14 mo old on verge of "failure to thrive" diagnosis - Page 4

[dividedsky]

regarding the egg thing... how about french toast? that is so easy to make and i bet he'd like it. mix up eggs, milk, a splash of vanilla, a smidge of sweetener (i use agave), soak whole wheat bread in it until soggy and cook on a griddle. try it!!!!!

[lkmiscnet]

My mother's instinct is that he is fine. He seems healthy in every way, other than being skinny and being able to see his back ribs when his arms are outstretched, which seems like that would be the case given that he would be pulling his skin taut in that position anyway. It's not like you can see his ribs when he's standing with his arms down.

Now, my big decision is whether to keep his feeding clinic appt on Monday or cancel it. I'm stressed about it and really think it's going to be a waste of everyone's time (and our money to boot), but then there's that little voice that says "What if...". Or perhaps it would be interesting to see what they all say. Sigh...

Thanks for the WHO chart link. That was very helpful!

If not for his ped, I would have been happily going along in life not thinking there was anything to worry about since this is a first time experience for me and I wouldn't have known any better anywya. And, there probably isn't anything to worry about. Still, she's the "expert" and raised 5 kids...

Double sigh...

Thanks for all the food ideas. I'm going to try them.

[aet.tea]

Just stumbled on this thread. Sounds like my DD is exactly the same age as your DS (almost 15 mo but was 3.5 wks early so about 14mo adjusted). At last check (about a month ago) she was still just shy of 15 lbs.

We have a very cool pedi who used to run the PICU, so he has seen a lot of very sick kids and is not too concerned with variations of normal. He has not been alarmist at all about our having a very petite daughter. That said, he has definitely encouraged us to fortify her diet with good fats and has kind of playfully charged us with getting her to gain a pound a month (not happening).

We have also had to see the renal specialists (she was born with only one kidney) who are more concerned about the slow weight gain. There does not seem to be any renal cause for it, though, so they have put it back in the pedi's court. Our next appointment is next week.

DD is also a VERY modest and choosy eater and I don't think she is eating any more than your DS. I am not at all confident that she is gaining weight any more rapidly and am a bit apprehensive about next week's appointment.

Developmentally I think she is where your DS is - she just started pulling to a stand in the last few weeks and cruising in the last week or so. We have therapists coming to see her twice a month through Early Intervention, and she's making good progress these days.

Anyway, I think we could probably find a lot in common and a lot to talk about. . . more than I have time to type right now.

What I'm currently doing to get calories into my picky eater:
- goat milk (3 parts) mixed with coconut milk (1 part). She drinks a couple of ounces of this at each meal and a little bit in between. She drinks more of it out of a regular (small) cup than a sippy cup. If I bring it with us on walks she drinks even more.
- pancakes made with coconut milk and almond butter. Makes a great "on the go" snack; sometimes I keep her in the sling so I can just keep pushing bites of these pancakes in her mouth
- scrambled egg yolk with coconut milk - this is what she eats for breakfast almost every day. Separate the yolk from the white for more calories/fat in a smaller serving
- cod liver oil, flax oil, coconut oil, etc.

Good luck with everything! May we both have happy healthy toddlers.

[Nanasi]

I read this post a while back and it stuck with me. Then at the library the other day, a book about vitamin B12 deficiency caught my eye. Apparently, in babies B12 deficiency can often result in delayed development and "failure to thrive." Please, read up on this and consider getting both yourself and the baby's levels of B12 tested. I'm also suspecting that my the dementia my father-in-law and grandmother are suffering from could be partly due to low B12.

The book was, "Could it be B12?: An epidemic of misdiagnoses" (http://www.amazon.com/Could-Be-B12-E...4075494&sr=8-1).

[kdtmom2be]

Originally Posted by dividedsky

are you offering him only pureed foods or foods with a smooth texture (avocado, banana, etc)? maybe he'd do well with more texture

Trying to catch up on this thread with interest as we have also been referred to a specialist for FTT. For now they are simply monitoring his weight, he is on track or ahead developmentally, just skinny (and a little short actually).

