Failure to Thrive - Bowdoinham,ME

Hi J.,

It sounds like he started to do worse after formula was introduced. It could be he does not tolerate it.

Good luck,
: ) Maureen

You don't mention solid food - by this time, he should be eating Stage 2 baby foods and putting on weight nicely. Trust me, when you feed him enough solid food, you'll be able to get more sleep (he won't wake up hungry nearly so often). I hope the pediatrician hasn't told you that he still needs only breast milk at this age. Sorry, I don't agree with that school of thought at all. Good luck!

Hi J.,
I'm so sorry that you are going through this. I'm home with my newborn son and I sent my husband to the library for me. He came home with a book, the promise of sleep by William Dement. In the first chapter he addresses a collegues nephew who had been diagnosed with a failure to thrive. It turned out that this little boy was having difficulty breathing while asleep because of larger than normal tonsils and adenoids. No one had noticed his sleep problem and it was what was causing the failure to thrive.
Obviously, I have no idea what is happening with your son, but it is possible that his trouble with sleeping could play a role in his problems.
Good luck, I hope this resolves quickly.

Hi J.,

We didn't get to the "failure to thrive" point with our son but he started getting leaner than we wanted. Most breastfed babies do when they start crawling. So this is what we gave him:

FATS:

gobs of organic, salt-free butter. He would eat it by the spoonful.

spoonfuls of organic coconut oil--it is solid in temperate climates...you can use it as a spread, too.

a spoonful of high-quality cod-liver oil twice a day. This has all the EFAs and Omegas that he needs.

lots of avocado.

Whole milk yoghurt--you can add fruit and maple syrup to sweeten it and add more calories.

Bananas--not every day though because babes can become allergic to them.

Also, my son had a similar pattern of waking. It could be teething. You can try Hyland's teething tablets before bed and then 4 hours later (gentle homeopathic formula) to soothe.

It worked!

Best of luck to you.

If your doctors have ruled out metal disability, and disease processes, you might want to try a pediatric chiropractor. Sometimes a few simple adjustments which for babies and children are very gentle, get everything back on track. Sometimes there is a problem with the joints of the spine working correctly, that then cause interference with the nerves. I have had babies go from less than 2 hours a night to sleeping through most of the night in just a visit or two. Also, it might be good to review what your son is eating with the chiropractor who has training in nutrition, or with a nutritionist. Sometimes, there can be a food sensitivity that is causing the problem.

Dr. E.

J.,

We have seen a feeding specialist for our daughter. She wasn't eating great and wasn't putting on enough weight. She was a preemie and born in the 5% and at a yeat was under 3%. The feeding specialist recommended some stuff that has really helped her to gain weight.
They are as follows:
cook there food in olive oil
add butter everywhere you can
whole fat milk
drinkable yogurts (Stonefield Farms has a low-fat one - no one has a full fat one)
YoBaby yogurt because it's full fat - you can buy others as long as it is full fat
Carnation instant breakfast drink with whole fat milk - better for them than pediasure
mashed potatos with gravy
eggs - scrambled my daughter loves with added cheese, also the dippy part of a soft bowled egg, also the yolk of hard boiled eggs. You can try egg salad.
cheese - the whole fat kind
things in a cheese sauce it nice too - I just rip up a slice of Kraft singles in a bowl add some milk and put in the microwave for 20 seconds. Take it out and stir until combined. You can put white fish in this or pasta or anything your son likes.
cottage cheese 4% kind
cream cheese
ice cream
fudge pops
carbs also help pack on pounds - breads and pastas
avocado - you can mash this with banana or pear - and pear, avocado and chicken as a meal is really nice
tofu is a great source of protein - you can put it in pasta sauce or any sauce
wheat germ - you can roll banana in it or add it to almost anything
Sunflower seed butter - it's like peanut butter but of course they can't have that til age 3. This is a good substitute. I put it on wheat crackers and my daughter like this. I got it in Trader Joe's
hummus
beans if your son will eat them - my daughter loves soups and I can get a lot of veggies and sometimes beans into her in soups. Also fairly easy to get when we are out. Au Bon Pan has good soups. She loves there cheddar and broccoli.

Some of the things my daughter likes are:
- Pastina (small star shaped pasta) with an egg, butter. You can add cheese to this as well as peas or carrots. The way I make it is cook the pastina, drain it, put it back in the pot and add the egg and butter. Stir and cook until egg is cooked (it basically disappears into the pastina). If I add the peas I add then to the water at the same time as the pastina. With carrots I generally do left over carrots - they tend to take longer to cook then the pastina.

- mac n cheese. I also grate carrot and zucchini into the pot for the last 2 minutes of cooking time. It disappears and they don't even know it's there. Use whole milk and butter

- My daughter loves mashed potatos with gravy. For Easter we had a spiral ham. I froze all the fat from around the ham. Now when I make gravy for her I just add a spoonful of that fat into the gravy. It makes it taste great and she loves it.

