Aibu to pull my child out of nursery

[Kanfuzed123]

So my daughter was SGA 2.3kg at 37 weeks. No signs of iugr or fgr, we were told constitutionally small, but who knows. Enter lots of mum guilt and blame.

She caught up to approx 15th centile by 6 months and floated in that range, got up to 25th for weight but then fell to 15th after she became more mobile. That’s fine our mid parental range is from 9-91st.

She started nursery and it’s big after big after bug, she held out ok still floating around that centile and before 2, her length fell between 2nd and 9th centile, weight stayed the same and then at a check a few months ago her weight has fallen to the same centile range and she’s now faltering growth. I feel like the worlds worst parent and like I’ve failed her. She’s got another cold and a sickness bug now again so she’ll drop further. I don’t know what to do for her. She’s been prescribed weight gain drinks but she won’t drink them. I think she eats enough to keep her ticking over (we do all the tricks to make her food higher calorie) but not enough to gain and her appetite gets affected by being constantly unwell. I’m concerned because she’s not eating enough it will impact her catch up growth. Her dietician who prescribed the shakes has said calories are required for growth and at a young age growth is largely nutrition related.

I’m at a loss, DH is depressed from it and ends up inadvertently putting pressure on her which makes it worse, I’ve stopped this as soon as i noticed, but it is a very desperate situation because we are so worried about her.

At this point, what would you do? Take her out of nursery? I’m considering it, just so her health can recover. I know she might get Ill then at school but since sep 20 she’s probably had 2 weeks cumulative of good health. She’s had 2 lots of blood tests because of how unwell she gets but they’re all normal. Are there any other tests? I do think she must be more ill than the average child.

Should I just pull her out of nursery? I’m on mat leave so I’m at home? Is it unreasonable to pull her out? Dh isn’t sure I’ll cope alone with both of this (kind of insulting but that’s another post).

She’s off her food with every sickness bug or every time she gets phlegm in her throat which is a regular occurrence with the amount of colds she has. She also passes it on to her brother who’s a newborn and I’ve already been chastised by our GP as he’s had bronchilitis twice.

Wwyd?

I'm not sure what's normal.

My child's at nursery and has only had the odd cold, maybe 2 in the last 3 terms. Their eating isn't impacted.

In your case, I would take her out and see how you go. 1) of course you'd cope, most of us have a preschooler and newborn at some point. It's daunting but absolutely fine once in a routine 2) it will be a good test to see if it's nursery making her so ill or if it seems to be more of an immunity issue.

Fingers crossed you find something that works, I can imagine how stressful it must feel

@Theunamedcat

Has he tested her for celiac? The excess mucus is occasionally indicative of celiac disease this would cause failure to thrive because the nutritients won't be absorbed

Yup she’s been tested for coeliac and had a fbc and all normal. Was v mildly anaemic but some iron supplements sorted that out but now due to tummy bug after bug she can’t take them anymore

If she's only 2 I'd definitely take her out. Concentrate on her health and send her back in September.

On a practical note have you tried anything apart from the shakes? There are options- juice, puddings, jelly. Try them chilled as they taste less strong.

You can also now buy an iron supplement that you spray on the inside of the cheek

I'm assuming they have ruled out cystic fibrosis acid reflux all that sort of thing?

@LuchiMangsho

Huh? Your GP doesn’t sound supportive at all. Most babies with RSV don’t end up on a ventilator. My 26 weeker got bronchiolitis and only needed a smidgeon of oxygen. That’s appalling from your GP.

Look the SGA thing is weird. I have a kid who was born on the 9th febrile and is still there. I am small, DH is not a giant. Failure to thrive is different but the idea that a child born just below the 9th, who has always been a little small and is still small needs her mum to be guilt tripped is a little strange. Maybe she’s always going to be small.

Yes, no one has ever said anything about my 2nd centile child (born more like 25th). Should they have?

Excess mucus can also be cows milk intolerance, I think you referred to ending breast feeding?

That was the case for my DC who was ill more dramatically than his older brother when he started nursery and stopped breastfeeding. A glass of cows milk makes him sick about 12 hours later, also every heavy cold makes him sick (the mucus makes him sick). I was also intolerant to cows milk as a child, it made me constantly ill with runny nose and it used to go to my chest. I had goats milk as a child, as does DC, immediate improvement.

