Has anyone dealt with failure to thrive?

[hokiegirl82]

DS is 4 months and 3 weeks old. He was born at 38w5d and was 5 lbs 11 oz and 18.75 in long. At his 4 month appointment he was 24 in long and 11lbs 11 oz, making him in the 1 percentile for weight. His weight curve is fine but he's still tiny. He was on similac alimentum for a few months and we recently switched to up and up sensitive (doctor said he could come off the alimentum). He hasn't been eating much the past couple of weeks. He's eating about 16 oz a day and the pedi said he should be getting at least 28 oz. he's also spitting up a ton but otherwise seems happy. We went in today for a weight check and hes only 12 lbs 3 oz and 25 in long, still in 1 percentile for weight.

The doctor isn't concerned about FTT yet but she said he's on the edge. She said to switch to similac sensitive instead of the up and up brand and to try a little rice cereal in his bottle (we tried rice cereal in a bowl but he kept spitting it up). We have to go back in a few weeks for another weight check but I'm concerned about him.

Does anyone have experience with this?

[winemaker06]

I'm kind of surprised your pediatrician is letting you worry at all. My kid has never been 'on' the chart, the doctor just marks him as '< 2nd percentile' and is happy as long as he stays on his own curve.

My DS was born at 36 weeks, 5 lbs 13 oz. It took him a long 3 weeks to get back to birth weight. At the end of the 2nd week, the pedi was suggesting we would have to do something to supplement if he didn't get to birth weight by 3 weeks. He just barely made it. He was and is breastfed, but food is food (IMO). He has never eaten a lot ounce-wise and doesn't eat a ton of solids either (though he loves what he does eat).

At 4 months, for your comparison, he was 11 lbs 9 oz. so very similar to your little guy! And failure to thrive has never been suggested to me.

He's 9 months now and at his 6 month appt, he made it to the 2nd percentile for the first time! We hadn't started solids yet, so we'll find out next week if he has gained much more than usual.

But you know your kid. If he's happy and eating something and having dirty diapers, don't let them get to you. If you feel like something may be worth worrying about though, certainly stay on the doctor.

[redheadk]

DD was diagnosed as FTT at around 4m (don't remember which week). She was very borderline. In our case, she dropped from about the 22nd percentile at 3 days old to 1-2% at 4m. My pedi was very clear that some babies are just small and that it was the drop in percentiles (which corresponded to only a few ounces gained in a month) that was the concern, not the actual percentage.

DD suffered from Severe GERD (severe reflux) and we were referred to a pediatric GI at a major hospital. The pedi GI determined that it was a combination of factors at play (mainly the Severe GERD and just being a small kid to begin with, she was 7,3 at birth and was over a week late), determined that she was on the correct dosage of reflux medication (the max dosage) and that it was working correctly for DD, and had us concentrate DD's feedings. She was very supportive of nursing and had me pump all of DD's daytime feedings and add formula powder to the milk to increase the calories/ounce and then nurse for her night feedings. We worked with her nutritionist to develop the exact feeding plan. I never suffered from large scale supply issues and she did not have any issues with lactose/dairy, something that seems to be common with reflux babies.

We had to go for regular weight checks at the pedi and saw improvement pretty quickly with the concentrated feedings. She never did get back up to her original percentage but she started gaining and staying on a steady curve, which satisfied our pedi. DD has always hit milestones on the early side, particularly physical milestone, has good hand/eye coordination, etc., and always done well on the screeners so it helped us to see that she was doing fine, just a small kid.

I do think that 16oz is pretty low but it's been a while since I had a newborn so I'm rusty on that, especially since DD was always breastfed so it was hard for me to know how much she ate.

[sent]

DD was a 33 weekend and didn't reach 12 lbs until at least 5 months. She was drinking BM at the time and taking around high 20s oz per day. Our pedi never worried and did a happy clap when DD finally got on the charts at 6 months. She started rice cereal at 6.5 months. At 10.5 months, she is FF and eating purees and weighs 17 lb 9 oz as of yesterday.

[rugbywife]

My doc said not to worry as long as the curve is going up.

[hokiegirl82]

Oct 24, 2014 16:05:34 GMT -5 winemaker06 said:

But you know your kid. If he's happy and eating something and having dirty diapers, don't let them get to you. If you feel like something may be worth worrying about though, certainly stay on the doctor.

He's definitely a pretty happy baby. Plenty of wet and dirty diapers!