What I wanted to add regarding food is that my daughter had HUGE texture issues and didn't really eat much solids until about 14 months. That is when I figured out what some of her issues were. She would never eat off a metal spoon but would happily eat off of a plastic spoon. She didn't like soft foods and to this day has eaten 6 bananas in her 3.5yrs and just recently started to occassionally eat mashed potatoes.

What she would eat, and eat a lot of, was crunchy stuff. SO, she ate crackers, banana chips, dry cereals, etc. If it was crunchy she would eat it. She LOVES corn nuts... not exactly my first choice in snack foods for a toddler... just giving the example. The crunchier the better. Might be something to try.

Also, it seems odd to me that one person is telling you that he is delayed by 6 months and another is telling you that he's just fine. I would get a third opinion on the skill development if i were you.

[mamadelbosque]

I haven't read the whole thread, so forgive me if I'm repeating what other posters have said... Have you tried just giving bits of food that he can self-feed? Thats how both my boys have always done solids - we never did purees with either one, just let them shove stuff in their mouths.

That said... 3-4 words by a YEAR?!?! Seriously, my DS1 didn't have 3-4 words till he was *TWO*! And, some kids walk late - everybody knows that. DS2 is 13 months and still mostly crawling - he can take a few steps and does so occasionally, but 95% of the time he just crawls. As for the 'point out eyes/ears/mouth/etc' stuff? Meh, I never did that stuff w/ my boys and I don't think ds1 figured it out till closer to 18-24 months. DS2 is 13 months and probably wouldn't have a clue.

Oh, and for the weight... ds1 is 29#s. He's 3.5. DS2 is ~19 months. He's 13 months. So, your ds doesn't sound *that* far off!!

[catters]

I haven't read the whole thread, but wanted to commiserate. This sounds just like DD, who was a week "late" weighed a good 7.5 lbs, but has continually slipped off the weight chart, despite growing taller and taller. My pediatrician thinks she is just fine as long as she is active, alert, eating (which she DOES A LOT!) and exhibits all other signs of health. She is still nursing as well (15 months old, nowhere near twenty lbs. It has been a source of anxiety for me as well. I hear you. All I can say is, trust your instincts. If you think he's not thriving, then maybe have him seen by a specialist.

[EdnaMarie]

Still, she's the "expert" and raised 5 kids...

She raised her kids. She hasn't raised yours.

[honeybee]

Originally Posted by lkmiscnet

I'm confused. I just charted his wt, ht and head circumference percentiles on the WHO charts and he is not off the charts and has no declines. Just a slow trend up.

I know that his ped used to mention corrected age and actual age and I think they were tracking both. I don't know what they are tracking now. I forgot to ask.

My general understanding is that you use corrected age for milestones, etc up until age 2.

I did use corrected age in my charting, so I subtracted a month from his actual age so it's comparing apples to full term babies, so to speak.

Length shows him in the 50th.
Wt is in the 3rd.
Head is in the 15th.

So, I'm now confused as to why his ped thinks he is on the verge of FTT. He is still on the charts, at least per my charting.

I guess it can't hurt to add more fat to his diet (I know it's recommended for the first 2 yrs), though I don't want to throw anything off kilter by doing so. Moderation is the key I suppose.

But, I just contacted the feeding clinic that the ped had written an Rx for 3 months ago (I wanted to take a wait and see approach knowing how poorly he did with PT) and now I'm wondering if I should even pursue that. I know my son will probably not eat on command in front of others. Then again, I just don't know. We just had the horrible PT experience, so I don't know what his temperment will be. He's a very sensitive boy.

