Failure to Thrive - Why isn't my DD gaining weight?

[Zenmama1]

Hello

My DD was recently diagnosed as Failure to Thrive. She has not gained any weight in the past 5 months. I have taken her to a dietician who says I breastfeed too much and need to cut back (havent done that yet though). I nurse on demand even at night. She also made some suggestions on increasing her calorie intake. She is allergic to dairy so she doesnt get the typical yogurt, cheese & milk that most toddlers get. but she eats pretty well.

We've been to a kidney specialist and ruled out any bone disorders. And her blood work & urine tests to date have come back fine. Now our Ped wants her to go to a GI doc. But I dread putting her through more testing. Sorry if I'm rambling here. I guess I am just wondering if there are any moms who have had similar experiences they could share with me. And suggestions on possible reasons why my DD isnt gaining weight. I don't need any diet recommendations though- I have already done a ton of research.

Thank you!

[BabySmurf]

my friend's daughter who didn't gain weight for some time ended up being celiac...so the testing may not be a bad idea.  i'm not sure that the girl showed many other outward signs either, but there was a family history.  she didn't grow in height or weight for nearly a year.  has your daughter been growing fine before this? is it height, weight, or both? i'm not sure of her age, but my son is about 20 months old and still weighs the same as he did at 1 year.  He has grown a ton in height though.  I am worried that he doesn't eat much solid foods (we are dairy, wheat, and corn free), but he nurses frequently as well.  In our case the doctor isn't concerned so long as he is nursing often.  I tend to think that there is an underlying issue that needs to be addressed. 
 

[1love4ever]

Have you checked into traditional foods, WAPF?  They have lots of info on feeding toddlers healthy, nourishing foods for proper growth and development.  I would definitely include fermeted foods in her diet as well such as real, lactofermented saurkrauts and pickles, pickled beets, etc (can easily be made at home), kombucha, water kefir, (there is regular kefir but since she is dairy free I wont suggest it.  Do you think she would tolerate raw goats milk?  Thats what I make mine out of).  It will help her gets lots of probiotics in her gut to help with absorbing nutrients.  If you are looking into doing your own fermenting (very easy, like I said), you might want to check out the book Wild Fermentation.  Here is the site for wapf as well http://www.westonaprice.org/childrens-health/foods-to-tantalize-toddlers-and-preschoolers    How is your diet?  Because that will impact the nutrition of your breastmilk and what she is getting from you.

[Bokonon]

How old is she?  It is not uncommon for toddlers to gain weight very slowly or not at all, and then go through a big growth spurt.

[blessedwithboys]

How old is your daughter?  Breastmilk should be the primary source of calories for the full first year.  I tend to think it's safe up til age two even.  My ds1 went through something similar and it turned out to be a simple case of "professionals" not knowing anything about breastfeeding.

[Zenmama1]

DD is 17mo and 16lbs. I will check out that link. Thanks for the responses!

[Zenmama1]

Babysmurf: we did the blood test for celiac but it came back negative. I still think it may be an issue though. do you know of a more accurate test?

1love: unfortunately because of her dairy allergy the allergist said no goat milk either

[1love4ever]

Quote:

Originally Posted by Zenmama1 

Babysmurf: we did the blood test for celiac but it came back negative. I still think it may be an issue though. do you know of a more accurate test?
1love: unfortunately because of her dairy allergy the allergist said no goat milk either

Thats ok, I think kids are just fine without dairy honestly.  Definitely check out the stuff that I provided, she does seem very small :(  Has she been checked (by someone who actually knows what they're doing, generally not a pediatrition) for any kind of lip or tounge ties?  I would also take her to a naturopath.  Be sure to optimize both of your internal flora with probiotic foods, which will help you both absorb nutrients better.  You could also check out the Traditional Foods area here on MDC http://www.mothering.com/community/f/365/traditional-foods

Another thing you could both start taking is fermented cod liver oil.  It's not as bad as it sounds :)  My daughter takes it plain, but she is NOT a picky eater, so unless your daughter is one that will eat anything you give her, try a flavored version lol.  I like livesuperfoods.com.  If you are going to give her kombucha I would also give her chlorella to bind to any toxins, mercury in particular.