- White fish, with egg, breadcrumb fried in olive oil. My daughter really likes this in the cheese sauce.
Also you can cook salmon in the microwave in 4 minutes in a bowl covered with whole milk and add butter. You can add the salmon to other things like veggie puree's too.

- pasta - spirals or penne or ziti in tomato sauce with peas it a favorite here too.

- Raisin cinnamon toast with cream cheese

- I make a peas soup imlusion she really likes. I cook 2 cups of peas (frozen peas) in 1 cup of vegetable broth for 4 or 5 minutes - til tender. I add cut up pieces of whole fat mozzarella cheese to the blender - maybe 2 or 3, 1/4" thick slices, cut up - then pour the peas and veggie broth over the mozzarella that is in the bottom of the blender. Blend until smooth. This is nice with wheat toast with butter.

I hope this is helpful. I hope your son's issue is just that he needs to eat more fat and not anything medical. However you should ask to have this thyroid tested.

Just to mention it. Does he eat 3 meals plus snacks? and nursing? My daughter eats breakfast at 7:30, snack between 9:30 and 10, lunch starts around 11:30. She is down to one naps after lunch. She has a snack when she get up around 2pm and then again around 4pm and dinner starts between 5 and 5:30pm. She is in bed between 6:30 and 7pm. She does still get up at least once during the night. Right now I'm trying to convince her that she needs to sleep past 5am but we are working on it.

As for the sleep issue. I don't know if I can pin point the time when she stopped gaining properly and if she had any real sleep issues. I do know that when we started feeding her higher fat content meals and making sure she was getting the snacks that she wasn't getting up around midnight for a nursing. Now it is generally around 3am.

There is a sleep book I just started using that I really like it is "Sleeping Through the Night" by Jodi Mindell. She deals with a lot of issues and how to solve them. Also she doesn't make you or your child cry it out if that isn't what you want to deal with. I would recommend this book highly. I know it's hard to not nurse at night when the baby isn't gaining but I do know that my daughter started to eat better during the day when I stopped nursing at midnight. Others that have bottle fed have said the same. They cut a night time feeding out and the kids eat more in the day time. I know it's hard to say you should cut out the night time feedings - believe me I've been there and I cried over it. My daughter is under the 3% I know when you say they are tiny and that they aren't gaining enough weight it was a stress I couldn't discribe. However if you start to add more fat to your son's meals and have him eat more times a day maybe he will be able to go longer stretches at night and then when you see the weight start to go on you can say you will cut a feeding out at midnight.

I hope this helps. Also if they isn't any medical answers and all this doesn't help ask your doctor to see a nutritionalist or feeding specialist.

Good luck,
L. M

Hi, J.- I well remember that feeling of living w/out a good night's sleep for a long time- that's rough! And I'm sure the worries of your little one's growth being off just compound the feelings.

A couple of resources I wholeheartedly recommend to my friends and doula clients:

first, Lenore Grubinger of Amajoy. She does truly amazing work with infants on all kinds of developmental issues. She offers group and individual sessions, and everyone who I have sent to her felt it was very worthwhile. She has a deep understanding of babies, both intellectual and intuitive, and is wonderful at gently 'translating' their needs to parents. www.amajoy.net.

Second- if you have the energy & time to read a book- (I know that may not be easy!) Kim West, Good Night, Sleep Tight. www.thesleeplady.com. Also excellent, practical advice- kind of middle of the road- not a cry-it-out method, not a sacrifice-yourself-for-your-kids method.

Good luck-
M.

M. L'Esperance, Certified Professional Midwife
Warm Welcome Birth Services

J.--
You are in my prayers. When my first child was born, she had trouble gaining weight. Long story short, her problems were not considered failure to thrive, but it certainly was considered before she was correctly diagnosed. One of the things that we thought about was supplementing with a very high calorie/fat content formula. I'm not sure which one it is--it may even be a prescription--you may want to ask your dr about it. Also, at his age, you can give him cereals--rice/wheat/barley, etc. Combine these with formula or breastmilk, applesauce, infant yogurt.

Just a few suggestions. Good luck.

I work with a lot of people who have nutritional deficiencies - in fact, most of us do even if we "eat right". Our foods just don't have the nutritional content anymore, even if we eat organically! Many children with nutritional issues (whether related to disease, allergy or nutrient intake) do phenomenally well on a fantastic nutritional supplement - I'd happy to connect you with other parents whose kids have turned around. In fact, in many cases, med insurance has actually picked up the cost. I'd be happy to share more.

The sleep issue may well be due to the failure to thrive. You both need more sleep.

Let's talk.