Here is a good link to an article talking about the CDC moving to the WHO charts, and the differences between them. Many fewer children will be diagnosed as FTT when using the charts of normal growth... ie, growth of breastfed babies in good environments, as opposed to charts based on formula fed infants.

http://www.cdc.gov/mmwr/preview/mmwr...cid=rr5909a1_w

But it takes a while for medical practice to catch up to the research and new policies. I would bring this information and the WHO charts with you to your ped's office. My ds2 never ate a single bite of solid food until he was 15 months old. And, yes, he had stopped gaining weight, for about a year. His case was a little different in that he was a large baby... so he slipped from 99th percentile to 50th percentile on the "old" (still currently used) CDC charts. Luckily, I knew enough not to worry too much or try to force solids on him. We did a blood test to check iron/lead, and allergy issues, but other than that, just watched him. He has oral motor issues and was late to speak and had articulation issues. He also later developed several food sensitivities, and I think all those issues were at play as to why he did not like solid foods. But once he was ready, it was like a light switch went off, and he just started eating anything and everything.

I truly believe that if your child is "picky" there is usually a good reason. And if there is a genuine case of FTT, I don't understand why docs don't look at underlying health causes instead of going right to the nutrition/feeding issue in breastfed babies... well, I do know... it's because they get ZERO EDUCATION on normal growth and behavior for breastfed babies and toddlers, so it is easy to blame the breastmilk/nutrition. I have a friend whose baby was constantly borderline FTT and they kept trying to tell her nursing was a culprit. She persisted nursing anyways. Finally, about a year later, her son was diagnosed with a kidney issue. After getting the appropriate medical help, he is now thriving and has completely caught up developmentally and is happily enjoying preschool.

I'm so sorry you've been led to believe that something is wrong with YOUR milk and that by bf your baby you somehow malnourished him because you weren't eating perfectly. Women in impoverished third world countries still usually produce adequate milk for their babies... they just may starve themselves in the process.

[lkmiscnet]

I'm still "struggling" with getting him to eat much. Some days, he might have just a few bites from a toddler spoon and that's it and his poop again is the consistency of a breastfed baby. I am flabbergasted at how he can manage his level of activity on how little he eats without losing weight. He hasn't been losing, but he is more active now since his last ped appt, so I don't know what the next weigh in will hold in 2 months. Certainly not the 2-3lb gain I had hoped for...

That said, I am forcing myself to relax as best I can, knowing that he knows his body best and whether he is hungry or not. Can a toddler be hungry and not know the sensation or how to express it? I would think he would cry if he were still hungry.

I will say that he seems to be very picky as just when I am almost ready to give up on a meal, I pull out a back up jar of some green organic veggie baby food (which he loves so long as it's a fresh jar) and he will eat it. Go figure! I usually have about 3-4 things out for him at any one meal.

I am trying to give him food throughout the day. The problem is that some of it can't be out for too long before going bad and I can't add healthy fats to the "finger" foods". He still tosses the small chunks of cheese. He has been eating steamed green peas though and teething biscuits. He loves the organic puffs, though they are lacking in any nutrition.

I am able to add coconut oil or olive oil, ground flax, and fish oil to the purees, if I can get him to eat them. It's just hit or miss.

A friend of mine has a same age child who eats well, but has not been putting on weight and he was not drinking much whole milk. She just decided to wean him a couple of weeks ago, as she felt that whole dairy milk had more fat in it than what she could provide through BM. She said weaning made a huge difference in her son's intake of full fat dairy milk and he drinks it up now.

It is something that I am considering because I do think that breastfeeding is displacing my son's intake of solid foods and he also only takes a few sips of organic whole milk or coconut milk. It's also something that I can't keep out all day because it goes bad. So, after he takes a few sips, I put it in the fridge and try again later.

I do have a frozen stock of 9 months - 1year old BM that would carry him through about 4 months, but have been waiting to thaw it because without him drinking a lot, it goes to waste. It also has excess lipase so has that off smell and soapy taste, though he didn't seem to mind it when I tried it on him a few months ago. I have always been concerned that I didn't have enough fat in my BM from the start because when pumping, there was only a very, very thin layer of cream on top in the storage bag. So, it could be that I just can't give him the necessary fats that he needs.