I think good, solid nutrition should be your focus, and staying away from sugar, white flour, etc (if she gets any of this at all), because that food fills her up with nothing, no nutrients, just makes her full so that she cant eat food that DOES have nutrients!

Orgnaic food will have higher nutritional values and much lower amounts of toxins in them.

Even a simple thing such as you taking FCLO and coconut oil would improve your breastmilk and benefit her.

[heatherdeg]

Kids are fine without dairy.  I even find mainstream docs that know that it's not a necessary component of the human diet.  But the test for celiac coming back negative really means nothing.  There is no test in existence that is a bona fide accurate test for celiac.  Even within the medical testing community they argue about what test might definitively nail it and there is yet to be one--biopsy included.  The best thing to do is to just remove it from the diet and watch.

FTT is worthy of looking into food intolerances.  You're already dairy-free, but I would also remove soy.  The coincidence rate is very high.  And while waiting out adjusting to soy-free, figure out how to live without gluten (it's not usually as bad as it seems--truly).  I would also get some probiotics into her diet.

[BabySmurf]

Originally Posted by Zenmama1 

Babysmurf: we did the blood test for celiac but it came back negative. I still think it may be an issue though. do you know of a more accurate test?
1love: unfortunately because of her dairy allergy the allergist said no goat milk either

There's two options; a GI scope or to just take wheat, barely, and oats (easily contaminated by gluten) out of your diets.  Obviously adjusting your diet is the easier option, BUT if she has big improvements and you then want to confirm with a scope, she will need to be eating gluten to cause the damage that the scope would need to find in order to diagnose.  Unless you have a large suspicion that she is Celiac (weird stools, stomach aches, etc), I would try modifying your diet; keeping those things out will give almost anyone better energy, and if you aren't using soaked grains, the phytic acid will act as an anti nutrient.  And honestly, it's way easier than cutting out dairy, IMO, so if you are already doing that, this won't be too much of a stretch.  It would be smart to stay away from the "gluten free" processed foods (since those can be very starchy and cause constipation, along with the fact that they don't have a lot of nutrition) instead use grains that are naturally gluten free (i.e. rice).  If you would need to avoid the gluten for a couple of months to see if she is growing better.

I also agree with 1loveforever's references on food...moving to that type of diet has helped us tremendously. 

[MichelleZB]

She's probs okay without the dairy, especially since she's still breastfeeding! But I'm going to give some pretty simplistic advice here. Is it possible she could just eat a bit more? Like, whatever diet you want--you said you've already done some research. But, just... more of it?

[happy1nluv]

i second modifying your diet and watching...  i did the dr sears elimination diet with my 3rd -- never did find out what the problem was (started around 5 mos)...  but today he can eat anything just fine... (although he(I) was on restricted diets til after his 2nd birthday...  i waited to reintroduce the top 8? 10? theres a list somewhere of the most allergenic foods...  til he could communicate so we could tell if there were issues...  sometimes their guts just need time to mature...
 

[Storm Bride]

What is she eating, other than breastmilk? I'm just wondering about the overall composition of her diet.

Since she's not eating dairy (definitely not required!), what other sources of fat is she getting? Does she eat avocado, nuts, seeds (or nut milks or butters)? And, how much does she eat? Maybe she's just not eating enough. Does she fill up on low calorie vegetables or lots of water, and not have much appetite for food?