[hokiegirl82]

Oct 24, 2014 16:44:31 GMT -5 rugbywife said:

My doc said not to worry as long as the curve is going up.

Even though he's tiny, his curve is right on.

[redheadk]

Oct 24, 2014 16:46:10 GMT -5 hokiegirl82 said:

Oct 24, 2014 16:44:31 GMT -5 rugbywife said:

My doc said not to worry as long as the curve is going up.

Even though he's tiny, his curve is right on.

This doesn't sound like FTT, it just sounds like he's small

[ohgillian]

Did his intake used to be much higher?

How's his head growth and how is his weight-for-length?

[stretchad]

Our doctor was always monitoring his weight & height growth but didn't label us as FTT until recently, when DS very clearly fell off the curves.
Early on, DS was monitored monthly for weight. He always stayed on the curve, just low. I think that if you're tracking on the curve vs. falling off, you're doing fine.

and honestly, I'm sort of surprised she mentioned rice cereal in a bottle...I thought that was a no no?

[stealthmom]

I'm surprised it's an issue too.

My kid was way smaller than that at his 4 mo. Visit and ftt was never even mentioned.

[barefootcontessa]

yes, my DD was FTT. the doctor defined not using percentiles but her overall weight gain. she said babies at this age should gain at least an average of .5 of an ounce/day.

[hokiegirl82]

Oct 24, 2014 16:53:36 GMT -5 ohgillian said:

Did his intake used to be much higher?

How's his head growth and how is his weight-for-length?

He was getting about 20-24 oz up until a week or 2 ago.

His length is in 20 percentile and is growing more than his weight. He seems to be getting much longer than he is heavier

[Birdie]

Oct 24, 2014 18:17:38 GMT -5 stretchad said:

Our doctor was always monitoring his weight & height growth but didn't label us as FTT until recently, when DS very clearly fell off the curves.
Early on, DS was monitored monthly for weight. He always stayed on the curve, just low. I think that if you're tracking on the curve vs. falling off, you're doing fine.

and honestly, I'm sort of surprised she mentioned rice cereal in a bottle...I thought that was a no no?

I think it's discouraged if you're doing it for non-medical purposes (to fill the baby up to STTN, etc) but it's used a lot for babies with GERD. And formulas like Enfamil AR are basically regular formula with rice starch added. The rice is said to help keep the milk in the tummy and not come up so easily.

[redheadk]

Oct 24, 2014 20:38:55 GMT -5 incogneato said:

I think many pediatricians overreact, TBH. My DD1 was 5lb 4oz at 36 weeks and 10lb 12oz at 4 months.

DD2 was 5lb, 13oz at birth at 39 wks and 10lb, 11oz at 4 months.

Both were 16 lbs at a year. Both around 19 lbs at 18 months (DD1 a little anove, DD2 a little below) Both are small. DD1 has stayed btwn 0-5% up until now at almost 4 yrs. DD2 has been below the chart since a year and is almost 2. My pedi is laid back and says that since they are meeting milestones, willing to eat, active, and appear perfectly healthy, that he just isn't going to worry about it. In his words, "I don't think anything's wrong-she's just small."

I love him for that. FTT should really take into account behavior and energy, etc. Growth charts are not achievement tests. I know it's hard not to stress. At times I have, too, but I've come to accept that some kids are just small.

I completely agree. When DD got her diagnosis, it was bc of the dramatic drop in percentiles and even then her pedi and the pedi GI were very clear that she was borderline FTT because she was (is) just a small kid, clearly meeting milestones, and appeared perfectly healthy, not counting the ridiculous reflux. We just couldn't keep enough calories down in her for her to actually grow. The idea that kids that are just small but are staying on their growth curve are FTT is odd to me. Someone has to be the small one. If it's okay for a baby to be at 99%, it's okay for a baby to be at 1%, providing the baby is staying on his/her curve.

[twodogsandababy]

DS1 was always off the charts small. Last year at his 4 year he finally hit 3rd percentile and I was excited. For the first 6 months we did weight checks every 2 weeks and at 1 year they did blood work to rule out genetic issues. Once everything was ruled out they just said he was small. They said as long as his curve didn't drop they would not worry. He will be 5 soon and is still small, about 34 lbs and 38 inches.

[auntie]

Maybe he's just a peanut. He did double his birthweight at 4 months which is pretty average gain.