HELP! Stressed failure to thrive

[Hazzyyy]

Hello,

Could someone please help/hand hold

My 16 week old has gradually dropped from 9th to the 2nd centile. He's never lost weight but only gaining 100g roughly a week. Last week, no weight gain.

Paediatrics have diagnosed him failure to thrive :'-(. They have recommended 2 x100ml bottles of high calorie formula. He is EBF.

He won't take more than 3oz (2/2.5oz usually) at a time and that's maximum, so it's taking me up to 4 times to finish the 200ml of formula.

He cries when he's done and won't accept more than that. He breastfeeds one on breast for 5-7mins every 2-3hrs. I can't get him to feed more. The other breast is 'dry' due to recurrent mastitis.

I was wondering if anyone could help me in any reassuring stories about failure to thrive or any help with silent reflux symptoms? Is that why he won't drink more?

He is such a happy content baby with plenty of wet nappies and a couple of dirty nappies a day.

Thanks

BF babies often won't take a high volume in a bottle.

Mine is a good weight at 15 weeks and has never, ever taken more than 3oz (90ml) from a bottle.

If baby is happy and feeding well on the breast...maybe she's just small? In 2 weeks time she could have gained 200g. Weekly weigh ins can be misleading.

Totally agree. BF babies at this age take roughly 25 floz on 24 hours. So if he's feeding every 2 to 3 hours, 3 floz is actually quite good.

Personally I'd do the following:

offer a BF every 2 hours in the day for a couple of weeks. I did this with DD and she started to climb the centile charts again.

Go to your local BFing Support Group and get some RL support.

Have a read of this on Tongue Tie to see if any of it sounds like what could be going on. Recurrent Mastitis could be a sign.

And have a read of How Might I Increase My Baby's Weight Gain?

Good luck @Hazzyyy

9th to 2nd doesn't sound like a massive drop to me? Some EBF babies do drop down the centiles in the early weeks. My DS1 dropped from 75th centile at birth to below the 25th at 12 weeks. He's now 18yo and well over 6 foot tall! I know it's stressful but hopefully he'll be fine.

Thank you all for replying

I didn't think the drop from 9th to 2nd was big either so I'm really shocked that they have diagnosed him as Failure to thrive. Such a horrible and stressful term!!

Thank you, I will offer every2hrs again. I have tried but he just arches his back.

He is 16 weeks today and when last weighed was 5.2kg.

Glad to hear that 2.5/3 Oz is normal per feed. I keep getting told it should be 4-6oz.

I have a telephone consultion with paediatrics on Wednesday and they advised a weigh in on Tues. Fingers crossed

Thank you all again

Its such a horrible term. I can remember asking the Dr if it meant ds would die, Ds was prescribed Infatrini. He was on the 9th centile and dropped off the charts. He is now 12yrs and on the 26th centile for height and 9th for weight. Very slim but healthy.

Four to six would be normal for a ff baby but his stomach hasn't been stretched in the same way.

Have they advised you to BF before the formula top up?

Ideally the best ways to increase are to feed more often, top up with BM and formula top ups should be a last resort if you've already tried the others.

I would definitely advise speaking to an IBCLC because with all due respect pediatricians are not known for their expertise on breastfeeding!

You might get better results that way without having to stress about formula.

@Discomboobulated that's the kind of question I felt like asking as that's what it sounds like! Horrible!! Glad to hear your Son is healthy!

@SiouxsieSiouxStiletto the Paediatrician has said he has to have 2 x 100ml bottle of SMA high energy formula (which she prescribed) and then BF the rest of the time.

@luckbealadytonight yes good idea, thank you!

He feeds 5-7 mins on one breast. I've tried then to offer him a top up bottle of breastmilk. He won't take it. I just put 20/ 30ml or so in there but he won't take it or even take the breast again for another 2.5-3 hours. It makes me feel like he's content as he doesnt cry and happily plays in between. But paed said he's not getting enough calories and weight gain is too slow, therefore diagnosed failure to thrive.
I tried to explain I can't get any more milk down him, I've tried feeding every 1.5/2 hrs but he just arches his back and cries and only takes it after 2.5/3 hrs. I thought he might have silent relfux but I think I'm just overthinking. This whole thing has got my mind boggled.

Was he born on the 9th centile?

Just wondering how you've managed to end up under a Paediatrician with a diagnosis of failure to thrive with a drip from the 9th to the 2nd.

@SiouxsieSiouxStiletto I've just checkes his red book...He was born at 6lbs7oz which on his red book just middle of 9th and 25th. Then he followes 9th perfectly until week 8 where he followed in-between 9th and 2nd. He's just hit the 2nd percentile now.
I am shocked at the diagnosis. It wasn't mentioned to me face to face but on the letter to the GP which the Paediatrician forwarded to me on the app, it says diagnosis: Failure to thrive.

This is not medical advice, obviously, and maybe I will get piled on but I know what I would do.

