Slow-to-Gain Baby Diagnosed Failure to Thrive

[UnderPressure]

Talk to me about your babies' growth rate/consumption!

Our family has been through the wringer lately and I need to figure out where I stand. Our son was born 11/19/14 at 40w+4d. He was 9lb5oz and had dropped to 8lbs6oz at his checkup with the dr at two days old. He's been EBF up until the last month and a half, when he's started taking some solids in addition to BF. My husband feeds him my pumped milk while I'm at work.

When we went to the dr for a weight check on June 25th, he diagnosed our son as FTT. Our son was still on the charts and still gaining but had dropped in percentile. At 7 months, he was 15lb10oz. He's done a great job meeting his developmental milestones and looks like his weight is proportional (he is neither fat or thin). Well, our family dr referred us to a hospital pediatrician who insisted prior to even seeing our son that he needed hospitalization for assessment and told me that my milk supply was low. This was very concerning to us and we decided to follow the dr's wishes. We were hospitalized Wednesday-Friday last week. They told us that our baby needs 43 ounces per day of milk or formula (they didn't care which) in order to achieve cath-up growth. I was concerned that there was a huge difference in the amount that they wanted him to take. He did nurse, drink pumped milk, and drin formula to their standards for the first day. After that, he became increasingly irritable during feedings and would nurse less and cry/slap the bottle away. Despite this, he did gain during our hospital stay from 15lbs14oz to 16lb1oz so they let us go with me having strict orders to pump after every feed to increase my supply and to offer a bottle after every breastfeed.

Our son has refused the bottle almost every time that it's been offered and won't take more than an ounce or two per day total from the bottle. Tomorrow we got for a weight check with a local pediatrician and I worry that he's not going to meet the growth standards they've set for him. He is such an amazing, happy little guy and I've come to a point where I feel that he WAS receiving adequate nutrition and we've basically been part of a traumatic experience for our baby for no reason. Everyone at the hospital kept saying he doesn't "look" like a failure to thrive baby. All of my confidence in breastfeeding and belief that I knew my child was shattered by this experience.

Has anyone else experienced anything similar?

 

[lanet]

That sounds like a terrible experience.
My 4 1/2 month old daughter also dropped on her chart, she always been low, between the 2-5th percentile. She didn't gain 1 oz the past 2 weeks. However her twin brother has jumped up on his chart so I know it's definitely not supply. I go back and forth trying to figure it out, maybe she's not eating enough, maybe she's not getting the hind milk. I've been pumping and giving her a top off after nursing. The dr says she is proportional and that she isn't worried but that we will need to do labs if she hasn't gained in 2 more weeks.
I wish I had some advice, I've felt selfish like I should just give her formula instead of trying to hold onto breastfeeding but luckily my dr said it wasn't necessary.
Have you seen a lactation consultant? They are very helpful.

 

[Mrsgoodhart]

OMG. I am horrified by your experience, I'm so sorry.

I think your doctor is crazy. as is the hospital pediatrician. 43 ounces a day seems excessive to me, and I also feel as though if he's proportionate (and still growing for that matter!) as well as meeting his milestones, there is not the huge issue they seem to be insisting on.


https://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

https://www.askdrsears.com/topics/f...w-much-weight-will-my-breastfeeding-baby-gain

 

[Button#]

My DS was referred for failure to thrive when he was about 16 months. He was born on the 25th centile and carried on putting on weight but dropping centiles until he settled on the 0.4th. I kept on being told by health visitors that he was fine but to see the dietician for advice as well. The dietician said to get the HV to measure his height as well to see if he was in proportion. That was when we got referred to the paediatrician as FTT because he was off the bottom of the chart for height. The paediatrician asked us questions about his diet (fortunately this was back when he used to eat a good diet!) and ordered blood tests. Apart from being a bit low on his iron, which most of our family are, he was found to be fine and he was discharged after about 6 months with the diagnosis that he constitutionally small.

I'm worried about having to go through it all again with DD. she has already dropped one centile. I was lucky with DS it wasn't questioned until he was past an age where my supply would be questioned and it does worry me that they'll try and get me to do top ups or switch to formula. My family are all short and naturally slim so I'm never going to have big children, but doctors don't seem to take that into account. My mum went through the same issues as me and my cousin is going through it with her DD.

 

[noon_child]

How can they diagnose FTT off one weight measurement? For all they know he could have dropped those centiles months ago and now be steadily gaining along the percentile line he's currently plotted on. I'm not saying there definately wasn't an issue, just that they surely need more evidence over time to want to panic you like this.

 

[gingmg]

I'm so sorry you are going through this. How incredibly stressful! My son also dropped percentiles. He was in the 25% then dropped to the 8th%. At 7 months he was exactly the same as yours, 15 lbs 10 oz. I was really worried but my pediatrician said she doesnt care where he falls on the charts. She doesn't care if he is in the 2nd % or 92% just as long as he is gaining weight, happy, meeting developmental milestones, and having plenty of wet diapers. She also said the charts are dumb because all it does is compare your baby to other babies. The more important thing is that your baby is gaining weight and staying consistent within themself. My son also dropped percentiles in height too, so in all actuality his BMI remained exactly the same, which is more important than where he falls on the chart. Another thing, I waited to introduce solids until after 6 months and am doing baby led weaning, which takes a few months to take off. My son also started crawling before six months. How on earth would it be fair to compare his weight gain to another baby's who wasn't yet mobile and who say was being spoon fed solids since 4 months?!

A few other things. She said breastfed babies tend to gain weight pretty fast in the first few months compared to formula fed babies but then around 4-6 months the tables turn and they don't gain weight as fast as they did. Is your little one crawling? When they start crawling they start going through their fat stores pretty fast. When my son started crawling that's when I noticed his weight gain slow down. He actually lost some weight at first when he was first mobile because he was more interested in moving and exploring than breastfeeding. Also my doctor said around 6 months genetics start to play a role. Are you and your husband fit?

I was lucky in that my doctor is very educated on breastfeeding, she breastfed both her girls. I actually switched doctors early on because I had a feeling our first one was not up to speed on what's normal when it comes to breastfeeding. To be honest, I truly believe if I had stayed with the first one I quite possibly would have been given the same advice as you were given. And I would have said yes to formula because no one wants to do anything that might not be in their babies best interest.

Also did you know that the CDC growth chart that most doctors use is based on white middle class American formula fed babies? The WHO's growth chart is more an accurate representation of breast fed babies worldwide.

I'm shocked that your doctors were talking about ounces when talking about a breast fed baby. I would have no idea how much my baby takes. Even if I pump and leave a bottle, he has NEVER drank more than 5 ounces at a time, ever! And its usually only 4. If you are worried about your supply you could always try taking fenugreek and power pump for a few days to stimulate making more milk. I did that for peace of mind that I was making enough.

The links above for kellymom and Dr sears are great resources.

Again, I am sooooo sorry you are going through this. Big hugs to you! You aren't doing anything wrong. Unless I am missing some information, I dont think your situation was handled appropriately. I am so sorry. Hang in there and feel free to reach out for support!