DD 11months referred to 'failure to thrive' clinic

[TheFowlAndThePussycat]

What are they looking for?

She was 4 weeks premature, is definately small (about 5th centile adjusted weight), has never lost weight but only put on 1 lb 4oz in total in the last 4 months. She is bright as a button, crawling, clapping, waving etc so I'm not worried about her development, just her size.

Assuming there is a problem, what sort of thing might it be?

Thanks in advance.

you may also wish to post this in breast and bottle feeding.

i'd say she sounds healthy from what you are saying but I am not qualified to answer.

Thanks foxytocin, will do.

sorry for you but sure it will be fine if she is doing everything. my ds was on 2nd centile forever. hvs were always screwing but i had to stop taking him to be weighed in the end. he was dairy intolerant but hvs were just telling me to stop breastfeeding.
he didn't eat a scrap till 14 months.

he's still a tiddler but bright as a button.

i'm sure your dd will be just fine, they will check developmental milestones, and possibly for allergies

My daughter has hovered between the 2nd and 9th centile, she is 2.7 and still only weighs 25lbs and is still wearing 12-18 month old clothes, she to is bright as a button, can hold a full conversation and dances all day!!

I think they are just following procedure and after your visit you will have nothing to worry about. We were referred to paeditrician and she said there was nothing wrong with her, so since that day I have stopped worrying

Good Luck!

Know a baby referred at 11m as failure to thrive who is now doing very well indeed and if they are behind in any way, it's not noticeably so. Born 4 weeks early like yours but could not sit unaided, barely roll and absolutely tiny - and in no way as developmentally along as your wee dd.

They ran tests to ensure baby was absorbing nutrients, investigated underlying causes such as cf and in the end put together a programme of physio which the parents instructed nursery to see to. It was also strongly suggested that putting their child in full time nursery from 4m old, 7.30am-5.30 and then home to bed, with limited parental stimulation (they have an older child with other needs) was also part of the underlying problem.

Just wanted to mention it as a more conerning case than your dd with still a good outcome.

I don't really have any advice but I wanted to say that I think 'failure to thrive' is a terrible phrase!

I'm sorry you have the stress of going through this and hope it all works out, your DD sounds lovely!

Thanks everyone for your help.

'Failure to thrive' is a really horrible expression, particularly as she really is thriving in so many ways... Even my GP looked a bit sheepish and called it the 'so-called failure to thrive clinic'.

At least we might get some answers through going to the clinic. It has been wearing turning up to every weigh-in & being stressed by the results but not really getting any explanations. It helps to know that food intolerances might be the culprit, it at least gives me something to google research.

Thanks again.

My dd was failure to thrive she to was 4 weeks early, she was never even on the chart till she was 3 and a half!!!

She had every single test going immunity, gene tests, cystic fibrosis, kidney things, heart scans, you name it she had it - all ok though. She didnt start to grow till she was 3 and a half, at this age she was still in 12-18 month clothes.

She is now 5 and is in age 4-5 she is still as thin as a rake and doesnt weigh much but she as healthy as can be and only had a growth spurt at 4.

I wouldnt overly worry (i know easier said than done). I have had a baby 10 weeks ago and she has only put on 2lb in 10 weeks and gone down 2 lines on her graph and they are talking about referring her, but i doubt i will let her have all the test dd1 had as i think i just have small children.

my ds4 was way below the 0.5 centile from about 6 months to dunno when at least for 2 years. My really helpful GP and health visitor reassured me and we just kept on watchful waiting as his development was fine othewise. He's 9 now, and by no means the smallest in class - i might even class him as average height, it does still amaze me when i see a child smaller than him
and hey it's cheap on clothes - he's onlu just too big for the shorts his brothers wore in reception.

I would not get her weighed too often. There is nothing to gain from weighing a baby every week except maternal stress and tut tutting from hvs. How often are you taking her for weigh ins?

