Failure to thrive. What can I do?

[belindarose]

I thought we were doing so well with EBF. No pain, baby settled and sleeping well, alert, smiley etc.

However, he has been dropping through the centile lines and is now around 2nd having been born 95th. He has put on 5oz in the last 25 days (coinciding with when I really thought feeding was going particularly well). HV has declared him 'failing to thrive' and is referring to a paediatrician. Exactly the same happened with DD, now 3. Her chart looked identical.

What can I do? I've posted before about lack of advice and support here and there is nobody I trust at all. Immediately after seeing HV this afternoon, I saw the Breastfeeding support worker from the children's centre. She's given me poor advice before, but I spoke to her anyway. She told me not to switch sides as he was getting too much, to eat more protein and to drink more fluids myself. I know this isn't helpful.

What could be causing 'failure to thrive' in a seemingly well and appropriately developing baby? Even as I was waiting to see HV, people were commenting on how alert he was for his age. I think he's growing in length as I can tell from his clothes.

My confidence is sinking fast. The implication that I'm doing something wrong isn't helping.

[OpheliasWeepingWillow]

How old is baby?
Can you call La Leche League?
TBH 95 to 2 is a big drop. How tall and is height tracking OK?
Latch alright? How many feeds a day? For how long?
My guess is something is amiss TBH which needs to be investigated. It's either the baby (no idea what could cause but mine has failure to thrive from silent reflux) or boob (poor let down?)

[ZuleikaD]

Can you get your breastmilk analysed? They might be able to tell you if there's a vitamin or other nutrient deficiency. Are you taking multivitamins at all?

[tiktok]

belindarose :( :(

The breastfeeding support worker needs retraining or sacking - very poor advice.

To see the paed is not necessarily a bad thing. The paed can confirm there is no underlying metabolic reason for the slow weight gain....if that is the case, of course.

The term 'failure to thrive' is way out of date. The term used these days is 'faltering growth' and it's a bad sign in your HV if she is still using this old term.

Some babies are like this - normal, healthy, thriving, and small.

The paed will be able to sort this out once and for all, I hope. You may have a naturally slow gainer, or there may be something concerning, that you need to address.

Make sure you take your older child's chart to the paed.

[tiktok]

Zuleika, an analysis of breastmilk tells you nothing - a vitamin deficiency (or any other deficiency) does not show up in tests, which are for drugs or other contaminants. In any case a vitamin deficiency of breastmilk (highly unusual, but possible in chronically malnourished women) would not affect the growth of the baby.

[ZuleikaD]

Oh, ok, it was just a thought.

[mawbroon]

How has the feeding been so far? I am wondering about tongue tie

does he display any of the symptoms here?

[belindarose]

Thanks everyone. tiktok, I remember you saying the same about the breastfeeding worker when she gave poor advice about my daughter over two years ago.

mawbroon, thanks for the link. Yes he had been showing some of those signs, but all seemed to have been resolved. I've been posting on here a lot about various difficulties - lack of RL support being the major problem! He's 13 weeks, by the way.

[mawbroon]

Which signs was he showing?

[tiktok]

When you feel able to do so, belinda, make it known to the people concerned how badly you have been supported - with both your children :(

The rubbish about eating more protein and drinking more fluids is especially stupid.

[Goatbongosanonynous]

I don't have advice, Belinda, but wanted to extend you my sympathies as we are pretty much in the same situation, down to the bizarre advice... But goodness, that tongue tie symptom list!! We have 75% of those...
I hope you get the right support and advice as soon as possible.

[Startailoforangeandgold]

Not much advice, but having had DD2 manage to fall completely off the graph you have my sympathy.

Paediatrician could find nothing wrong with her. Agreed after his nurse had tried that she would not take a bottle for love nor money.

She was a bit older ~22 weeks and so just got fed heaps of yoghurt and formage fraise with his blessing.

In hind sight the only advice I can give is if your DS feeds continuously stop. Go for a walk or a drive in the car. Give your body a rest.

I don't think feeding DD as continuously as I did was good for either of us.
I was stressed about something very trivial at the time and that didn't help either.

As for DD she climbed up to the 50% line by a year old, continued BFing well into school.
Has never drank milk and only once used a bottle. It was full of squash she put in one she had for her dolls aged about 5.

[belindarose]

Thanks everyone.

HV made me an appointment with GP instead of referring immediately to paed. Just back from there. He feels there is nothing wrong with him, but agreed the charts looked bad. He wants to see him fortnightly.

He suggests expressing between feeds and topping up. I really don't want to do this but will if I have to. Is there really any reason why this would cause better weight gain than more frequent breastfeeding? If I offer the breast even more than I do now, and add breast compressions, wouldn't this get more milk into him (IF he will take it anyway)?

He also said he will be suggesting early weaning when we get to four months. DD only started gaining once she began weaning, but I did BLW with her from 5 months. 4 months seems far too young to me.

Any further thoughts? No RL support here!

[OpheliasWeepingWillow]

I would get in touch with La Leche League as soon a possible and get baby checked for tongue tie and latch issues. I would also (personally) offer a bottle after every breastfeed or express and bottle feed so I would KNOW how much LO was getting. I have a solute to thrive baby and it's because there is simply not enough milk getting into her.

