Just another suggestion - do you have any friends with kids that you could have lunch/dinner with? I find that Evan eats way more at daycare with his peers or at a friend's house because he wants to copy a four year old.
This is a good idea! Owen eats WAY more and a way bigger variety at DC than he does at home. I don't even want to think about how much smaller he'd be if he didn't eat well (relatively) there.
GL with everything. I hope the LC can provide some good guidance.
Are there any foods she really likes? What are her favorite things? Maybe you can start giving her extra of those types of foods and go from there, while you slowly decrease the boob snacking time.
I think her number 1 favorite foods are blueberries and cheese. But when she wants boob she will refuse anything. So that tactic hasn't worked. I just nursed her at 10:30 when we got home and she already wants to nurse again. So I got up from the couch and she is chasing me around the house clawing at my legs and crying. But shakes her head and runs away if I offer solids.
C25K...it works Seaside 5K...........40:45(2012) Turkey Trot..........41:30(2012)/37:08(2013)/37:40(2014) St Pat's 5K..........39:27(2013)/38:48(2014)/35:12(2015) Belair Town Run......38:09(2013)/36:27(2014) Back To Football 5K..37:36(2013)/43:44(2015) Balt Run Fest 5K.....34:59(2013)/41:50(2014)/35:54(2015)
Post by UnicornDog on Jul 30, 2013 10:02:44 GMT -5
I'm so sorry you had such a scary appointment. I am also enraged reading some of it.
I personally would be concerned that since the pump gets less milk out than a child, she would actually end up getting FEWER calories if you EP. WCM has fewer calories than BM, and while the nutritionist will help you get more calories into her diet in general, it seems like initially her calorie consumption might decrease, and that makes me feel like some of this might be a knee-jerk reaction from the doctor and not carefully thought-out medical science.
I think that whatever you end up deciding to do with your milk, you should get a second opinion. Anything that would prompt a doctor to suggest hospitalizing a child is serious enough to warrant a second opinion. If another doctor takes a less alarmist stance, then you don't have to go through the ordeal of forcing her to wean. If the other doctor says you must get her off the breast, too, then perhaps it really is necessary. I have to think there is some happy medium, though. I hope the nutritionist has some ideas that perhaps the doctor hadn't thought of that are less drastic but equally helpful to her.
Maybe you could get her on some kind of schedule where you deny her the breast, but only within the hour or so before a mealtime or something? If you aren't already doing that, I have to think that cutting down on her snacking right before meals would leave her hungrier for food but be easier on her than total breast denial.
Post by biblionerd on Jul 30, 2013 10:04:42 GMT -5
I am so sorry you're going through this. I cant imagine how frustrating and lost you feel. I am not a medical professional, but worked on a GI unit in a children's hospital. A peds GI is who you need to speak with ASAP. They will work in conjunction with a nutritionist. I would not solely see a nutritionist and LC. They are obviously necessary to support whatever treatment plan you guys have or come up with, but with an actual FTT diagnosis you need to see a dr. I wouldn't even bother with a 2nd pedi opinion- just go straight to the GI. There are MANY reasons that can be causing ftt, aside from just snacking. Has she been tested or checked for any GI conditions or issues with malabsorption or anything g of the like? This is something that is to territory and is their expertise. You know you have an issue now, so all you can do is move on with it and stay strong!
The drs are not insulting you. I can't imagine how hard it is to sit and hear, but theyre trying to fix Peyton's issues. There is a difference between being small and ftt though. If they truly believe she is not thriving and is going to potentially suffer medically then it's their job to do all they can do to fix it. I'm not saying I agree with them though, just not to take it personally. I am NOT anti-bf'ing, BUT your overall feeding situation isn't working for her, and that's ok. It happens. But you just need to speak with someone else who can set you guys on a new path! She might need to be cut off the boob and you pump. If she's refusing food because she'd rather bf, then it could be causing an issue. There are MANY other ways to comfort her though. Do not feel like (if that happens and you EP or whatever) that you are depriving her of something. You've done great!
Are there any foods she really likes? What are her favorite things? Maybe you can start giving her extra of those types of foods and go from there, while you slowly decrease the boob snacking time.
I think her number 1 favorite foods are blueberries and cheese. But when she wants boob she will refuse anything. So that tactic hasn't worked. I just nursed her at 10:30 when we got home and she already wants to nurse again. So I got up from the couch and she is chasing me around the house clawing at my legs and crying. But shakes her head and runs away if I offer solids.
youve said it numerous times like above- when she wants to bf she will refuse solids. unfortunately this seems like a very logical conclusion your drs made. It sucks but she really may thrive once she adjusts to ep'ing or whatever.
