Posts Tagged "failure to thrive"

Failure to Thrive

Posted by on Mar 30, 2012 in Blog | 2 comments

Lex at 15 months. Weight: around 17 pounds.

“Failure to thrive” is what they call it when your child is not gaining enough weight. It’s what they call Lex’s condition at the Children’s Hospital when they talk about the reason for our visit. The word “failure” has such a negative connotation and when you pair it with the word “thrive” in reference to your child, it’s a bit upsetting. No one wants to feel like their child is failing at anything, especially not at thriving. It’s an old, blanket diagnosis that doesn’t really tell you anything that you don’t already know, which is that your kid, for whatever reason, is not gaining enough weight.

When Lex was born, he weighed 7 pounds, 8 ounces– a good, healthy weight. When we went in for his first check-up, though, he hadn’t gained back up to his birth weight, and the doctor already started to show some concern. I was breastfeeding exclusively so she gave me medicine to help my milk production. The next week when we came in, he was back up to his birth weight so all was well. After that, he continued to grow, but not at the pace that most babies do. Then he kept getting ear infections and colds once he started daycare, so everyone attributed his slow weight gain to that. This past Winter was not near as bad, and when he went in for another check up, the doctor showed me the growth chart and how Lex has fallen below the chart and how his weight has plateaued.

When I talked to family and friends about his weight, no body (except maybe my mom) seemed too concerned. They all tried to make me feel better, pointing out the benefits of having a small baby or telling me anecdotes about their own children being small. I wasn’t all that concerned, thinking that the doctors were probably overreacting, but seeing that growth chart had planted a seed of doubt in my mind.

We went to see the specialists at Children’s Hospital in Little Rock. I couldn’t go to the first visit, so Vinnie had to go instead. He told me that they wanted me to wean Lex. Most of my friends thought that was absurd. Why would weaning him help him gain weight? I thought the same thing, and since I wasn’t quite ready for that transition yet, I decided I would just try harder to get him to eat more.

It’s not that the kid doesn’t like particular kinds of food like a lot of picky eaters. He actually seems to like foods with a lot of flavor, especially if he sees me or his dad eating them. The thing is, he’ll only take a few bites and then refuses to eat anymore. Or, even if you can get him to take another bite, he’ll spit the food out which is especially frustrating. Anyway, we tried adding Carnation Instant Breakfast to his milk to help him get extra calories, but when that didn’t go over well, I started mixing it with Greek yogurt. He ate that pretty well when he was at school. When he was at home, it was a completely different story. He still wanted to nurse all day instead of just in the morning and at night like on the weekdays. I’d half-heartedly try to get him to eat a decent meal of solid food, but he wouldn’t have any of it.

After two months, we want back in to see the specialists at Children’s Hospital. They didn’t tell me how much he weighed, but since they weren’t celebrating, I knew it wasn’t good. The doctors were nice and asked about how he eats and what he eats, etc. Then they asked what I thought and if I was very concerned about his weight. I told him that I wasn’t that concerned but since all the doctors were, I guessed I should be. The doctor said, “Well, you should be because he’s starving.” That definitely took me aback. “Oh. Wow. Really?” I replied. She confirmed. She went on to talk about weight to height ratio and growth charts, etc. but I was pretty stuck on the whole “he’s starving” thing. She told me that he would be considered malnourished. My kid is malnourished!? I thought that only happened in Third World countries or to really poor children. I felt like I had been somehow neglecting my child, like a really crappy mom. The doctors were really nice as could be and not judgy or anything, but how can you not feel like a bad parent when a medical professional tells you that your child is starving?

If the doctor’s goal was to really make me understand how serious this is, she definitely succeeded. Next, we talked to the nutrionist who gave us a game plan. She gave me an example/goal menu for a toddler (finally!) and recommended adding powdered milk to his whole milk for extra calories as well as adding high fat dairy products to all of his food. She said to give him lots and lots of butter on everything. Of course, they also told me to wean him, too. They were understanding about my reluctance, but assured me that he could handle it.

Ever since that visit (about 2 weeks ago), I’ve been trying my darndest to get that kid to eat, eat, eat! I even started weaning this week. The weaning has been a bit difficult, of course, but he has actually been doing better than I thought he would.  The key for Lex seems to be distraction. As long as we’re not in the nursing position or I’m not sitting in our usual chair, he is ok. If he starts trying to nurse, I have to find something else for him to do instead. I still nurse him before bed and in the middle of the night, but that’s the only time. I think after a week or two of that, I’ll give the last bit a try, too. I think that since we have a good bedtime routine, he’ll be ok with giving that part up. The middle of the night will be harder.

As far as eating goes, it’s really just a matter of trial and error. I give him food I know he likes and try to add cream cheese or butter to it. I’ve also introduced new foods that are high in fat and calories and hope that he’ll eat them. Usually he’ll take a few bites and then want to play with the food. And by play I mean fling across the room. I can’t tell if he doesn’t understand that I don’t want him to throw the food or he does understand and is just ignoring me. Since starting weaning, he has started drinking more whole milk with powdered milk added, which is really good. He’s also supposed to take a complete vitamin, but getting him to eat the whole thing is also difficult most of the time. Since it’s chewable and he only has front teeth, he will suck on it for a while and then take it out of his mouth and throw it somewhere. I can’t wait until this throwing phase is over!

I suppose all we can do is try as best we can to get him to eat a little more every day and then wait to see if it works. If you have any advice or experience with getting a toddler to put on weight, please leave a comment below.

Update (9-13-12):

Lex has been doing much better since I wrote this post. We completely weaned within a couple of weeks. It was definitely difficult, but I’m glad we decided to do it. Any other moms in the same situation who are debating whether or not to stop nursing, I’d recommend stopping. We still have the same intimacy at night and before bed; the only difference is he’s drinking from a cup rather than the breast. He now drinks milk with the Carnation instant breakfast mixed in. Usually he has 2-3 a day mixed with whole milk, and it’s still how he gets most of his calories. I still have trouble getting him to eat a substantial amount of food in one sitting, but at daycare they say he eats well. The doctor told me that was typical because he’s got a good routine there and he sees all of the other little kids eating. At our last check-up at Children’s Hospital, the doctor said that while Lex is still on the small side for height, he is gaining enough weight relative to his height that he no longer has to go back to that clinic. I was so glad to hear that! They also did a blood test and found that he was anemic. We’ve been giving him a prescribed iron supplement once a day now. I can tell that he’s finally getting bigger now. He’s actually starting to outgrow some clothes. I hope this is the last we see of failure to thrive.

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