7 week old diagnosed with Failure To Thrive. What the hell!

[aimeeeleanor]

I’m so deflated right now & need to know if anybody has been in a similar situation

My son is 7+1 weeks old. He was born on 13th July weighing 7lbs3oz. Born on Dropped down to 6lbs9oz at first weigh in. Then has verrrrry slowly been gaining weight since. Approx 10g per day. He now weighs 8lbs2oz & is small

• He is EBF
• Had a tongue tie cut at 2 weeks old

He seems otherwise healthy - Alert, has started to smile, seems strong (can lift head for short periods etc), tracks objects in front of him, makes cooing noises

The only issue we seem to have with him is wind. He burps a lot after a breastfeed (despite having s good latch) & seems to struggle some of the time when passing gas from his bottom or pooping. He writhes around when on the breast & also when trying to poop on his changing mat. Plus he goes A LOT. Like 10+ dirty nappies a day. Mostly yellow runny poops with one green one on an evening every other evening or so

Health visitor said he has dropped 3 centiles from birth yesterday on weigh in, he’s now on the 0.4th centile

She sent us to the GP who sent us straight to the Paediatrician at the hospital for peace of mind. Paed commented on him being a long but skinny baby who didn’t seem unwell in the slightest. She said he seemed ok & it wasn’t uncommon. Have suggested I cut out dairy & soy, though i’m not convinced as he doesn’t seem to have any symptoms of an intolerance or an allergy

Also said to stop letting him sleep through 5-6 hours on a night & to feed him every 2 hours during the day, 3 hours on a night

I was feeding on demand before but didn’t realise timings were from start to start, so he was definitely going longer than 2 hours between feeds (sometimes napping for 3-4 hours during day). I was also taking him off the breast whenever he pooped & seemed to have gas, which i have now been advised not to do.

Blood tests & pee / poo samples have also been taken to rule out anything related to that

Has anybody else had their child be diagnosed with FTT & they’ve turned out ok? I’m devastated thinking I have failed him. Unfortunately babies don’t come with a hand book & I thought we were doing a really good job. Obviously not :(

thank you x

@aimeeeleanor OP ignore the judgement of her sleeping 5-6 hours. My DD was born at midnight and after a quick feed & Dressing, she slept through until 7am and has slept all night ever since. She stayed right on her expected percentiles and always has. That won't be causing the issues your child has. It sounds like a dairy intolerance. I would try her on pre-mixed cartons of formula for a day or two & maybe even ask your doctor to prescribe dairy free formula to try.

I couldn't breastfeed at all due to my health issues requiring essential medications. I've often wondered if her formula contributed to her good sleeping but she's 7 now & still sleeps through (once I finally get her to sleep......she's still awake now at almost 10pm 😑) so perhaps not.

Please don't worry. It very much sounds like this is down to something that can be solved!

Why are people suggesting formula? Need to check whether dairy allergy first

op, failure to thrive is usual caused by a deficit in calories- just add in a bottle of formula.

failure to thrive can have long term effects on growth and health if not addressed early.

you have absolutely not failed your child, you sound like you’re doing great. But now you know, addressing the issue by adding in some extras calories and quickly, is the healthiest option.

But the baby has also been seen by a paediatrician who has recommended cutting out dairy. Formula is dairy. Yes, there are non dairy formulas, but the same paediatrician would have prescribed them if they thought it necessary. Just popping to Boots and giving the baby some
Aptamil is the opposite of what the expert doctor has advised. ‘Fed is best’ or otherwise 🙄

@ThePumpkinPatch Nonsense, you can't tell if a child is malnourished or not because they are wearing clothes a size or two down. One of DD's friends is absolutely tiny, but she isn't malnourished in any way - she has two small parents and is just very delicately framed. Kids, like adults, come in all shapes and sizes.

OP, you've had a lot of good advice (and some not so good). I think it's a bit of a myth really that centile at birth relates to what centile your child eventually finds themselves on. Both of mine have gone different ways: DD1 born 50th and up to 95th by six weeks and DD2 born 80th and now tracking 50th quite happily. So there could just be an element of him finding where he 'fits', particularly if his output is good and he is feeding well and often.