[newmamalizzy]

I was going to say the same thing as Storm Bride.  We recently removed dairy from my 2-year-old's diet and I had to really work to add a lot of fat back in.  From what I've read, fat should constitute at least 30% of her calories.  I remember a graphic from the book Where There Is No Doctor showing a toddler sitting in front of a gigantic heap of rice (representing the calories he needed to consume) vs. a very small heap of rice with a large dollop of olive oil on top.  Little kids may just not have the appetite for the amount of non-fatty food they would need to make up all their calories. 
 

[SimpleLove]

Just had to say that I have a 4yr old who is/was "failure to thrive" and a million other such labels. We were constantly at every kind of specialist trying to find a reason, and there really was none. In hindsight I wish we would have just left it alone (after *some* testing, like genetic/celiac). So now she's 4 and only weighs 24 or 25 lbs, but she is active, healthy, and happy. Another huge indicator is whether or not the child is meeting milestones. We were given endless nutrition and diet suggestions, including things like Pediasure simply to make her fatter, which I couldn't agree to. It doesn't matter how much she eats, this is just the body she has. Someone has to be on the 95% of the growth charts and someone on the 5%.

[Yeeska]

I agree that weight gain alone is not the only indicator to look at. Is she otherwise healthy? Has she grown in other ways? Is she meeting milestones?

Undiagnosed allergies can sometimes affect weight gain.

Too much breastmilk is certainly not the problem. I guarantee that it is the most calorie and fat dense food source she is consuming. Although, perhaps you could encourage her to nurse more often from one side and get more hindmilk into her?

[1love4ever]

I agree with the milestones as well, sometimes there is no problem.  I was also going to say that I love avocado's for my kids- all the fat and vitamins are great for them!

[lioralourie]

Probiotics, Vitamin D, and DHA is what I'd recommend for general health.

A yummy treat can be made: mashed avocado, banana plus coconut oil.  Nice fats and a nice treat even for picky toddlers.

Others mentioned this: why not just boost her food intake?  She is 17 months.  (I nursed to age 3.5, 2.5 and currently nursing 3.5 year old so I am all for EBF and we are dairy free too!)

[lioralourie]

The other thing that comes to mind is poor sleep causing low growth hormone?  (how's her height?)

Another thing to check out is iron status.  Don't supplement iron without a documented case of iron deficiency anemia, though as excess iron is stored in the CNS where it is toxic!

B vitamins can also help if anemia is an issue but iron levels seem ok.  B vitamins (especially Methyl donors like Methyl B 12 spray) are great, methyl donors are needed to turn our genes on and off as needed!

TMG, Trimethyl Glycene (betaine) is also another way to get methyl donors into the body with a relatively good flavor too.  With all supps, start low and work up.

[mnnice]

Originally Posted by SimpleLove 

Just had to say that I have a 4yr old who is/was "failure to thrive" and a million other such labels. We were constantly at every kind of specialist trying to find a reason, and there really was none. In hindsight I wish we would have just left it alone (after *some* testing, like genetic/celiac). So now she's 4 and only weighs 24 or 25 lbs, but she is active, healthy, and happy. Another huge indicator is whether or not the child is meeting milestones. We were given endless nutrition and diet suggestions, including things like Pediasure simply to make her fatter, which I couldn't agree to. It doesn't matter how much she eats, this is just the body she has. Someone has to be on the 95% of the growth charts and someone on the 5%.

While I never went through any testing or formal labels DS2 I can relate. DS2 was born at term (7 and half pounds) but from six months on was tiny (similar size as the OP child at that age).  DS2 is currently 7 and finally shows up on the growth chart (10% for height and 8% for weight).  He was 42 lbs and 45 inches tall at a recent well child check.

Anyway I had an aha moment when DS2 was about 3 and we were looking at baby pictures of DH and his brother.  DH was tiny and BIL was huge.  DS2 was equally tiny and his cousin was very tall and heavy for two (like his papa).  Anyway ever since that moment I have stopped being nearly as concerned about their DS2 or my nephew's size. DH and BIL are both pretty average sized adults BTW (5'10 and 6'0 and 180 lbs and 160 lbs).