A friend of mine was upset when her daughter was referred as failing to thrive but it turned out that the poor little thing had gall stones...sometimes there is a reason for it and its worth getting checked and out and dont take it personally. x

In your extended family are there any tiny adults or a history of people who were small as children but carried on growing until the average age of growth? I always find it amazing how drs ignore history and extended family traits.

I'd say most of the family is average or below height-wise, not tiny but certainly not huge. In addition mil & other women in her family are petit weight wise too (not me unfortunately!) my dd1 has always been 25th centile all round, but she has always put on weight. I think what concerns me is that dd2 has pretty much stopped putting on weight over quite an extended period. Foxy, I only have her weighed once a month, but the hv always ask me to bring her back each month as they are 'keeping an eye on her'. She was pretty slow to put on weight before weaning & they kept trying to get me to wean her early which I refused to do because she didn't seem ready to me. She did have a bit of a spurt when she started on solids, but then very quickly slowed back down again. Anyway, I guess we'll just see what the tests turn up.

Thanks again for all your advice & experiences.

forgive my ignorance but to me on average 5 oz per month sounds like a healthy weight gain to me. maybe with her prematurity they ought to check that she isn't anaemic but that would have been an issue which originated with her early birth and something to keep an eye on not something that developed because of a poor diet later on.

you may do well on reading up on Kellymom as linked above for related topics like prematurity and the breastfed baby and iron levels and breastfed babies. Even print out a few articles to take along with you as medical people can be woefully uneducated about breastfeeding issues even when to us it may seem obvious that they ought to have more knowledge.

hope you are not too worried about the appointment.

I think i read somewhere that the NICE guidelines only recommends 5 weigh ins from birth to 1 yr. (something like at birth, 5 days, 6 weeks and two more till one year) Obviously with prematurity the weigh ins till maybe term and in some cases I'd suppose, six months would be more frequent but it is more important that the measurements are interpreted appropriately and health visitors are not always best informed on how to use this information properly.

Wow foxy, that's a real eye-opener, she would have had to put on twice that (10oz) a month over the last 4 months to stay on the same centile line on her current chart. We don't have the breastfeeding ones, they were brought in just after she was born. I guess (hope?) the clinic will have access to them though so hopefully they will be able to assess her on a more realistic basis. I do feel much better now, thank you.

I just wanted to add my 2p's worth. My ds2 is 22 months and also bobbing around the 0.4th centile line (9th for height), so I sympathise.

I think the phrase "failure to thrive" is also a horrible one though, whenever I hear it it seems to me more like "failure to mummy" . Maybe that's just me. I thought that HPC's were now supposed to refer to it as "faltering growth" though, although I'm not convinced I like the sound of that any better.

BTW, don't know if it makes you feel any better, but my ds2 has only put on 600 g (just over 1 lb) in the last 7-8 months. I did find though that stressing has only made it worse and I recently re-read the book "My Child Won't Eat!: How to Prevent & Solve the Problem" by Carlos Gonzalez. The first time I read it I kind of thought nice, but it won't work my my ds2. Now, we are actually trying out the ideas he suggests (basically just let your child get on with it) and you know what? It actually seems to be having a positive effect on all of us. I would thoroughly recommend it.

i found this informative powerpoint by digging around the net.
I think slide 18 is one to print off and plot your baby's weight against at the intervals the powerpoint recommends for babies whose weight needs closer attention. Then compare the profile with that of the one in your baby's book.

I'd take the results along with you to the appoointment as well as a printout of the relevant pages of the ppt.

Thanks Foxy, I've had a quick look and the lines seem to be lower and to flatten out a lot more before a year so she is on a higher line and hasn't fallen as much. She still has fallen a bit though, but I wonder if GP wouldn't have been so worried if he was looking at that chart. Anyway, just waiting for the appointment to come through, no doubt delayed by Easter weekend. Just hate hanging about.

Thanks for the suggestion Unseen, another friend had the same book and thought it was great but she had borrowed it from someone else & couldn't lend it to me. I'll have to get my hands on it somehow!