17 answers

Failure to Thrive

My daughter weighed 8lbs 12oz when she was born and is now 8 1/2 months weights only 15lbs 10oz (she hasn't even doubled her birth weight). She went to the doctor today because she has a cold and the doctor was very concerned. Two months ago he said she had failure to thrive, but said he wanted us to be aware of it but not to worry to much let him worry about it. When I took her today he made an appointment next Friday for us to talk about nutrition and see if we can increase her calories without making her eat all day long. He said if that did not work we would have to take more "drastic" measures, test, etc.. (what the heck is etc..? )She eats 19 to 22 ounces of formula a day, and we mix 1tsp of rice per ounce of formula (she has reflux so it helps weigh the milk down and add calories) and she gets 2 fruits and 2 veggies a day (the Gerber 2's I think they are 3.5oz per jar). Does this amount of food seem normal, I thought it was enough and she wont eat anymore? Has anyone ever had this issue and if so what did the doctor do?

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my daughter at 12months was 19 lbs. I agree with the others I wouldn't worry about it, or get a second opinion!!!

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It sounds like she is getting plenty to eat. My daughter weighed 7.3 when she was born and now at 15 months weighs 17 lbs. She is not even on the charts for age group. I'm not worried, I know she is eating and drinking plenty. The doctor was concerned when she turned 1 about her weight and did a blood test and everything was fine. I would recommend getting the blood test over with if you're that concerned. It would put your mind at ease. I didn't think it was necessary with my little one, but it never hurts to double check. I hope this helps, you just might have a petite princess on your hands.

E.,

It sounds like we have all been in your shoes. My son who weighed 6lbs 7oz at birth but only weighed 20 lbs at 18 months. I was concerned for a very long time but my peditrician just kept telling me not to worry...that it was just the way he is. I switched doctors for several reasons and my new pedi recommended I call ECI (like someone else suggested). The ECI case worker, nurse and nurtitionist did assessments on him and decided he did not qualify since he was not showing a delay in development (cognitive, motor skills, etc). It wasn't until this visit that I heard the term "failure to thrive". The nutritionist explained that this generally means that your child is below 5 percentile. She also explained that does not mean they will not develop normally otherwise. She was able to give us some suggestions on how to get more calories in his diet and gave supplement samples. Hopefully, they could help you too.

My daughter was 7 lbs. 8 oz. when she was born and is now 10 months old and still weighs less than 17 lbs. She eats like you wouldn't believe and everyone always says they can't figure out where she puts it. I have always been petite and my husband is about average sized, so I think she's just going to be small. She has never been above the 10th percentile for height or weight and since she was 3 months old, her weight has been in the 5th percentile (or less), but her pedi says this is normal for her. She is developing normally in every other area such as motor skills, crawling, standing, talking, etc. So, if your daughter is also happy and developing normally, I wouldn't necessarily panic just because she is tiny. I would see how her pedi handles the situation and if you feel like he is overreacting or if you're concerned, then you should definitely get a second opinion.

Good luck!

I was going to say that you should see a chiropractor who specializes in pediatrics! I am a chiropractor but stay at home with my 3 little ones. I take them to see an awesome one in Mesquite. They have been adjusted since birth and they have never been sick!! I think it is great to have someone else to support you other than a pediatrician. I don't believe in "failure to thrive". That would just make me mad if a doc told me that. I love the support my chiro gives me and my children. She gives me an alternative to medicine and I love that choice. Her name is Dr. Marsha Heikenen and she is wonderful! Good luck.

E.,

Have you ever taken your daughter into a chiropractor? I am a chiropractor and I have worked with children with failure to thrive and with reflux. They respond tremendously to chiropractic care. Also, I can test her for allergies and using a cold therapeutic laser we can help to eliminate those allergies. We can also use applied kinesiology (muscle testing) to determine if her organs are functioning properly. It is easy and pain free. Call or email if you have any questions. Thanks! Dr. Sandra S. ###-###-####

Is she growing fine, height-wise, and just skinny, or is she not growing well in linear height as well? Did your pedi ask for bloodwork? It might be worth having her IGF-1 level checked. And also celiac disease.