And formula may cause more problems than it solves. DD1 could tolerate it fine but DD2 just brings it back up horribly (and it stinks) and if there's any suspicion that a dairy allergy could be involved, it's the last thing I would be trying. If you want to supplement with a bottle I would attempt pumping some extra first before trying formula, as if he is sensitive of stomach, formula tends to not be as gentle and digestible as formula is. It's often the first suggestion but when a breastfed baby needs more milk, more breastmilk should be the first solution!

So you are advising that the mother ignores the paediatrician? You think you know better than the paediatrician? And you think the paediatrician is in favour of 'breast at all costs'?

FFS.

@SarahAndQuack Just because you disagree with someone, doesn't entitle you to hurl abuse & tell them it's 'utter nonsense!' This child is starting Reception so will be nearly 5! Age 2-3 clothes are incredibly small. I'm simply showing concern for a child?

Don't understand why you're saying there's no allergy symptoms. Those poos could be symptoms. Some kids don't have skin reactions just digestive ones.

Sounds exactly like my daughter, she's two now, but born at a tiny 5lb 4 and then dropped to 4lb, she had to have a feeding tube. She wasn't diagnosed with failure to thrive as my trust doesn't use that term anymore but told me that's that she was 😂. She did end up having cmpa, i never breastfed (due to medications I'm on) so she got prescribed new formula and started putting on weight.
She's still tiny now but eats well and hitting above and beyond her milestones 😊
You're doing a great job never forget this!!

Also both of mine have slept 5-6 hour stretches as newborns from week 2 or 3, and definitely neither have been starving! It's not uncommon for newborns. Sadly it often changes around four months! If the paediatrician isn't overly worried then I wouldn't be either.

I'm also not a breastfeeding fanatic.

I think mix feeding is wonderful and DP and I both agree we'd do it again, like a shot, if either of us had another baby. I would be totally happy to FF if breastfeeding didn't work, for whatever reason.

But, I found the advice to do a top-up formula feed in a situation like the OP's was very unhelpful and seemed actively to make things worse for my DD. I'm not sure if my post is one of those being characterised as anti-formula, but in case it is, hope that clarifies.

They are not supposed to count birth centile any more, because the normal and expected weight loss after birth confuses things. That's why there's a gap on the chart in the red book. It even explains this on the preceding page. You're meant to look at whether the initial loss exceeds 10% (it didn't from what you've said) and then that it goes back up to birth weight, which it sounds like it did.

How many centiles has he dropped since 2 weeks old? I can't tell from your figures but it looks like he's between the 2nd and 0.4th now?

Ds1 had this. It was CMPA, with reflux so severe it burned his oesophagus.

Do try an elimination diet. Cut out all cow products and soya for at least a month, and see how you get on.

How can you tell by looking at a child that they're NOT malnourished????

The child I'm referring to WAS diagnosed as failure to thrive which is a medical term for a malnourished baby. A deficit in calories

We had the same. Luckily my HV was amazing and the midwives at the hospital were really pro-breastfeeding so we just kept going. Dd was born 99th centile because she was so long and big, and eventually ended up on the 25th centile where she plateaued. She's 5 now and is just very tall and skinny despite constantly being the fridge wanting more.
We did do the wake ups though, which was knackering but worth it.

I'm sorry, but you must be kidding! You did that passive-aggressive 'kindly' bit. You can't do that and then object when other people take a similar tone.

Do you really not know anything much about children? A child starting Reception won't necessarily be 'nearly 5'. A child could turn 4 on 31st August and be starting Reception today, aged 4 and one day. Are you really going to tell me you are shocked and horrified that a child who was three yesterday must be malnourished if they still fit into age 2-3 clothes?

Also have a baby born on 13th July here! He had a tongue tie divided at 1 week and today we have just had it cut again as it reattached - symptoms of that were excess wind, fussing at the breast and green poos. A couple of people have suggested it but maybe get the tongue checked for reattachment? Hope that helps.