If baby is content, lots of wet and dirty nappies, and otherwise healthy - I would decline any weigh ins for at least 2-3 weeks to see how things pan out.

Sometimes we get scooped by the medical system on a technicality and it can cause a lot of unnecessary stress and intervention.

I don't know if your a ftm but from my experience a lot of parenting comes down to 'suck it and see' or 'wait it out'. The fact is you know your baby a lot better than your doctor does which means you can call some of the shots yourself - especially if you know baby is perfectly ok otherwise.

Food for thought!

At risk of also getting piled on and also not medical advice, I would do exactly that. I was told by my midwives that a healthy child will not starve itself. So unless there are other signs that baby is unwell I would continue feeding as usual and offer more often and then weigh back in in a few weeks.

Constantly worrying isn't going to help either of you.

That is quick given that he hasn't even dropped 2 centiles. Was the Kellymom link of any use?

@SiouxsieSiouxStiletto I couldn't see the link but have googled it, very helpful thank you!

@Plankingplanks @luckbealadytonight thank you, I will try that attitude. As you said it's not helping either of us and I'm so stressed I can't think straight and am short tempered. Which I'm sure he's picking up on

Doesnt help that since 7am he's only had 2.5oz ina. Bottle and won't breastfeed. But like you said, I'm sure he wouldn't go hungry.

Thank you all so much for you advice and kind words. I'm hoping he's gained some weight (will be two weeks since his last weigh in and I have to do it next week due to telephone consult with Paediatrian)

Doesnt help that since 7am he's only had 2.5oz ina. Bottle and won't breastfeed.

Boys not a lot. Hungry babies can often be very sleepy, so is he bright and alert at times?

Is he displaying any hunger cuess*?

We had big issues with weight gain - although slightly different as caused by tongue tie leading to poor supply. My son dropped from the 50th to the 2nd and didn't gain weight between weeks 7 and 9, so I know how stressful it feels.

We were told to aim for 150ml of formula per kg per day - so at 5.2kg, that's 780ml a day or just under 100ml every 3 hours. So only just over 3oz, rather than 4-6oz, and he'll be getting even more if you're breastfeeding on top.

My son is now nearly a year old, and has hit the 90th centile so they can definitely bounce right back (unlike my back haha).

@SiouxsieSiouxStiletto he's suuuuper happy and alert. Sleep wise he's done 3 X 45 min naps today, which is his norm.
So far he's drank 3oz from a bottle and had 2 X 5 min breastfeeds today. I keep offering bottle and boob and he just won't take it. Arches back, turns head to the side and cries if I try.

@Nejnej that's so reassuring to hear that your son has bounced right back! Yes it's very stressful.
3oz is the max he will take and that's not often. Today he's had 3 Oz all day :-( and a couple of breastfeeds

I'd also do this. weekly weigh ins can cause more stress and aren't helpful for everyone. if your baby is content after a feed, and has plenty of wet and dirty nappies then I'd stick with the EBF and offer the formula after bf if you want to.

@lochmaree thank you, yes I think I will offer as much BFs as possible. This whole this has just rocked my BF confidence but I have to find it again! X

@Hazzyyy bless you thats such a shame! weight issues can be really worrying. something else Ive read previously was that your baby may have weighed heavier/further up the centiles at birth due to fluid, and then as they lose that, they go down the centiles a little bit. hope you're doing OK ❤️

I'm sorry, but I don't think it's a good idea to ignore a baby dropping down the centiles. Babies with reflux can and do go hungry, eating only the minimum they need, as they associate eating with pain.

I had a similar situation, (except ds also cried for hours every day). Turns out he had CMPA and reflux, with an elimination diet and medication he climbed from off the bottom of the charts to the 90th percentile in 6 months.

Have you tried seeing whether he improves if you cut out allergens?

@CatherinedeBourgh OP isn't ignoring it, she's so far done what the doctors have advised and is posting here for advice too. Doctors are notoriously not very protective of breastfeeding in weight / centile loss situations. as the OPs baby is happy, alert, has wet and dirty nappies, it seems less likely that there is anything untoward going on. And yes you could say well she shouldn't risk it, but there are risks associated with introducing more formula too.

I know she isn't, I'm just responding to the posters who said she should.

I know there are risks associated with formula (mine had CMPA, so formula totally fucked him up!). Unfortunately dropping centiles does mean there's something untoward, I think the OP should try to get to the bottom of what it is.

My son dropped to the lowest percentile then off the chart completely but as I was breastfeeding no-one seemed particularly concerned and I was never advised to supplement. He was tiny throughout childhood and was never interested in food/ would never say he was hungry (age 2-3 clothes when starting school). He is now a strapping teenager who won't stop eating!!

@CatherinedeBourgh thank you for replying! Can I ask what your little ones symptoms were of CMPA? And what medication you were given for reflux?
I feel there is some thing definitely going on with him, he just hates feedings, always burping and grimaces when milk comes up, always congested and sneezing and coughing.

@sequin2000 that's good to hear! Thank you for replying