Post by dixeedeluxe on Jul 30, 2013 10:11:58 GMT -5
I don't think the pedi is saying she should give P WCM 8-10 times a day. I think she's saying nurse less/give less heavy drinks and then her body will make up for the caloric loss with food. Which will pave the way for her being a better eater. With the intention of her getting back on the charts with her weight so they can just move on and not further investigate the FTT.
C25K...it works Seaside 5K...........40:45(2012) Turkey Trot..........41:30(2012)/37:08(2013)/37:40(2014) St Pat's 5K..........39:27(2013)/38:48(2014)/35:12(2015) Belair Town Run......38:09(2013)/36:27(2014) Back To Football 5K..37:36(2013)/43:44(2015) Balt Run Fest 5K.....34:59(2013)/41:50(2014)/35:54(2015)
I don't think the pedi is saying she should give P WCM 8-10 times a day. I think she's saying nurse less/give less heavy drinks and then her body will make up for the caloric loss with food. Which will pave the way for her being a better eater. With the intention of her getting back on the charts with her weight so they can just move on and not further investigate the FTT.
Yeah, If she is wanting to only BF instead of eat, by cutting down on the actual boob time she will adapt and substitute (i.e. realize that food comes first) and gain calories from other foods.
Have they checked her for issues though, like I wonder if she could be consuming plenty of calories but not absorbing them? I assume they already considered this though and checked for things that might cause that to happen?
I don't think the pedi is saying she should give P WCM 8-10 times a day. I think she's saying nurse less/give less heavy drinks and then her body will make up for the caloric loss with food. Which will pave the way for her being a better eater. With the intention of her getting back on the charts with her weight so they can just move on and not further investigate the FTT.
Yea, I agree. My Pedi actually wants Violet to drink milk just once or twice a day so that she's hungry for other stuff. It has been working really well for us.
I think Faevantastic's idea about eating with other kids is a great thing you can do immediately. I also wonder if there is any way you can be gone from her for more than 4-5 hours? Like can Wes or your mom keep her all day? And just offer yummy stuff constantly? Thad still nurses 5-7 times a day if I'm home but is just fine eating and drinking if I am gone.
I think you need to take a deep breath, have a good cry, and then make a list of things you can try while waiting on doctors appointments.
I'm so sorry. I can't even imagine how you feel right now. Many, many hugs coming your way. I hope you can see the specialist soon to make sure there isn't a serious medical issue going on. You are a great mom and I know Pey is loved and you will get this figured out!!
Post by DesertMoon on Jul 30, 2013 10:25:48 GMT -5
I'm sorry, Julian has only gained about that much all year. Your pics of pey look a little like Julian's weight. Although I think he is between 20 and 23 pounds.
The doctor told me toast a butter, especially butter will help in the fattening up dep.
Post by lauranicole91 on Jul 30, 2013 10:33:44 GMT -5
It's getting hard to keep up with all the advice and suggestions so sorry if I don't answer some questions.
At her 15 month well check they suggested 2 4oz sippy cups of milk a day. Now she is suggesting milk 2oz BM with 2oz WCM for every nursing session she demands. That's based of the fact that I am able to pump 4oz every time I pump. So they assume that's her usual oz intake.
Now I forgot what all else I was going to respond to. Haha.
Post by lauranicole91 on Jul 30, 2013 10:38:43 GMT -5
At her 15month check up she did discuss lab work. But today after consulting with the other doc (outside of our room-I didn't hear any of it) they decided lab work was not necessary at this time.
Post by dixeedeluxe on Jul 30, 2013 10:45:28 GMT -5
My cousin has CF so she has a problem with fat asbsorption. She eats Stouffer's frozen meals for breakfast. Point is, when she does come around to the whole food world, if she's still needing extra fat, think outside the box. CHICKEN FRIES AND MAC AND CHEESE FOR BREAKFAST, YO!
C25K...it works Seaside 5K...........40:45(2012) Turkey Trot..........41:30(2012)/37:08(2013)/37:40(2014) St Pat's 5K..........39:27(2013)/38:48(2014)/35:12(2015) Belair Town Run......38:09(2013)/36:27(2014) Back To Football 5K..37:36(2013)/43:44(2015) Balt Run Fest 5K.....34:59(2013)/41:50(2014)/35:54(2015)
2nd: Remember, pumps aren't as efficient as BFing. You may only be pumping 4 oz, but shes probably drinking a lot more at a time. Take a day, log how many times she nurses and for how long, and then see if you can do a weighed feeding. That will probably be much more accurate about how much she is actually drinking.