He is 10 months old and you haven't mentioned if he eats solids yet. Is he eating yogurt, cheese, etc. What else is he eating besides formula and breastmilk? As far as waking up a few times a night, he could be teething. My son was teething between 9 and 10 months and again at one year. So a little tylenol before bed could help him sleep longer. My son didn't sleep more than 4 hours until I stopped breastfeeding and trained him to sleep through the night. I stopped breastfeeding at 10 and half months and stopped nursing at in the middle of the night at 7 or 8 months.

My son was brlow curve from 9-11months. he was allergic to dairy & until I stopped having dairy & he stopped it just wnet through him. I had a great allergist. & went to a dietition. She had us add oil( I did flax seed) to his cereal & avocado. High fat foods. good luck.

Our baby was in the lower third for the first four or five months (he's just six months) and it was a tiresome task to keep the weight on, its still so much work to get him to eat- he definitely has allergies or intolerances as they related to formula and food is a very slow start- he finally made it to the 50th percentile but slides back the minute he's sick (which he has been a lot) we are working iwth a dietician- I highly recommend it, he can make sure your baby is supplemented with the right source foods and also suggest supplments to help nutrition- especially if your baby is dealing with any food intolerances or allergies which absolutely can effect sleep. Also, teething affected our son's sleep for the first two years of his life so your baby may be very sensitive. Last night our six month old was up every hour, I finally gave up and let him cry himself to sleep- it took twenty minutes but it was very liberating to let it happen if you haven't already done it!

If there isn't a major underlying medical condition then hopefully working with GI docs, allergists and dietician can help your baby gain. I know it is consuming and scary and I'm sorry you are going through it- I recommend Mass General for GI, and their north shore office in salem is excellent.

Also, it might be helpful to consult a holistic/natreuopath just to cross reference western and eastern- that is how we ended up with a dietician.

Good luck! and you will survive lack of sleep, our first son still doesn't sleep so I'm three years sleep deprived plus six months in, your body just learns how to readjust although the greatest gift someone can give you is to let you sleep in or to babysit for a night :)

Hi J.,
Both my boys were just like this. My first, now 16 was the worst. He wouldn't eat. Turned out he was allergic to eveything. So I made all his food for him. He still looked sickly - stomach protruding, pale less than 5% on the charts. We were so lucky to find a great doctor who found out that he had reflux complications. The doctor is in Woburn, I have his name if you need it. We had to use special formula and I just held on to what I could. It is hard, but you are not alone. I felt very alone - please know you are not. Blessings to you!

Do you or your husband come from smaller sized people? or are you both tall and your famiy tall? I come from a small family, my Dad is under 5'5, I am only 5 foot and this also could be a reaosn for a smaller baby..your family.

My son was early and we 'topped' him off after each feeding with pumped milk to help him grow, but you must look at both your families and then the charts and see if is could just be small due to that or if there could be an issue?.

As for sleep, well you have a 2nd one coming so do not plan on too much more! lol Have your husband more involved by take turns (pumping milk will let him feed the baby) and on weekends have him start the day so you can sleep in (he needs to be part of it as much too)

If your son is not sleeping in any long stretch read The Happies Baby on the Bolck to work on sleep issues or longer time periods and that will give you more sleep. You cannot do it all, have your husband help more as you could cause yourself or you child an accident being so sleep deprived. The dishes can wait, the trash can wait, get some sleep!!!

OMG, I so feel your pain. We dealt with that with my youngest. Push the doctors to find out what's going on with him because it's not you and supplementing and all is just not working. I was miserable for the first six months of my sons life until we found out for sure that it was not me who was 'starving' my baby. I actually had to switch doctors to get someone who would listen to me and my concerns. I was writing down all the times he ate and his bowl movements and what they looked like and stuff. It was terrible. I went to a new doctor and told her everything we had been through with him and what my concerns were that the other doctor was not addressing and it turned out that he had acid reflux. So simple. He's back on the growth charts. Still on the small side, but he's on the chart. He's now 18 months old and he does have to have pediasure to help keep the weight on him. I think he naturally just has a fast matabolism. My husband was 120 pounds when I met him. We aren't big people. So I don't expect him to be all that big. As long as he stays on the chart hovering around that 5th %tile I'm good ;).

Anyways, I don't know if your situation will be anything like mine was, but if they've ruled out things like acid reflux and the like I would ask that he be seen by a gastro doctor just to rule stuff out.

Now in the meantime he is 10 months old, is he getting table foods yet? Or baby food or anything? You can start adding that stuff. I had a nutritionist come out and she said the more fat for him the better. It doesn't have to be junk. Whole milk yogurt, cream cheese on things, extra butter. Make sure you keep a good balance of fibers though because the fatty foods ar binding. It's a tough balance. There is this powder (I can't think of what it's called) that you can add to his food or drinks to make it more fattening. That's if you want to go that route. You can ask the doctor about it though.