No advice re nursery, no doubt the lack of mixing last year has increased bugs in circulation this year.

@BungleandGeorge

On a practical note have you tried anything apart from the shakes? There are options- juice, puddings, jelly. Try them chilled as they taste less strong.

Weight gain jellies? I’ve not heard of them.

We tried puddings and stuff, she’s not arsed and won’t eat it.

The shakes are prescription and fortified for weight gain

I think your over obsessed with her size 😳
My daughter was 10 pounds at birth but dropped rapidly over her first 3 years.
She caught everything going and at almost age 8 she still does.
But you can't protect them from every germ and what you going to do when she is 5 and needs to be in school?
My daughters on the 5th percentile for weight and height but her attitude is much bigger and she would hate for me to about germs and food! She's a kid she needs to be able to be a kid

My daughter was also an IUGR baby born at the same weight as your child at 38 weeks. IUGR due to gestational diabetes and placenta deterioration. Went to the 25th centile at 3 months and unless I took her to weigh clinics (which no one checked up on and then stopped when covid hit at 7/8 months) then no one has checked up on her weight until her recent 2 year check up! And I'm amazed by all the professional input you have for your child! Did you have all this from the start? As we have nothing! No one has measured her height so no idea what centile she's on for that (I have measured her myself).

I weighed my daughter and she dropped centiles when she was mobile and then went back to the 25th. My daughter doesn't go to nursery but obviously still mixes with children and gets cold often but nothing like illnesses my friends children get who go to nursery. I remember when my niece started nursery at 3 she had a constant snotty nose for the 1st 6 months its just the way it is when children mix.
I've noticed all children are different when they're ill and a few of my friends children do go right off their food when they're poorly and loose weight.
If it was seriously affecting my child and their health I would take them out of nursery for a while, however everyone's situations are different, we don't know your family dynamics/financial situation.

@Theunamedcat

I'm assuming they have ruled out cystic fibrosis acid reflux all that sort of thing?

Heel prick ruled out CF. She was v sicky as a baby but always dismissed

I’d recommend contacting the specialists at Solid Starts who are experts in picky eating or at least having a look at their Instagram reels if you haven’t already. Our NHS dietician was beyond useless, wanted us putting cream in everything to try and get our daughter gaining weight. Excellent advice but she wouldn’t actually eat anything. Dropped from 50th percentile to below 9th. She’s gaining again now, at 20 months just starting to outgrow 9-12 clothes and size 2.5 feet.

I know op it's just that's not necessarily what's she's actually eating is it.
Unless you literally see it go in etc.

Ok @germsandcoffee that’s so unhelpful I’m not obsessed with her size, i don’t care how tall she is as long as she’s where she’s meant to be genetically and currently she’s not.

@Metallicalover we had nothing. I paid private for a dietitian and paediatrician, we just had so much grief from the HV around her size

Just take her out if you want she's only young and you are home anyway.

I'm sure your DH will cope!

To be honest I'd just stop weighing her and stop worrying about it as long as she's eating. It's just completely stressing you out and not helping her.
What about if you found a childminder rather than nursery, she wouldn't be mixing with so many children then and it could be a good compromise.

I absolutely wouldn't remove her from nursery...so far all the positives you've stated have been directly linked to there, so she eats really well when she's there (I wouldn't consider removing the only place where she eats well), she loves and enjoys it, she has friends, it's improved her development. All so positive, and she's not a little baby, she's a little girl. Obviously the constant bugs are a worry 😟 My eldest (DS now 4) was sooo poorly growing up, he had constant bugs, viruses, tonsillitis, hfm, rashes, hospitalisations, he was treated for Meningitis, had a reaction to his MMR. It was so bad I developed crippling anxiety, depression and pts after the spinal tap. After that initial Autumn/Winter it got to about end of February and I honestly don't think he's ever once been poorly since (apart from a few colds) in 3yrs. That exposure despite being a living hell at the time made him Bomb proof with a superb immune system. Baby DD 11mths is the opposite. She's been at nursery 3mths now and has had a couple of cold viruses/ear infection and hfm but hasn't been really poorly with any of it. The only difference is we give them both Haliborange every day without fail and I honestly think that makes a difference. Personally I'd try and weather the storm because you're nearly through winter and the benefits to her of nursery sound huge - playgroups really aren't comparable.

