Failure to Thrive

[civano]

I took Miles to his 4 month check up a couple of weeks ago and he only gained 7 ounces since our last visit 2 months prior. Miles has really bad reflux and throws up much of what he takes in. It just isn't a little spit up...it's usually feels like at least 1/3 to 1/2 if not more comes back up after a feeding.

So the next day after his check up, Miles had to have blood tests (blood chemistry panel, CBC and an allergy panel) and an upper GI. The blood tests were normal and didn't show anything that Miles was allergic to. The upper GI only showed that he did reflux some of the barium back up. We ended up doing a lower GI as well because the radiologist saw that there might be an issue with Miles' large intestine in that it's higher than it usually is for people, has a shorter tendon connecting it and it's mobile where it should be stable. According to his pediatrician, this has nothing to do with the Miles' difficulty gaining weight or fussiness but that sometimes they correct it with surgery because the intestine can twist and kill the gut. She doesn't think we will need surgery but wants us to discuss it with a surgeon. So, we've got a consult with a pediatric surgeon next month.

For now, I've been pumping all of my son's meals (and supplementing with formula when I don't have enough pumped). I've got to pump because I add barley to all of his meals if not using thickened formula. The pediatrician prefers I give him breast milk since it's easier to digest and really he seems to do better on breast milk. It's a lot of hard work so I really commend you mamas who pump mostly and work. I need to take him in for a weight check next week to see how he is doing. I have no idea how long I'll continue to have to add cereal to each bottle and how long I'll have to pump. My husband thinks we should just use formula because he thinks it will be easier on all of us but especially me. Miles just doesn't seem to keep the formula in as much as the thickened breast milk. Since adding cereal, he does significantly keep in more of what he eats.

Having your son's pediatrician write on lab slips a diagnosis of FTT (Failure to Thrive) just brings about all kinds of guilt and paranoia and is just a shocker. First off, I look at my little baby and feel terrible he's still tiny and/or smaller than most children his age. According to his weight, he's at less than 3% for his age. In fact, he isn't even on a curve anymore on the growth charts. I have a cousin whose baby was born a month after mine...her's is so much heavier than my little guy and even seems more advanced developmentally. My mother keeps asking me if they've found out what's wrong with my baby. She doesn't seem to understand that some babies have terrible reflux. I begin to wonder do people think I don't feed him? Do people think because he cries so much and/or is so fussy that I just have given up? Do people think that I'm not trying to find out what is really wrong with my baby?

I know people don't really think these things (or if they do...they just don't understand)...but my mind starts to go these places.   

[Hollyadmin]

Kim - I've been thinking about you and this post. I can only imagine the feeling of seeing FTT on your child's record like that. It sounds like you are doing everything you can for Miles...it's not your fault AT ALL that he's not gaining!  If you can keep pumping, I would imagine that's best for him...but I know that can also be extremely challenging and draining on you.

If people really are thinking you're not feeding him, etc., that's just....insane. It's not your fault he has such terrible reflux, and the fact that you're continuing to pump simply because you know it's best for him, even though you could easily switch to formula, is a great testament to you.

I wish I could say something that would help. (((HUGS)))

[civano]

Thanks for the reply Holly.  

I took Miles to a weight check yesterday and he's gained 1.25 lbs in 2 weeks! Woohoo!

This weekend, my husband took the kids away (with breastmilk and some formula) and my husband let Miles spend a night with my father-in-law and his wife. He wasn't very fussy that night and they fed him twice as much at a time the doctor has told us to feed him. (7 oz versus the max 3.5 oz per feeding). It was one of those nights that he did really well for which I was grateful. However, I wasn't so happy about them suggesting we just needed to feed the baby more to keep him happy and/or pointing out that he didn't cry with them like he does with us. I know I need to get over that and just be happy my son had a good night and that they offered to give my husband a break (who was staying with his mother).

I just get upset because people don't seem to understand...(1) even fussy babies have good days/nights; (2) stuffing him isn't the answer either...sure he didn't throw up while there and he slept more but even his doctor said that he was probably really stuffed and that while we want to put weight on him overfeeding him isn't the answer. When he came home we even upped his feeding to 4oz max and sometimes that's too much and the little guy will vomit it up; (3) what works today with our guy doesn't always work the next day; (4) I'm not starving my baby and he gained weight from the work we (mostly me and then my husband) have been doing...not from the 10 hours or so they had him.   **Oh and edited to add...also possibly from changes that are hopefully naturally happening in my little guy to his anatomy and reflux**

Anywho...thanks for the kind words and in advance for letting me blow off some steam.  

[Hollyadmin]

oooohhhh, that makes me mad just reading it! (their advice to 'just feed him more', and that he 'didn't cry while he was with us').

That's awesome about the weight gain!!! Way to go mama! 

[nursemommy]

I  have a friend who went through the same thing. her baby was hospitalised for 15 days because he had lost so much weight... and my friend's step mom was always on her back saying stuff like your family did....it's not even my child and it drove me nuts!!! ( she's the type of parent who told my friend to spank her 7 month old because he was fussing!!!)

Our families have NO idea about what a fussy baby is.... it drives me nuts too..... you are a excellent mother to put up with all that.

keep up the good work, It will pay off! My friend's son is now a normal child who is up to date with his curve ..... there's hope!!