3rd: Insist on the labs. And I mean make a big huge stink about it. If she has, for example, a thyroid problem, you need to know and you need to know now. There is no way to diagnoses that without the lab work.
4th: I haven't read every response yet, but getting her to a nutritionist and PT to see if she has texture issues is the right move, but the way your doc went about it is totally not cool. Look for someone new and get that second opinion. Tell the new doc (or docs) that you don't agree with your doctor's attitude and response to her lack of weight gain and you're looking for a different approach.
5th: Come her for all the support you need. You know we are totally here for you!
I think you can find some middle ground between cutting some sessions and not entirely weaning, if you wanted to. It doesn't have to be all or nothing. I hope you can get into the specialists soon. I feel like if she was FF or on WCM exclusively you would have been sent straight to the GI,from that appointment, and not told to cut either out entirely (reduce qty. yes, remove from diet no).
But I think their concern is the breast itself, not the breast milk. That she enjoys it so much that she is choosing it over food. ?
Laura, I wonder if you could get her to associate it only with bedtime or something, so that you can continue to nurse but also encourage Peyton to eat more during the day because the breast is not an option then.
I agree, I think they are trying to get P to not use the breast so much just because it's taking over, rather than her learn to develop a healthy relationship with food. I think with the information you supplied, they have a right to be concerned and expect some changes.
I don't think you need to cut out nursing, either. Tamb's suggestion about making it a night thing and/or even a morning thing (if you close at work or something like that) would still give her the comfort and and closeness, but she could move towards more table foods during the day.
I like their suggestion of specialist to help with her pickiness, it seems to me like they actually are really trying to help P have an OVERALL healthy appetite were BM is just one part.
(((Hugs))) I completely understand why you would feel upset with them. No one wants to hear their child is FTT! Just move forward with the specialists, they may offer more insight!
in my personal experience, I find it really, really, really hard to hear anything negative about my child and not become very defensive and upset, even if it has nothing to do with me. It is just a natural reaction sometimes, and with something as personal as breast feeding (and also something I know requires such a mental and physical effort over the past 15 months) it must feel even worse.
But, I agree with others that you need to try not to take it personally. Don't look at the drs as attacking you and your choices, but instead look at them as passionately wanting to help your child (....and not saying things in the best manner possible). From what you have described, her nursing and eating habits are not typical of a 15 month old. This would be no big deal (what IS typical with a toddler??), but taken in conjunction with failure to thrive it becomes a big deal.
I know a big concern is that the last time you tried to have her eat more it really backfired. I think this is why a pediatric nutritionist is a good resource. They won't just tell you "don't let her BF", they should give you strategies on how to best introduce a new feeding plan with as little stress as possible. There are different strategies you can use, but it can take a while.
(((( hugs)))) You have received some great advice here, but I think the best advice for you and P will come from your doctors and specialists.
I talked about it a little bit, but we went through major feeding transition problems. DS really didn't start eating solids until 12 months. I also never talk about his stats but I suppose he's considered a " peanut". He's around the 75th percentile for height, but hovers around 10% or so for weight. Our pedi suggested the same thing that Trudy did for V. I think you wold be getting the same advice if P was BF or fed WCM/FF. While we bottle fed, he was preferring that over his solids. So, I just started cutting them back and low and behold he started eating. It was hard sometimes when he cried and refused, but it honestly didn't take long for him to realize the food was good and would make his belly feel full. He didn't associate food with a full belly- only the bottle. Maybe P is doing the same with the breast. He now gets milk only at night and in the morning. I've been working on weaning his night bottle by giving it in his sippy with his dinner. It has been working. He still occasionally wakes early in the morning for a little milk snack.
He's definitely gained in the last 3 months and he has grown just shy of TWO inches.
I would request that you want lab work or at least get a reason as to why they don't want to see it right now. I would also skip getting a second opinion and go straight to a pedi GI and make an appointment with a nutritionist. Maybe they can find a balance for you and P by going to night and morning nursing sessions. I know medical advice can sometimes be hard to hear, that not all doctors have the best " bedside manner" or have matter of fact personalities, but it's their job to care and be concerned and at the end of the day they do have our best interests at heart. I know they will figure out a way to make this better for you guys and we will be here for you.
I don't know if she would be amenable to it, but could you make a deal with her with food? Like, have a boob out, let her nurse for 10-20 seconds, then unlatch her and cover your boob with your hand. Offer a tiny bite of something (yogurt, a blueberry, something), then after she eats a bite, praise her and give her more boob. Rinse and repeat. It shouldn't take long for her to realize she can "earn" more boob time by eating solids.