I'm a children's social worker and you really can see the difference in children who had that early nursery exposure (with relation to bugs!)

DS1 was prem and tiny - he actually dropped off the bottom of the centile chart. He also caught everything going, but not once did anyone recommend we remove him from nursery. The dietician we had actually recommended grazing since he was so small his stomach wouldn’t cope with big meals. He had plenty of high calorie snacks, added cream in cereal etc. he’s 10 now, and has finally caught up to his peers. He will never be the tallest or broadest, but he’s fit and healthy, and rarely ill.

Forgive me if I missed it but is she actually losing weight? Weight gain and growth are not linear, and will tend to happen in fits and starts. His weight chart looks like a flight of stairs! If you are concerned I would go back to the dietician since their recommendations aren’t really working for her if she won’t drink the shakes.

If you aren't already on there, go on the child growth foundation page, there's a sub group for IUGR/SGA support from the cgf.

You story is not unusual with SGA, so much so it's quite familiar and I'm wondering if I've seen you on the group.... if so wave of support.

Its balls and the doctors don't listen.

[quote Kanfuzed123]@Namechange12312 her dietitian said she’s seen more robust children fall 3+ centiles post lockdown due to bugs but she’s so much more fragile. She recommended the weight gain shakes but she won’t drink them and now she’s got another sickness bug so I’m going to email her Monday.

@Forgotthebins she doesn’t have a condition, so there is no one to refer to. It’s not failure to thrive anymore it’s faltering growth but it’s the same thing really. So stressful[/quote]
OP my lg has always been on the 0.4th centile due to premature birth. All the consultants know her are pleased with her growth and ability to maintain her growth even if it is on the 0.4th centile because it’s difficult.

A newer consultat also hits us with ‘failing to thrive’ and like you felt really guilty, had very test and genetics looked at and there’s nothing. She’s 6 and suddenly starting to grow. She’d been in 12-18 months until 4 and now in 3-4 the past year. It’s crazy how suddenly it just changes, it’s like somethings kicked in.

So if you’re in a similar boat to me where anything medical has been ruled out, you just keep plodding along. I would consider taking her out h til March/April and see how you get on…

Also worth asking your dietician for the powder you can add to food that adds calories. It mixes with everything so they don’t know and it was great. You could add it to anything liquidy - gravy, yoghurt, milk (therefore add to cereals, porridge or just surging you add to milk. I found I could add 100’s of calories a day to meals which meant that even though she was poorly and not eating as much, she was getting plenty of calories x

nursery IS great for them, and i am a big fan of it, but i do see your issue.

when do you have to go back to work?

In this case i would possible pull out until summer and try again say from june onwards, give her a good 6 months off ?

If you aren't planning on keep her in doors 24 hours a day, 7 days a week, then there's absolutely no point taking her out of nursery.
They will still catch bugs at tesco, at the park, at toddler groups etc.

@Tal45

To be honest I'd just stop weighing her and stop worrying about it as long as she's eating. It's just completely stressing you out and not helping her. What about if you found a childminder rather than nursery, she wouldn't be mixing with so many children then and it could be a good compromise.

@Tal45 sorry I should have been more clear she’s weighed by her paediatrician and dietitian and will be soon by her endocrinologist, not us.

I’m sorry OP this sounds so hard. I really hope things improve.

I’m not sure why the dietician suggested structured meals, my experience of that age was very much that preschoolers want to graze as that’s more natural for them. Sonif the dietician’s advice isn’t working you could maybe try more snacks like nuts and seeds etc.

Other than that all I can suggest is ask to be referred to a specialist and be careful how much you rely on the GP’s opinion as they don’t have good knowledge of specialist areas.

Anyway as to your question, absolutely I would take her out of nursery until the weather improves and there are less bugs around. Maybe just until April. But that’s just what I would do it doesn’t mean you should 🤷‍♀️