Recently had a very similar situation. GP suggested topping up with formula at the 6-8 week check and although I was reluctant I decided to do it as I just wanted my baby to be gaining weight and fed, so did 1-2 formula feeds a day and breastfed the rest of the time. Baby gulped it down and gained weight nicely, after about 3/4 weeks baby didn’t seem to be as bothered about taking the formula so I stopped offering it and weight gain is still going well, breastfeeding hasn’t been negatively impacted at all. The way it was described to me is that sometimes if they’re not feeding that effectively (so not extracting enough milk from the breast) they get weaker and are even less inclined to feed effectively, and it becomes a viscous circle. A bit of formula top up can give them the energy boost to feed better from the breast. Just make sure you protect your supply and keep feeding plenty, maybe express as well.

I know it’s hard and emotional but try not to feel defeated - you’re doing a great job! Don’t feel guilty about a bit of formula if it’s needed, it’s just a little boost and doesn’t have to mean the end of breastfeeding at all if that’s what you want to do.

I was in denial for a long time that my DS’s dodgy and frequent poos, wind and skin issues were due to an allergy, as he didn’t fit the bill of what I thought a CMPA baby was like. He was happy, smiley, growing and slept well. I thought all CMPA babies screamed all day and never slept.

Upon giving him a bottle of formula at 5 months, he had an instant reaction and it was very clear he had CMPA. I cut out dairy completely and I’m still breastfeeding him at 1 year old. I combi-fed for several months with Neocate formula which you can get on prescription from the GP. Now he is over 12 months old, he has oat milk.

As soon as I read your OP, my first thought was CMPA. Please don’t give your baby a bottle of dairy formula. Give the dairy free diet a try, and ask for some Neocate formula from the GP to top up if you want to. Also, remember it can take at least a month for all dairy to leave yours and your baby’s systems, and for you to start seeing improvements in his symptoms. There are also several CMPA support groups on Facebook.

Good luck, you are doing great!

Clothing size is much more to do with height than build. And they vary so much between brands it's totally useless as any kind of metric! Not to mention individual variation of preference of fit etc. Some people move up a size as soon as they don't drown the child, others keep them in the clothes until they look too small, we always tend to have about 2-3 sizes in the drawer at any one time anyway.

@SarahAndQuack You've made that up! I never mentioned any 3yr olds?!

Most children who turn 4 in the summer holidays (my birthday is 30th aug & I did) don't start Reception until the new year - as said to me just today by the school admissions department of the county council for the biggest county in the country before you declare that 'nonsense' as well!

Stop projecting and 'taking offence' whenever anyone has a differing opinion ffs!

I had this with my 3rd child, I was very shocked as thought all was well and breast feeding seemed fine. Ended up in hospital seeing the paediatrician who wanted to keep us in but I refused as had two others at home. In the end I had to express whilst she fed to get my supply up, I then offered her the expressed milk from a bottle as a top up. This seemed to work and she soon regained weight, it’s demoralising and you feel like all you’re doing is feeding or expressing but we got there. Good luck!

I was going to say, the uncomfortableness during and after feeds, during toileting and the amount/content of nappies does sound like it could be lactose/cmpa issues. I’d definitely cut out dairy and soy for a while. Just bear in mind it takes a good 2/4 weeks to filter out completely. I’d offer boob more often and maybe pump a bit after to increase supply a little. You can always bottle feed or freeze the pumped milk if you’re not ready for that stage.

You’re doing amazing, he may just be finding his line but even if he’s not you’re not the first or last person to post similar.

DD had all these symptoms as a baby. Was a cows milk protein allergy. She was also a bit rashy and had silent reflux. She used to vomit back a lot more than a posset. The paediatrician gave her antacid and antiemetic and I had to cut out dairy from my diet. I persevered with breastfeeding and her symptoms improved and she gained weight normally, she is now a strapping almost adult and grew out of the cows milk allergy as a toddler. She’s always had a sensitive gut though. Big hugs, I remember being stuck in the midst of this hell and around me all the other babies looked fatter and were feeding well. You’ll come through it, keep in close contact with your GP or paediatrician in the meantime as there are things that can help,

Totally depends on what the clothes are and which shop they come from. DS is 5, and is 25th centile for height and 9th centile for weight, and he is still wearing some of his age 2-3 shorts and tshirts. He’s 110cm, and is in age 5-6 trousers, long sleeve tops and coats, size 9.5 shoes. Not malnourished in the slightest, he eats like a horse. He was actually a bit of a chubby baby until he became more mobile.