If she eats a normal amount, and acts energetic, healthy and normal, but isn't growing normally, it could be a growth hormone issue, or celiac disease.

Now, your pediatrician probably wants to rule out the most obvious thing first- if your child is not getting enough nutrition, that would be a problem with growth and weight gain, for sure! But if she eats well and is generally developing normally, it is possible that something else could be going on.

My daughter was 8 lbs 8 oz and 20.5" at birth, so quite average. At nine months, she was 14 lbs. 5 oz. and 26" long, but otherwise healthy and normal. Just tiny... And she fell further and further and further down the curve, then fell off of it entirely, and kept falling further and further away. Finally with the help of a pediatric endocrinologist, we were able to get her the help she needed and while she will always be a petite person, she is, at least, growing now.

D.
http://www.cherishbirth.com

Does she still fuss a lot during the day? If so, she may still be hungry but unwilling to eat more due to the reflux. That was the case with my DD, who was only eating about 17 ounces per day. She was still very hungry, but it just hurt too much to eat. We started her on a reflux med, which I wasn't thrilled about, but it doubled her intake! After two days on Zantac she was up to 30 ounces per day. Girlfriend can eat! And I feel much better knowing that she is obviously feeling better. It might be worth considering. Good luck!!!

I know how you feel. I have a daughter that was a preemie born at 24 weeks and only weighed 1 pound at birth. She wasnt even on the growth chart for I cant even tell you how long. I was really worried about her not gaining weight. She also had reflux and we had to thickin her milk and was on meds. I felt that she was eating a normal amount of food but not growing. Her doc said all children have growth spurts at various times and sometimes its not what you would think the normal time should be. sHe said some children just grow at a really slow rate (which my daughter did). She said as long as they pee/poo and function normally to not really worry and just give it some time. She eventually got on the chart and she is now 3 1/2 and is 3ft tall and 30 pounds so she caught up it just took awhile. She is now in the 95% on the chart for height even if you dont adjust the 4months behind she actually is in age. The weight she isnt where she should be but her dads side is tall and skinny and she is built like them so Im not really worried. I hope this helps a bit and hang in there and keep good contact w/ the doc.

My first thought is to ask if her reflux is being treated properly? And is she losing weight, or just not gaining as quickly as expected? Also, is she developing normally otherwise -- crawling, meeting physical milestones, etc?
My daughter only weighed 16 lbs at one year, but she also started out at 6 lb 11 oz. I don't think the actual weight is as important as whether she's staying on her growth curve. My daughter was consistently at the 10th percentile, so our doctor never worried. I think they also worry if the percentile for height and weight are out of proportion.
The amount of food she's eating seems normal. She should be basically eating 3 meals a day plus her formula. The formula sounds a little low, but only by about 4 to 6 ounces. But every kid is different. My daughter barely, if ever met the minimum recommended amount of formula, but my son would regularly exceed it.
I have a friend whose baby got this diagnosis. The "drastic measures" will likely involve getting a stool sample. I think they'll look for blood, fat and excess mucous, which could be signs of a food intolerance or a digestive disorder. Both things are often very easily corrected through dietary measures.
Good luck!

E.,
I totally feel for you. We had the same issue with my son. He was 9 1/2 pounds when he was born, and didn't even reach 20 pounds at 1 year. His doctor totally freaked me out. He ordered all these tests, he even had to be catharized to check his kidney functions. I felt he was eatting enough. He ate until he was full. Anyway, to make a long story short, after all these test were inconculsive, the doctor, I felt just blew me off. We have since changed doctors, and my son is a perfectly normal, healthy and a happy 3 year old who weighs 29 pounds. Our previous doctor was Dr Burton, we now have Dr Alvis. You may want to consider changing doctors. I hope this helps.

