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

Hi Op, sorry you are having a stressful time! I haven’t read all the replies but my thoughts are:

• it’s important to wake (or dream feed) a baby when they aren’t gaining enough weight. They can become too sleepy from lack of energy to wake up despite needing the feed.
• your baby is showing signs of an allergy, perhaps CMPA, so I would suggest cutting it out of your diet and see if it helps
• see a lactation consultant to check baby’s latch
• if baby is having enough dirty nappies, is alert and not showing signs of dehydration then I wouldn’t rush in to using formula. If it’s CMPA that could make the situation worse (unless dairy free of course)

Just to say

1. You're doing great, keep going!
2. My lactose intolerant DD (yellow and green nappies, stomach aches) did much better when I cut out dairy and brilliant when weaned. The stool sample should confirm or rule that out. She's now almost 6 foot tall...

Made what up?

Where we are (North Yorks, England), children are eligible to start Reception as long as they are 4 by September. So August babies will be only just 4. They were 3 until just before they started school I didn't realise other counties do staggered starts, but so what? Even if you are talking about a four-year-old who is, say, four and four months, or four and five months, surely you can see that this is really not a big difference from being 3?

As @BertieBotts, clothing is often about build - and it varies hugely depending on who made it, and in what country. I've taken out DD's t-shirts and put them on top of each other, and there are inches of difference in width or length depending on where they're from.

Ugh, and I mistyped and said build not height. Sorry, @BertieBotts!

I cut out all dairy when my dd poos were as you described after dr mentions this could be causing it. It helped a lot.

Cards on the table, I trained as a breast feeding supporter. I have one very slight build child who has always tracked somewhere between the 0.4th and 2nd percentile. He was combi fed and I am
by no means a ‘breast feeding fanatic’, believing that we are very lucky to have it as an option where it is needed and helpful.

But this baby has been seen by a paediatrician who has recommended cutting out dairy. ‘Giving him some Aptamil’ as has been advised on this thread, would be the very opposite of this advice, and could do a lot of harm. I agree, some of what you describe could be CMPI/A, or it could be just normal baby behaviour! I think the paediatrician’s advice is sound and I would follow it. I would also, as some other people have said, have the baby checked by a feeding specialist to see if the tongue tie may have reattached, or was not completely divided to start with. That said, in the absence of pain on your part, even if it’s not perfect now, as he grows it will likely improve of its own accord, but they may be able to advise on positions that could make feeding more efficient for him.

You have not failed your baby, OP.

Ds was like this. Wheat and Dairy completely intolerant to.

Not RTFT but I’ve had two CMpA babies. The second was basically shitting herself to starvation. If the food/milk isn’t staying long enough in the gut for the goodness to be absorbed they won’t gain weight.
I would cut out the dairy and soya. It’s really easy now with all the vegan foods available and see if there’s an improvement in a few weeks.

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!

Totally depends on where you are - round here, you can only start at the correct time or defer by a whole year. They think it is disruptive to start midway through the year.

Breastfeeding fanatics indeed! The only fanatics seem to be the ones who have bypassed the cutting out dairy suggestion and leapt straight to giving formula. Yeah, give the baby with a possible cows' milk allergy, um, let me see, some cows' milk. Christ on a bike, it's so predictable.

My cousin was in the same situation as you OP and it was suggested she gave up dairy. She did and it was like the difference between night and day. She breastfed him until he was 4 and he's now a big tall 15yo, albeit with a dairy allergy.

We had similar. Midwife and Health Visitors concerned, giving me the impression that DD was in danger vs GP and paediatrician not concerned at all and exasperated that yet another BF baby had been sent in their direction.

I continued with breastfeeding after a consultation with the hospital lactation consultant who observed a feed and said DD was taking milk absolutely fine and gave me the confidence to keep going. I stopped attending weigh ins.

When I started introducing food to DD I discovered she had a dairy allergy which hadn't really been noticeable while she was BF despite me eating dairy. I do kick myself and wonder if this might have been at the root of slow weight gain.

DD was a bit smaller than her direct peers for the first couple of years but was happy and energetic. She has always been 1–2 clothes sizes smaller than her age until now, at the age of 5 she is taller than most of her friends. She is very fit, active, happy, healthy and bright and there is absolutely no indication at all that her early low weight gain was an issue.

On the poster who wheeled out the word 'malnourished' about a child wearing size 2–3 at the age of 4, this is utter nonsense. My DD at just turned 4 was still firmly in 2–3 despite having a very healthy appetite (teachers have told me how surprised they were at her appetite for a slim child!). I buy French brand clothes for her as they tend to be a whole size slimmer than UK clothes so in French clothes I can buy the 'right' size for her age.

For me, you've mentioned a couple of key points in your OP, which are worth tweeking. Time between feeds count from start to start, and whilst they are so young, it's worth dream feeding them at the 2 / 3 hour mark, or waking with a nappy change. I remember having to do this in the early days. Secondly, leave baby on for a full feed, the fatty bit of the milk comes at the end, so leave baby on until they drop off. Mine had green poos if they fussed and didn't take full feeds. I had friends that were also advised to cut out diary and it made a difference to them. You've got this, you're doing so well, a couple of changes and it will get easier. I attended a great breastfeeding course which taught me so much, and then followed people like The Milk Meg on social.media. Helped me so much.