Just a thought...

I am truly thankful to everyone that has responded. I had no idea that so many would answer.

Thanks!

[LadyCatherine185]

I would absolutely not wean him to cow's milk unless he was eating a wide variety of solids. Right now he is getting the perfect balance of nutrition from your breastmilk. Human milk was made for human babies, cow's milk for baby cows. He may start eating more solids if you cut back on nursing a little bit, but I wouldn't cut back a lot so that your supply stays.

Oh, and about the not much fat on top thing-- I never had much fat on top of my milk either, but my DS has always been in the 75-95% for weight, so I don't think your breastmilk is lacking. Also, I don't think that the milk you have frozen is any good anymore, as from what I have read it only lasts for 3-6 months in the freezer.

[lkmiscnet]

I am also worried about BM supply issues as well. I started the weaning process in June and would sometimes go 6-7 hours without BFing during the day and 4-5 hours at night. We had a setback (accident with our DS) and I ended up having to nurse him every 2 hours or so because he regressed and seemed to need it more during that time so I backed off on trying to wean.

He just doesn't seem to be swallowing (less than 5 min duration) a lot when he nurses, so I am worried that my supply may have been impacted when I tried to wean. Then again, he detaches when he wants and doesn't appear to be hungry afterwards.

The BM I have is stashed in a stand alone deep freeze. It supposedly keeps BM for more than 6 mo. I don't know if a year is too long or not. Aside from the taste, I just hope the nutrients have remained. Pumping was a stressful ordeal and I would hope that 9 months of it did not go to waste! I stopped pumping 6 mo ago.

[Curlyfry7]

I have a small DD, who at just over 20 months old weighs 19lbs 15oz, which I don't think is even on the charts (the CDC ones, that is) She is roughly 25% for height and her head is somewhere 50-75%, which is supposed to be the biggest indicator of FTT.

I think she only eats about as much as your DS does, at least some of the time. We still BF on demand in the day, I have nightweaned as we are planning to TTC soon. My ped gives me somewhat of a hard time when we have appointments. I did let them do bloodwork at her 15 month visit, which was....normal! Not a shock to me. My MIL is only about 5 ft tall and probably weighs about 90lbs. I myself have very small bones, am about 5' 6" and weigh 120, and DH is also on the smaller side. DD is meeting/exceeding every milestone.

I try to encourage DD to eat good protein each day-sometimes it works, sometimes it doesn't. I have found the best way to get her to eat is to ignore her-that may sound bad, but I serve out the food-the same thing everyone else is eating, and then just let her do her thing. Last night she dumped blueberries in her soup and painted it on the table. Tonight she gobbled down whole wheat rotini with butter, salt, pepper and parmesan cheese, some pieces of chicken thighs, and some broccoli slaw tossed with soy sauce, rice vinegar, sesame oil, and garlic. I don't stress over what she eats each day because we're bfing, and I know that she will get what she needs.

Could you maybe try for 1-2 weeks just offering stuff to him and not worrying about what he eats or doesn't? Since you have said he's very sensitive, perhaps he really is picking up on your anxiety. I know anytime I really try to get my DD to eat something, that is a guarantee that she will NOT so much as touch it to her lips, LOL.

Good luck mama!

[Amila]

I am sorry to have not read all the posts, but just wanted to add that my DD was 19 pounds from age 1 until age 2, and nobody ever batted an eye! She is just little...in fact now at age 4, she weighs the same as my 2 year old DS! 32 pounds each...

[BMG580]

My good friend has a child with serious food allergies, lack of ability to gain weight and refusal of most foods were the biggest signs at first. Her son just turned five and he graduated from Neocate (prescription formula) and now has some sort of super high calorie, nutrient packed kind of creamy fruit drink that looks packaged like a juice box. Could you see if your son would try and drink something like that once a day? Ask your pedi about it, I think they are prescription like the Neocate formula.

Good luck!