J.

Dear E.,
If you are concerned and would like to have a nutritionist come to your home for a consult you can call your local ECI program. They will also look at her development. If you let them know she has had a diagnosis of failure to thrive you should have no problem having a nutritionist that specializes in birth to three year old issues. The nutritionist can let you know what should be going on for you daughter at this moment in time and do it all in the comfort of your own home. I do not know the number to your local ECI so you will need to call 800-628-5115 to get that. Please keep us informed of what happens. J.

Hi E.,
What other signs of Failure to Thrive is she showing? My first child was 7 lbs 12 oz and I can't remember what she weighed at 8 months but at 9 months she was 17 lbs and she was around 19 lbs at 13 months. Although she was considered tiny as well, I never had a doctor tell me she was at risk for failure to thrive. How is she developmentally? Have you noticed a change in her growth pattern? I honestly would not worry at this point unless she is getting behind on her skills. You may want to introduce some protein in her diet, like a turkey with veggies, or chicken and rice baby food. Is she eating 'foods' three times a day? If not, I would add the third feeding of baby or finger foods. As for "drastic" measures, there are nutrition programs at Our Children's House in Dallas, that help children who are having issues with this. There may be other medical places that do the same thing, but what you are describing is not what I observed when I worked at Our Children's House. My lil' one has reflux as well, you may look at giving her a probiotic to see if that helps level out her digestion some. Feel free to contact for more ____@____.com

my daughter at 12months was 19 lbs. I agree with the others I wouldn't worry about it, or get a second opinion!!!

You might also want to check if there is any gluten in her diet. Gluten is a protein found in wheat, barley and rye. It can also be in oats (through cross-contamination). Failure to thrive can be caused by celiac disease, or a gluten allergy, which is often undiagnosed and can present by these symptoms. This can be corrected 100% through diet. My son and I have this (it's hereditary) and my pedi had to do a little research himself about it. Good luck!

As mentioned in another response, failure to thrive is an indicator of celiac disease (gluten intolerance). It is treatable through diet. They can screen for this through a blood test. My mother has this. It is a highly undiagnosed condition. Please consider this as a possibility and hopefully you will be able to rule it out.

Good luck and God Bless!

I didn't have your issue, but it sounds like your daughter is eating ok... maybe a little light on the formula (compared to my daughter, but every baby is different). My daughter was 7lb 2 oz at birth and just went to her 1yr yesterday and is 21 lb even.

My daughter was having about 30oz of formula at 8.5 mo, 2 veggies, 1 fruit and about a 1/4 cup of cereal mixed w/2oz of formula twice a day. I also gave her some soft tofu to add protein to her diet. Her favorite is still the cereal (mixed to a thick oatmeal consistency). We started giving her the tofu when she was started having trouble sleeping through the night and I read that a lack of protein at that age could be the culprit. We added the tofu and she started sleeping through the night again. If your daughter doesn't seem to like the tofu, I would mix it with a fruit or something.

I would try to not let the dr freak you out too much and maybe get a second opinion from another doctor.

I hope that helps ... try not to stress, I'm sure it will all work itself out.

E.,
Your daughter is in approx the 5th percentile for her age. While this is low, this can also be normal for her. Are you and your husband large or small? Were either of you "slow growers'? An adult woman is considered the 50th % at 5'4 and a man at 5'9.
In our office we look at the full picture- is she growing? is she eating, peeing and pooping? Is she meeting all of her developmental milestones? Those paint the whole picture. To check development try: http://www.aap.org/healthtopics/stages.cfm
I know this is scary- this is your baby after all! There are also ways to make formula more calorie dense- http://www.med.umich.edu/1libr/pa/pa_forminst_hhg.htm BUT CHECK WITH YOUR PEDI ABOUT THIS!!!!!

Please feel free to e-mail me w/ any questions.

D.
____@____.com

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