My DD (also born on 13th July, but 4 years ago!) was a chunky 8lb 7oz at birth but steadily dropped down the centiles for weight over the first few months (EBF). She was a great sleeper and had to wake her regularly to feed throughout the night for a time. She is now a petite four year old - she was never going to maintain her birth centile as she’s just a genetically small person! Keep going, you’re doing a great job - it’s just quite overwhelming and confusing at the time, particularly when a lot of advice is conflicting!

I was diagnosed as failure to thrive, my mum switched me to formula and I never
looked back. I was hungry and not getting enough milk!

that was 45 years ago however so best to follow current advice and guidelines

@SarahAndQuack Just some solidarity for you.
I have worked in Early Years for 20 years and you are talking complete sense...👍

Ok. This is not good advice at all and pretty ignorant.
Babies don’t guzzle bottles down because they are starving.
The suck reflex means they will suck when a teat is introduced.
Formula is heavy like a roast dinner and breast milk is light like a chicken salad. This is why once formula is introduced regularly it can be almost impossible to go back to EBF. Plus milk supply drops with the lack of time at the breast and the vicious circle of hungry baby and not enough milk starts.
Saying give them a ‘good bottle of formula’ implies that breast milk is substandard and not enough.
A midwife insisted on formula for my 3 day old baby and insisted on giving it herself despite my tears and protests of wanting to breastfeed.
Undermined the whole thing and destroyed my confidence as a new mum and my breast feeding journey.
OP you baby is pooing and sleeping and happy. Some babies go on to be kids who are always small eaters and small sized.
More time at the breast is needed and I would also look into cutting out known trigger foods such as dairy (the number one) to see if that makes a difference.
Contact a breast feeding consultant if you are able.

This!

Honestly feel like some people lie in wait for these types of post so they can suggest a bottle of formula.

You sound like you’re doing a fab job OP. I would trust the professional rather than mumsnet.

If you wake baby to feed, the more frequent feeding will also up your supply. The more your baby empties the breasts, the more they get the signal to produce milk.

Adding in formula feeds can, when supply is not well established, reduce your breast milk supply as you aren’t sending the “empty, make more” signals as often.

Hope you seen an improvement soon

One of my failed to thrive for a while due to being a very poorly preemie. I was encouraged to keep breastfeeding and the paediatric team prescribed a high calorie formula to supplement once a day. In our case, there were other very complex medical needs at play and these would have been impacted by not having breast milk.

So many well meaning people advised me to stop breastfeeding and that ‘fed is best’. Fed is best but that may not mean giving standard formula. I am glad that we were guided by our medical team for the best outcome and now have a cheeky, brave and caring little girl.

I would advise following the advice you have been given. you may see a difference. Weight/progress will be reviewed frequently and the advice may change.

This is very good advice.
Yes leave baby on longer until milk flow is very slow to get the fatty milk.
Little and often feeds are the watery milk and will produce green poos.

I think trying to feed more often is a great place to start, try expressing too so that you can offer expressed milk after feeds. If there is an allergy it can take 6 weeks to leave your system so don’t worry if you don’t see improvements straight away. Lmj.infantfeedingsupport on Instagram is great for breastfeeding help highly recommend giving her a follow

Sounds like you're doing great but also the advice sounds good and you should definitely follow it. It does sound like it could be allergies and feeding more regular is definitely sensible.
We know a few tiny babies from DSs baby group. He's bloody huge in comparison but developmentally they're on par, they just get more use out of their clothes!

Yes, my perfectly healthy teen DD was diagnosed with failure to thrive at a few months old. She was constantly refusing to feed after just drinking for a few mins, but did feed better at night when she fed half asleep. We ended up with a feeding tube (which only lasted a few days as she vomited it out and then ended up with a rota virus she caught in hospital). Lots of investigations but nothing found. Essentially it was a stressful 6 months or so which improved once she had solids. And she was fine as a toddler, no health issues. So essentially it may end up a shitty worrying time for a few months but it will be ok in the end.

My son was born a good weight and dropped multiple centiles, he was weighed weekly and each week they were concerned, he was referred to paediatrics who said he seemed healthy for his age, he was weaned at 15 weeks and still didn’t gain enough weight, we were sent to hospital constantly by HV for check ups who eventually told the HV to stop sending me there, he was discharged at just over a year old, he’s now 10, tall and slim, small appetite and was under weight the first 6 years, he has sensory processing and is a grazer but the most active child I know.
My daughter was the same dropped multiple centiles didn’t double birth weight until over a year old and also a now healthy 8 year old.
i remember feeling so scared and worried because I was always made to feel bad about them both, both were weaned before 16 weeks under paediatric advice and it didn’t change the way they gained weight, they’re both slim, both full of energy and do multiple sports clubs.

if the doc isnt concerned and you’re happy, the baby is alert and eating then what else can you do.

DH was diagnosed with this when he was younger. Perfectly fine 6ft 12 stone (and possibly more now) but it was difficult they were really worried for a bit.

This isnt your fault, it is just one of those things. Follow the advice to begin with (and for now I recommend just following the medical advice). Cut those things out and feed more and keep an open mind.

You will get through this and be a great mum

I mean this kindly - If she's in age 2-3 clothes at age 4 then she sounds very malnourished.

What a load of rubbish. Small does not necessarily equal malnourished. You can tell a child is malnourished by their skin, eyes and teeth etc not simply their size.