Failure to thrive

[armywife11]

My girlfriend is breastfeeding her third child and up until recently (6 months) she was meeting all the expected growth milestones. She went in for the 6 month checkup and had an expected height measurement but her head and weight were way under. She had even lost weight and is not crawling, lifting her head, ect. Her ped is pro beast feeding and had her breastfeed and give premie formula for a week. She did this feeding routine every 3 hours for a week and she only gained an ounce. She is now seeing another specialist who is very anti breastfeeding and really upsetting my friend. She's calling her ped to see if theres another doctor they can refer her to that supports it a bit more.

Has anyone dealt with this or known anyone who has. My GF wants to keep up the breastfeeding if at all possible but these doctors keep putting doubts in her head making her question everything. They haven't tested her milk and she hasn't made any diet or lifestyle changes so she doesn't understand why her milk was fine until now. They just started doing all these tests so no one knows the possible cause other than an overfed baby didn't gain squat when she was expected to.

I talked to my GF and she said she hasn't noticed a supply drop, baby is nursing like normal and has a good latch, also spits up now and then (not constantly) so she sees milk come up. She has plenty of wet diapers and dirty diapers (other than she has blow outs more often than just small dirty diapers). She really hasn't really started solids yet. Solely because she was waiting till 6 months like she did with her other two kids.

Again she is listening to doctors but she's worried about the advice since some of it seems to come from a weird place. She has nothing against formula but wants to give her breastmilk since it's the real thing. We have done some internet searches but they all discuss babies who don't eat or have obvious digestive issues. From there it goes on to talk about solely formula fed babies. Just hopping someone has been there and has some advice or words of encouragement I could pass on to her.

She just saw this specialist today so they ran a bunch of tests that will be back in a few days. Hopefully they can get an answer or a better ideal of whats going on.

If anything thanks for letting me get that all out.

 

[fdcsw126]

my daughter was hospitalized for this at 4 weeks, the one thing i can suggest is for her to stick with it because now due to dr telling me to only bottle feed for a few days its very hard for me to get her to latch so i give her as much pumped as i can. how long are her nursing sessions? because if they are too long she might be burning to many calories (this is what i was told) maybe tell her to do half breast and half formula and have her get in touch with a lactation consultant its something i wish i had pressed harder for when my daughter was in the hospital

 

[patch2006uk]

The only worrying thing I can see in your post is that your baby isn't lifting their head at 6 months. Is that right? Crawling usually comes later-6 months seems very early to be worried about that-and an occasional blip on the growth charts also isn't usually a problem, but if there is seriously a lack of muscle tone, then that's where my concern would be. And that wouldn't be a feeding problem. I'd want to be getting tests done to check that hormones are all in order, and that there aren't any underlying conditions. I would be very loathe to make that a feeding problem, when it sounds more like a muscular problem.

Your girlfriend's milk won't suddenly have 'gone bad' so something else must be at play here. Maybe an underlying tongue tie, meaning that baby can't get so much milk out now it's completely supply and demand. Or a reduction in the number of feeds, perhaps. Consider introducing a dream feed, or a middle of the night feed if baby sleeps a lot. I'd be wanting better answers than just 'give formula', especially as you've been trying that and it hasn't made much difference.

Hope you get some answers x

 

[armywife11]

fdcsw126 I may have found something no one is looking into but I will answer you real quick:

She nurses around 10 to 20 minuets depending on the time of day. She will nurse faster during the awake hours. She was fed on demand until this all came to rise but on demand she was nursing the average amount for her age, her Ped made sure to go over all that. She did see a LC at her last Ped appointment and didn't express any concerns.

She got a call back from her Ped who wasn't to happy about the push to feed her formula without any proof that there is something wrong with her milk. The doctor didn't even ask questions or test it. She came in and said ok so we want you to start giving formula and only supplement with breast milk. When my GF started asking questions instead of sighting medical sources she used examples of other patients like a mom who had several kids. Also all examples given the kids were having this issue from go, not 6 months into nursing. She also seemed confused why at 6 months my friend wasn't having engorgement, leaking, feeling a let down, ect. She said she felt the doctor didn't know much about breastfeeding. I kinda got that same feeling after hearing everything she said. Her Ped. said to do what she felt was right but hinted to staying with the breastfeeding and supplementing with the formula.



