse. Even after I adjusted my diet we struggled with nursing and he flat out refused bottles. I don't think it was a supply issue because I could pump plenty and we offered more milk after he would nurse but he never took it. We introduced cereal at 4 months and then higher calorie breast milk (added formula to his milk). We had so many weight checks and nothing seemed to help. We saw a GI doctor and had a lot of blood work that showed nothing. At 2.5 years he had an upper endoscopy which showed nothing. He just doesn't eat much and is super active. It's funny because we have DH's records as a baby and LO1 grew at the same exact rate but was 3 lbs heavier at birth so it was never an issue. At 4.5 he is about 32 lbs and still super skinny. We have 2 younger LOs who grew at the exact same and slower rate as babies. Our second is a great eater and not as active so his growth has really picked up in the last year. Our youngest is only 6 months so we will see but he is also rather uninterested in food. Neither of them have been labelled FTT because they were born bigger and didn't fall off the chart even though the growth was no better.
Sorry no advice, just our experience. -
@Mrs.Panda: @Mrs Green Grass: @sarac: @skipra: thanks for responding! I was waiting to have some before basically writing out my life story. Ha!
I was also tiny growing up. I've seen my medical records and every visit the dr would tell my mom to feed me fattier foods. When I was pregnant with dd and measuring small they ordered extra ultrasounds, but she was born just under 7 lbs. she's always been tiny and while always gained weight dropped in percentiles. She's had a ton of weight checks but didn't hit the 0%ile till she turned 2.
DS is 5 months and even tinier than dd was, plus he's a boy so his %iles are smaller. At 4 months he was down to the 0%ile. We increased his bottle size (of breast milk) and a week later when I went to the dr because I thought he had the flu had gained 11ozs (but with clothes on).
2 weeks later after being on tamiflu and being sick he lost a couple ounces at his weight check. Although they weighed him with clothes off.
Yesterday we went to a pediatric Gi (and he gained about 8 ounces from that last weight check last Thursday), but was officially labeled ftt. We're tracking food the next 3 days so they can do a calorie count then going back in Monday. Based on his weight gain they might hospilize him at that point.
I will say that even those he's tiny he's on track with all his milestones. He really is the happiest, most content baby. I just think sometimes if he's not hungry he's doesn't want to eat, and he's he's so content if he actually is hungry he doesn't get upset. I know this was definitely a novel, so thanks for reading along!
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@Miss Ariel: I don't have helpful advice, but was waiting until you got some to chime in that I'm right there with you. DD3 was an IUGR baby, came home from the hospital at around 4.5 lbs, and is currently just under 10 lbs....she's six months old next week. Like your baby, she's meeting her milestones, but is gaining very, very slowly. She's still below the growth charts, and her pediatrician doesn't expect her to hit them until at least 2 years old. Her current doctor isn't labeling her FTT yet (I'm confident that with her old one, we would have been in the hospital ages ago for some more intense interventions, which is one reason we sought a second opinion), but we are going to see a pediatric GI next week. I was supposed to start her on solids, but she's been spitting out everything I offer. We may end up going back to beefing up her breastmilk bottles with formula to get it to 22 or 24 calories/ounce, the way we did when she was a newborn. Like your baby, she meets all her milestones and is a chill, happy, social kid....so I'm trying not to worry too much!
Also similar to you, my older daughters both started out below or at the bottom of the growth curves (born around 5.5 lbs each). DD2 is now almost three and very much average size for her age, and an awesome eater. DD1 didn't hit the growth curve until around 3.5, but at nearly 5, she's solidly on it - maybe 10-15% for weight and about 40% for height.
Fingers crossed for you - 8 oz in a week sounds AMAZING! At DD's last weight check, I think she'd gained more like 12 oz from the previous MONTH! Now I've written a novel too, but just wanted you to know you're not alone in this!
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We can't edit posts anymore? Sorry for all the typos in mine! The worst typo was pediasure...that's what we tried at a year.
Why would your son need to be hospitalized? Do you do any bottles? Can you fortify your milk to get a few more calories in? My son had severe reflux and never ever ate more than 19oz in a day. Even though I was stressed our doc did a good job of not stressing!
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@Mrs Green Grass: we normally do bottles at daycare and nurse at home. But to be able to track exactly how much he's eating these next few days I'm supposed to pump and feed everything through a bottle. I will say I'm burning through my frozen stash already, which may be part of the issue, since maybe he's drinking more through a bottle than nursing? But at least today there were 3 bottles where there were 1 or 2 ounces he didn't drink so it's hard to say.
I think for hospitalization, I didn't ask for specifics, but probably should have. I think it's more if they can measure how many calories they think he's getting and the weight gain is drastically less they would.