[civano]

Thanks! It's just frustrating when people are trying to be helpful and it feels condescending and/or said in a way that feels like your face is being rubbed in it. I guess I just would never think to be like that with someone, and even though I know it's more about them (and how they do things and/or feel about themselves and/or their egos) it just kinda burns. I have a hard time letting things go and I really need to because I can't control what people say. Of course, this was all said to my husband. I did tell my husband that if they ever say anything directly to me...I probably would snap and/or put them in their place pretty quick. Honestly, I don't hope for that to happen because I don't want any conflict but I'm also not going to be made to feel bad or less than when I know I really try and care about my kids and seek out help/information.

Really, unless someone has a loud screaming fussy baby who can out scream out cry and drive you to the brink...you don't know what it's like.

And as for the reflux...people just really don't get that either. Even my mother who should know better (my dad has severe reflux issues and subsequent health issues) should know how reflux can affect someone...but she doesn't seem to think that it could be related to my son being so underweight. She keeps wondering if they'll find out what's wrong with him when we already think we know what's wrong with him (weight wise).

[nursemommy]

oufff I totaly agree.... in fact, I just got back from my inlaws, like 30 min ago and my son, who takes after me, is 29 in long ( at 5 months) but is like 14 pounds ahahah!!! ( he started solids because he kept on feeding every2h during the day and 4h during the night!) and because I'm breastfeeding, they are always asking me why I dont give him any formula, and are always saying that he seems to have lost weight!!!! I snapped this afternoon saying that breastmilk is the best he can get ( he has gastric issues too) and I've chosen not to give him any formula and that I dont want to listen to anything concerning this anymore! anyhow, he dosent want to feed from a bottle anyways! I just love it when my 65 years old father in law thinks he know's everything,permits himself comments on me BF!!! ( and i'm a nurse to top it off!!! arrrrrrrrrgh)

ladies, here is the best place to vent hehe!!! I just love to know i'm not the only mother in the world who has conflicts with relatives because of my fussy child!

[fbsurvivor]

I went through this.  It was horrible.  One night I just had an awful meltdown about it.  My daughter is 18 months now.  It took until her 18 month check up for the doc to say that "any concerns we may have had were misplaced."  I went through all of the same type of tests.  I even got a second opinion.  I thought I was in some kind of nightmare, and of all things, given the weight issues my husband and I have dealt with, it was the last thing on my mind. At around 8 weeks, my daughter turned around and started gaining normally, but it took months and months until she got to a normal weight.  Everytime I looked at her I saw Auschwitz baby. We went to a pediatric gastroenterologist who basically said that she was spitting up all the time because the pediatricians were pushing us to overstuff her and that she was an irritable alert baby, and that there were babies like that.  Have you seen a pediatric gastroenterologist? For the reflux alone, I'd try to see one. What is the reason for the barley?  Is that for reflux?  My cousin's baby had really bad reflux, projectile vomiting 6 times in 10 minutes.  He's doing well now, but still very skinny,  That's kind of the genes on that side of the family, though.  The most important thing for you is to get rid of any guilt or doubts you might have.  This isn't your fault.  The FTT is like a red flag.  But also, now that I've been through all of this, I think in this day and age there's just so much measuring and weighing and whatnot and freaking parents out. 

[fbsurvivor]

cont'd

On the Facebook group there are quite a few women whose babies have had problems gaining weight.  I think that there probably is a relationship between the fussiness and the weight gain.  I always felt that my daughter was so fussy that the minute she got the breast she fell asleep because it was so soothing.  And if I managed to wake her up, she'd just fall asleep again after a few sucks.  These fussy babies spend too much time screaming when all the other babies are sleeping.

I had a lactation consultant tell me over the phone that the baby was always crying because she was hungry.  Well, even when she started gaining weight normally the screaming continued, so she obviously wasn't sceaming from hunger.  Also, she was a perfect weight when she came out, and she came out screaming at the top of her lungs.  The nurses were blown away just in that first hour.  And in my case I was hearing so much about feeding her that we were overstuffing her, she was puking it back up because her stomach couldn't handle it, and that was making her even fussier.

I so feel for you.  The FTT was really the bottom of the barrel for me.  In many ways it just made the fussiness not that big a deal.  I just wanted my daughter to live at that point.  Even now, when I take my daughter to the pediatrician I have memories of taking her for weigh ins every other day and hoping and praying that she'd gained another ounce and not just plateau as she so often did.  It's very painful.  Be strong!  You will get through this.

[nursemommy]

I would like to reassure you guys. I have a nephew that had FTT and today he is borderline obese AND I have a friend who has a 2 year old who was REAAAALLLLY sick from reflux and today he's normal!

I was a skinny child and still today i'm not a fat adult! I have trouble maintaining weight, even if I eat a truckload of Mcdonalds!!!! it's REALLY annoying to be reminded that all the time, to be asked if you have a eating disorder!. We tend to forget that in society, there's many sizes and shapes!  My son is long and skinny but our doctor dosent have ANY concerns by it because he know's he's probably like me!!!! I stopped going at the clinic to weigh my son and I follow cues instead: If I have to get rid of pyjamas because they are getting to short and tight therefore he's gaining weight, I don't care how much! He pee's and poop therefore he's ok!

I dont know where the obsession of a fat baby comes from in our society but I personnaly think that if your child has energy, dosent show any signs of dehydration, eats/feeds until he is full then you should not worry. Babies are different and develop differently.