Good luck! The most important thing is that you stay strong and insist that the doctors figure out what's going wrong. A failure to thrive diagnosis is what they give when they don't know what else it is. And there could be an underlying problem.

Good luck with the new baby.

Hi J.,

My daughter (21 months) has always been considered small. She has never been over the 10% for her weight. She has always had a fantastic appetite and I nursed her until she was 7 months old. I got pregnant with my son when my daughter was 5 months old. My daughter has been through several tests all of which find nothing wrong. I am currently waiting for an appt. with an endocrinologist to make sure that her doctor didn't miss anything. My guess is that my daughter is fine. I wouldn't worry so long as your son is meeting all his milestones (teeth, rolling over, etc).

My daughter is 21 months old and weighs 19 lbs, my son is 7 months old and weighs 18 lbs.

I nursed my daughter and she was up every 4 hours. I weaned her before the new baby was born. I made the decision to feed my son formula so that my husband could get up with him and so I wouldn't have to pump. It sounds selfish however I was very tired and with 2 babies life is very busy. I still don't sleep through the night however I do get more than 4 hours at a time.

I hope this helps.

How tall are you and your husband? I have a sister-in-law who is 4'10 and her daughter does not hit the charts. It's good that the baby is eating. I'd try a different formula. There may be some intolerance to the current one. You could also see an endocrinologist to make sure all the bases have been covered. Good luck.

I didn't have this issue with my girls, but I do know that certain types of solid foods, along with his milk/formula, can help out weight on. For example, good fats like avocado, olive oil on some pasta, cheese, and shole milk yogurt (Yo Baby) are good places to start, if you haven't already. At 10 months, he can eat a variety of finger foods, even things like pancakes cut into small pieces, bananas, cereal, etc. Be choosy about what solids you do feed him, and try to make about half of them as high calorie as you can. That, along with plenty of nursing and/or bottles, should help, I would think. I feel badly that you are dealing with this - I always thought the phrase "failure to thrive" must make a mom feel like a huge failure, something we don't need at any time!

As far as not sleeping through the night, it can definitely be teething at this stage. Try some Hyland's teething gel or tablets, or even a sippy cup with a little water when he wakes up. If you think he really is hungry, there is nothing wrong with feeding him during the night. Many babies give up overnight feedings by 10 months but many don't, as I learned with my youngest. She was legitimately hungry and didn't give up her overnight bottle until 11 months or so, and it took her a good 18 months to sleep consistently through the night without needing comfort. We let her know we were there, patted her back, shushed her, etc., but we tried as hard as possible not to take her out of the crib and hold her. You will find what works for you... good luck and hang in there! Let us know how it turns out.

Hi J.,
My daughter was born a month early almost 17 years ago. She weighted 5 lbs 14 ozs and was 21" tall. Day two the pediatrician at the hospital said we needed to see our own doctor the next day. Day three she said we needed to see a cardiologist the next day and we did. She had a medium large hole in her heart. She was put on digitalis and laysix and I was constantly nursing her (about every two hours for 20-30 minutes). We had two to three doctors appointments a week between the pediatrician, cardiologist and nutritionist. At three months my peaceful baby became fitful and cried all the time. Two days later we were meeting a surgeon to repair a double hernia the following day after she consulted with our cardiologist. After that her weight flat-lined until we referred to her as being in "the upper 2%" (her cousin was born a month later at 10 lbs and was 24 lbs by 3 mos.) By 6 mos she barely doubled her weight and just tripled by a year. I continued to nurse her, trying to supplement with a medina taped to my breast but she would not nurse at all with it. The nutritionist suggested adding butter to her jars of vegetables and she would not eat them. We used pediasure instead of milk when making pancakes and the doctor prescribed policose to be added to everything she ate. She continued to grow, slowly but surely. At her cardiology appointment when she was 5 years old it was determined that she would need surgery. After her open heart surgery she was finally able to gain weight and was no longer elbows and knees. We spent many hours reading when she was growing up and now she is a beautiful, petite young woman who will turn 17 on June 8. She is a wonderful scholar and we are very proud of all she has accomplished (attended the inauguration, accepted to a private summer school program this year alone). Having spent so much time with doctors, she plans to go to school to become a cardiologist. I never thought this day would arrive all those years ago but looking back it doesn't seem all that bad. One day at a time we all survive. Good luck to you and your son.
D. C. Mom of 4 (G16, B15, 12, 9)
PS. look back at your baby book. I too was tiny and today she and I can share clothes.

J.,
I am so sorry you are going through this. Does anyone in your family have any digestive disorders, specifically Chrons of Cilliacs? I would strongly encourage you to visit the GI and nutrition Clinic at Children's Hospital Boston. They are number one in the country and from our experience will not stop until they have an answer for you. It is worth the visit to get their opinion.
Good Luck!
M.