However I just uncovered something that no one else had said to her. She is taking a medication that she didn't start taking till 3 or 4 months ago and I found on KellyMom and a few other breastfeeding sites that there are concerns it affects an infants weight gain. She mentioned to the doctors she was taking it and they all seemed ok with it and said it was safe and had no affect on breastfed babies. If this is the case she has a few options to try, from reducing the amount she takes or switching to another medication. But if that doesn't work she would have to stop breastfeeding. It makes sense to me that this could be the reason since the timing is right. I didn't know she was taking anything until now. She didn't even think about it because she was told there were no side affects and very little if any was passed to the baby. I sent her the info I found and she's calling the doctors right now to talk about it.

 

[armywife11]

The only worrying thing I can see in your post is that your baby isn't lifting their head at 6 months. Is that right? Crawling usually comes later-6 months seems very early to be worried about that-and an occasional blip on the growth charts also isn't usually a problem, but if there is seriously a lack of muscle tone, then that's where my concern would be. And that wouldn't be a feeding problem. I'd want to be getting tests done to check that hormones are all in order, and that there aren't any underlying conditions. I would be very loathe to make that a feeding problem, when it sounds more like a muscular problem.

I may have found something no one is looking into but I will answer you real quick (posted the new info above):

Your girlfriend's milk won't suddenly have 'gone bad' so something else must be at play here. Maybe an underlying tongue tie, meaning that baby can't get so much milk out now it's completely supply and demand. Or a reduction in the number of feeds, perhaps. Consider introducing a dream feed, or a middle of the night feed if baby sleeps a lot. I'd be wanting better answers than just 'give formula', especially as you've been trying that and it hasn't made much difference.

Hope you get some answers x

Yes she's not lifting her head. She has no muscle tone from what she's told me. The Ped. also said the same thing, she doesn't believe or feel that its a feeding problem but is leaning towards an issue with how her body processes the food she is getting, like its not absorbing or converting it properly. She is going to continue breastfeeding then supplementing with formula until they can pin point the actual cause. She said she doesn't want her to be sick, or to be malnourished but until they can get a real answer she doesn't want to stop giving her the food nature intended solely to appease some medical professionals that have some weird issue with breastfeeding. However if it is in fact her milk or something to do with her milk she will give her formula or donor milk to ensure she thrives.

I asked her about TT and she even brought it up to her Ped before I mentioned it because my daughter had Lip Tie that caused us a few issues. Her Ped didn't notice anything. She is also going to continue the feeding every three hours plus demand feeding if she asks for it, for now.

 

[armywife11]

An update on the medication. After bringing it to the doctors attention they looked at it again and although it's deemed safe while breastfeeding it is still a category c drug. They also didn't find anything about the weight loss issue but her Ped is going to look into that a little more because of the info from KellyMom. They will be taking her off that medication and putting her on something different.

 

[patch2006uk]

That all sounds reasonably positive. At least you have a few differnent things to try rather than just being told to give formula. I hope you continue to get good support and that you get some answers soon

 

[armywife11]

As she finds out things I will be sure to update. It will be a few days to a week or so because of all the tests and things they ordered and are getting back. Its just a hard situation to be in and she doesn't have the breastfeeding support like I do.

Plus the only info we both had on failure to thrive were for formula fed babies or preemies who didm't nurse well from day one. Having this diagnoses several months in was a new one. She is doing better now that she has a few methods and plans to try in hopes that those are the actual causes.