One thing the dr mentioned, which is the first I've heard about why being small is a potential issue, is that in case he were sick his body doesn't necessarily have the fat store to be able to fight it off.
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@PinkElephant: I do know that he gained less than a pound from 2 to 4 months, so I definitely agree 8 ounces is really good comparatively. (Although it may actually been closer to 5, but still, not bad.)
One interesting thing of note, was that at ds's 4 month visit our Doctor recommended delaying solids since he would get more nutrients from milk and would potentially nurse less. But the Gi Doctor said instead to start solids asap. He recommended something with meat (even noting he wasn't yet 6 months when you normally start, but was close). So ds's first food is now officially chicken and gravy!
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LO was FTT. She was born full term at 8 lbs. I nursed for two years and did baby led weaning around 5 months old. She started dropping off charts around 6 months if my memory serves me correctly. I was concerned bc the doc was concerned. However, she is part Asian, which is generally more petite than the growth charts and my husband and I had constitutional growth delay, according to LOs allergist, which is basically that we were the smallest kid in our class until late puberty. DH is now 6'2"and I am 5'6". We couldn't ignore FTT though and make an effort to give her superfoods and a well balanced nutritious diet.To this day, if she says she is hungry, we jump. Aside from FTT, she got sick frequently from 2 to 3 so every pound she gained would come off when she was sick. It was probably the most challenging thing.
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My husband was FTT. Just to ease your mind, he is about 5'9" and muscular build with absolutely zero deficits, other than selective hearing loss (by that i mean he miraculously loses his hearing when I talk to him)
He had some illnesses growing but but a lot of those were related to living in third world countries (he was born in the US). He is never sick now. -
@Littlebit7: that is good to hear! I think dh's biggest concern with this is that ds won't be a mlb pitcher. Ha! So it's great to here from someone where there weren't really long term impacts.
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@Miss Ariel: The fat store issue is what really concerned me. My daughter was growing lengthwise, her head circumference was increasing normally, and she was hitting her milestones early. But not having the fat reserve was really stressful. And then we all did get a stomach virus, and she barely ate for a week, and I worried about that quite a lot.
If you're just getting started with solids, you've got some time, but make sure to research high fat foods. My daughters eat eggs cut with whipping cream, whipped cream on berries, dark chocolate (the darkest kinds aren't very sugary), toast with butter, pasta with tons of olive oil, entire avocados. Etc etc. Any high fat, high calorie food I can feed them while still trying to get them a balanced, low sugar diet. It really helped my baby, eventually.
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I think DH was FTT. He was normal weight at birth but gradually fell off the charts. He has old medical records showing all sorts of tests that they ran on him as a child. In his case, he just grew slowly. He wrestled in high school so he remembers that as a freshman, he had to eat/drink a ton just to qualify into the very lowest weight bracket. He didn't grow into his full height (5'5") until well into high school. He's perfectly normal and healthy now.
My kids have not been FTT but I do worry that this label will end up applied to them as they are both naturally very small. DS is 4 months and has been consistently 10% for weight since birth, so his growth can't really slow much without triggering it. DD started at 50% for height/weight as a baby but has been consistently been going down each year and at her 3 year appt, she was down to the 10-20% range.
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@sarac: he's just starting solids so we're not there yet, but I think some of those ideas would be great for dd's. She isn't ftt, but did hit the 0%ile as well at her two year check up. We do avocados a lot, although in general we don't really cook with a lot of cream or butter. But I do think she'd appreciate berries and whipped and it might be fun to try.
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Also as a general update, daycare called today because he's wasn't feeling well. He felt warm but never actually developed a fever, but the breaking point was when he wouldn't eat his 1pm bottle. I took him to his pediatrician and turns out he has a double ear infection!
I called the Gi Doctor to see what he wanted to do, and they pushed the follow up appointment and calorie count back a week, so hopefully he's feeling normal by then.
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@Miss Ariel: I don't cook with butter much either - I can't handle it. But I'd totally suggest looking into all the ways you can add fat to the food you make. I try to use plant fats whenever possible, because those are easier on my stomach.
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@Miss Ariel: my Dh was also FTT but is an athletic 6'0"!!
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Mrs Chocolate wrote about her experience. http://www.hellobee.com/2014/02/11/failure-to-thrive/
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My 24 year old son was FTT, he was born at 7# 1oz . He was unable to Breast Feed but I did pump and feed EBM when he was not gaining weight we added cal to the EBM with powdered formula and oil. At a year he was only 11 #, he was taking in more than enough calories and not gaining weight. Lots of time in the hospital and lots of testing. We ended up getting an NG tube so that we could have continuous feeds overnight plus eating normal during the day. We then placed a G Tube until he was eight years old. He had a high metabolism , and celeac disease. He is still not big 5' 10 and 124 lb. He can eat anyone under the table.
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