[OpheliasWeepingWillow]

Failure not solute. What is solute???

[tiktok]

belinda, you need to ask him why he suggests expressing and topping up, ask him why he thinks this would result in greater weight gain....then you can judge from his answers how confident you are in his advice.

Can you call him and ask for a phone conversation - say you appreciate his advice but you have considered it and don't understand why it would be a more effective way of getting milk into him than more frequent feeding and breast compression.

Tell him you are unhappy about weaning at four months and why.

I still think a consultation with the paed would be a good thing.

[smk84]

Hi belinda, I am just on my way out but just wanted to say I really sympathise and will have a think abou5 your post and post again later

[belindarose]

Thanks all. Smk, did you get in touch with LLL Plymouth in the end? I'll
give them a call.

Tiktok, I need more confidence, don't I? I was pleased he hadn't insiste on formula, but didn't really think to question his other advice while I was there.

[tiktok]

belinda, I think it happens to all of us at some time or other - we listen to what the doctor says and then only think to question it on the way home :) :)

But honestly, it is likely to save a lot of worrying and angst, if you pick up the phone, explain that you need to get the doctor to explain something more, and either make another appointment or ask for a call back.

A talkboard can point out when things are absolute and clear rubbish (like when people post saying their HCPs have said something plainly stupid/wrong/ignorant - for example your breastfeeding 'support' (ha!) worker with the 'eat more protein crapola) but what your GP has said isn't absolute and clear rubbish....and there may be reasons why he has advised one thing rather than the other. So you need to ask him not us :) :)

[smk84]

Hi belinda, how are you today? Have been thinking about your post.... Have been trying to think of reasons why expressing could be more effective than direct feeding and can only really think that would be useful if lo wasn't able to extract milk as effectively as a pump. Yes I did contact lll, the lady was very helpful, although couldn't really help us any further without going to see her, and it is a bit of a trek for us as ds doesn't settle we'll in the car. She does run a drop in on fri ams. It is quite expensive, but we saw a lactation consultant at the weekend and she did such a thorough examination of ds and gave recommendations for osteopath. It is the best rl support we have ever had . If you think it might help you I can give you more details.

[belindarose]

Smk - yes please to details of lactation consultant. Thank you for thinking of me.

I've spoken to GP as tiktok advised. He said that he'd suggested expressing as a means of increasing supply. I've since spoken to LLL. Advisor was very concerned about supply when I described his weight pattern to her. She believes that the nipple shield used earlier on (as advised by everyone I saw) is the likely cause of a drop. Recommended a few days of skin to skin and very frequent feeding with breast compressions. I'll do the best I can with that. But I have already found that any feed where I persuade him to stay on longer/ do breast compressions he possets afterwards. Never did this before!

He's one of those so-called 'good' babies at the moment. Doesn't cry, quietly sucks his thumb (a lot. I'm going to try offering a feed every time he does it I think), easily pleased. I guess all this is actually quite bad.

I feel so let down and dejected, especially since I knew there was a problem and have asked and asked for real life help.

[smk84]

Belinda if you google Ann Dobson lactation consultant it will take you to her website. I really sympathise. I would try to look at your dss behaviour as a positive if you can. I so understand you feeling let down, hopefully now with lll and LC you can get some decent support and move forward.

[waitandseepudding]

Belinda, I feel for you, this is such a stressful thing. I was in exactly the same position as you a few months ago when dd was about the same age as yours is now. I too posted on here and got lots of moral support and guidance as, like you , rl help was useless.
Please get ur ds checked for tongue tie,my dd had one, which we got privately divided at 12wks. I too had asked for help and was told several times that dd latch was perfect!
being referred is horrid,(it's happened to me twice! ) unfortunately we had to wean at 16 weeks, dd just was not getting the food she needed and had lost weight and refused the bottle. Paeds recommended it at 11 wks but I just refused. In the end it was the best thing for us, I felt trapped by dd-whatever I did wasn't good enough and the stress of the situation seemed to just maKe everything worse.
Whatever happens, you have done brilliantly. I'm still feeding dd, at 8mo, though I know her calories come from her food.

[tiktok]

belinda, it seems clear that the doctor feels there is nothing fundamentally 'wrong' with your baby but extra calories would be a good idea...on the basis of what you have shared here, I think that is a reasonable view, and yes, yes yes.....more feeding, every time he looks as if he might take a feed, is the way to go. Happy, laid-back, babies don't always ask 'strongly' enough for what they actually need, so there are plenty of opportunities for you to get more milk into him :)

I think the nipple shield explanation may well be sound, too - shields have their uses, but they have their drawbacks too and undermining supply is one of them.

Hope the extra feeding (and compressions, but the extra feeding is the basic essential) helps.

[belindarose]

He pretty much refused to feed for most of yesterday (with long evening feed). Now I think I have mastitis. Woke him up to feed.

[cheesemonster]

Belindarose- sounds like you are having a really tough time so my thoughts are with you. We have been going through something similar and I would second smk84 suggestion of trying to get in touch with Ann Dobson- she has really really helped us. Just dashing off to feed DD but will follow this thread and keep up the good work.