 

[CandyDay]

did she get blood work done? Blood work will show if she is lacking in HGH (human growth hormone). If she is then they will likely give LO the injections which should help.
Also as her LO is 6 months old she should look into healthy high fat options for food. Avocado is a great one as its easy to puree and very healthy and fattening. Also can she add olive oil to food puree's that she does feed. That is also very healthy and can be added to anything.
My LO was on the low end of the growth curve so they were concerned. (not the same as your issue) So I had to see Ped's and a dietician etc.
I would not stop breastfeeding till they have looked into if HGH is an issue and switched her meds for awhile to see if that is the issue. All things to do before saying you need to give formula.

 

[armywife11]

She mentioned a few tests they were doing but not all of them. I will ask her if they did a HGH test. She has only seen her Ped. and a GI specialist at the moment. She has an appointment with other specialists but they are a little down the road. (She's trying to get in sooner but it sounds like they all want to wait on the GI tests first.)

I talked to her about foods yesterday and the only concern with them is that she's not always "chewing" them, just letting them sit in her mouth, but she will chew on occasion. I thought she should experiment a little with them (like you said the healthy fat foods) and see if it helps any. She said she would give it another try. I haven't talked to her today so not sure if she had any luck.

 

[CandyDay]

Even if all she gets is a tiny spoonful in that is still better then nothing. Their stomachs are not that big that they should be eating lots anyways. She should keep offering every day even if she doesn't see much going in. And offer it at the time of day when she seems the hungriest. Some is better then none. She should make it as runny as possible (mix it with breastmilk to make it more liquid). Then Lo won't really need to "chew" just swallow.

I hope she hears back soon on the tests she did have done.

 

[patch2006uk]

Solids would also be where I'd look to boost calories rather than formula. But again, if LO has very poor muscle tone and can't lift their head, that would be my priority rather than weight gain.

 

[BabyMaybe917]

It looks like you've gotten advice/plan for continuing bf so I'll skip that issue...

I find it very concerning that the baby isn't lifting her head. Have they looked into this issue further? Was she able to lift it before? Low muscle tone can contribute to poor feeding? Regardless of if it's related it is still concerning.

Also, if she does find herself having to supplement perhaps she can ask about fortified breastmilk. Formula is added to bm for extra calories. My preemie had issues gaining and would take 3/4tsp 2x a day of formula. She could also consider a supplemental nursing system as opposed to bottles.

I wish her good luck.

 

[armywife11]

It looks like you've gotten advice/plan for continuing bf so I'll skip that issue...

I find it very concerning that the baby isn't lifting her head. Have they looked into this issue further? Was she able to lift it before? Low muscle tone can contribute to poor feeding? Regardless of if it's related it is still concerning.

Also, if she does find herself having to supplement perhaps she can ask about fortified breastmilk. Formula is added to bm for extra calories. My preemie had issues gaining and would take 3/4tsp 2x a day of formula. She could also consider a supplemental nursing system as opposed to bottles.

I wish her good luck.

Her Ped. has talked about the low muscle ton and the lifting of the head. From what I gathered they are just putting that with the underweight issue, like she is so small she just can't physically do that. She will be seeing a physical therapist but I am not sure when. I believe soon as I think thats the next person on her list. She is doing everything she was doing before in regards to movements. She reaches for things, kicks, looks side to side, but she still can only hold her head up for a few seconds like a baby whose still learning to do that. I am not sure if there has been a dramatic change or not. She didn't mention it to me if there was.

I didn't even think about fortified formula but I will be sure to mention that to her so she knows other options out there if she ends up needing to supplement. She is staying with the premie formula at the moment. She is able to get the formula in her with the dropper technique and she said its going ok.

 

[angela98661]

I heard ped. Are more trained with bottle feeding formula

 

[armywife11]

Well a positive update.. she gained 5 ounces doing the breast feed first then supplement with formula. She is starting to include foods but with her being force fed so much she isn't very interested in foods at the moment. I don't know how long they will have her keep this up but it is a positive improvement so she is taking it.

 

[armywife11]

So she is chunking up and doing wonderful! Holding her head up trying to crawl its amazing how much of a difference there is. She is still breastfeeding and formula supplementing and still they have no answers.

 

[irish_cob]

I missed this thread originally but fab to read it now and see your latest update

 

[Shandelion]

Thanks for the update!