Again, I don't know if she would let you do that, but it might be a slightly less traumatic way to get her to eat.
At her 15month check up she did discuss lab work. But today after consulting with the other doc (outside of our room-I didn't hear any of it) they decided lab work was not necessary at this time.
That's bizarre. We had LOTS of FTT kids and babies in and the first thing that was a slew of testing to rule out any metabolic, thyroid, etc. issues. You definitely need a GI dr. before listening to them. I would personally want to make sure there was no underlying issues causing the FTT. A lot of times, also, kids came in to the hospital because it was quicker than getting in with a GI dr. honestly. For instance- you could schedule an appt on your own with a peds GI and the soonest you could get in would be 2 months or so. Come into the ER and you would see a peds GI and be admitted that day. KWIM? So it's not ALWAYS a worst of the worst severity type thing when they recommend going to the hospital. A lot of times it's just the quickest route to see a professional and get treatment quickly without having to go from appt to appt, here and there and seeing a bunch of different specialists. If that makes sense? But the fact that they said no testing, but talked about sending her to a hospital is so weird and really makes me feel that this is NOT their area of expertise really...
Post by charmediamsure on Jul 30, 2013 11:26:18 GMT -5
Oh, Laura, I'm so sorry you are dealing with this. I see why they are concerned if she isn't gaining. I know some of that might just be genetics, but there could be other reasons so I know they are just doing their job even if their bedside manner is lacking. Like others have said, please know this is not a reflection on you as a mother at all. I think others have given some really sound advice so all I can offer are hugs to you and sweet Pey.
Post by dixeedeluxe on Jul 30, 2013 11:26:56 GMT -5
That study I just read said that 92% of all cases labled FTT were environmental/situational. So I can see why a doc would want to hold off on invasive/painful testing until after the environment has been given a chance to change.
C25K...it works Seaside 5K...........40:45(2012) Turkey Trot..........41:30(2012)/37:08(2013)/37:40(2014) St Pat's 5K..........39:27(2013)/38:48(2014)/35:12(2015) Belair Town Run......38:09(2013)/36:27(2014) Back To Football 5K..37:36(2013)/43:44(2015) Balt Run Fest 5K.....34:59(2013)/41:50(2014)/35:54(2015)
That study I just read said that 92% of all cases labled FTT were environmental/situational. So I can see why a doc would want to hold off on invasive/painful testing until after the environment has been given a chance to change.
Eh, invasive and painful testing, sure. But there is lots of testing that can be done from simple labs. I don't consider a needle stick to rule out something that out of the ordinary.
Post by imimahoney on Jul 30, 2013 11:31:45 GMT -5
I'm so sorry.
I just want to chime in on the pediatric GI issue. Most regular pedi's are not familiar with or no a lot about food issues the way a pedi GI does. As well, while a lactation consultant probably knows a ton about bfing, she won't be able to run tests and see how Pey's body responds to the food that she is eating. It also does sound like she has texture with food so hopefully the speech person can help with that.
We were sent a pedi GI while we were dealing with Ari's mspi. He was not gaining, responding poorly to my diet changes and was in general, a mess. His pediatric GI did immediate testing to make sure that he was absorbing the calories that I was offering him. It took a week to get the initial appointment at our Children's Hospital and then we went every 6 weeks.
Food and weight gain issues are hard and scary but going to the GI was the absolute best decision that I could have made for him. I hope you are able to figure things out soon. Hugs!
I saw this on the app Most Recent Threads. I hope you don't mind if I jump in (I'm a MMM regular).
My DD has had weight gain issues since early on and we saw a pediatric GI at about 4 months for FTT. We got in very quickly (less than a week) because my pedi had the referral marked as urgent in bright red. We also saw a pediatric nutritionist while there. Due to her age, we didn't discuss solids other than holding off until 6 months, but both the GI doc and the nutritionist were extremely supportive of breastfeeding. They happily designed a plan for my DD that included breastfeeding as part of her diet. (When I told the pedi GI that I wanted to continue nursing, she said, "Of course!").They were also not alarmed by her size and she's about the same size as your DD (hovers between off the charts and around 2% for weight). They really wear wonderful and more knowledgeable than my pedi just because this is their area of specialty. I was very nervous but it was a really positive experience. Perhaps ask your pedi for referrals to a pediatric GI?
Sorry you are dealing with this It really does suck and is so incredibly frustrating.