14 mo old on verge of "failure to thrive" diagnosis - Mothering Forums
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#1 of 75 Old 08-06-2010, 12:42 AM - Thread Starter
 
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This despite BFing on demand since birth. He nurses about 8 times a day on average and still wakes up around 3 times at night to nurse (we co-sleep).

He was born a month premature. He is technically 15 mo old, but his "corrected age" is 14 mo.

He just had a ped appt today and the dr is concerned that his weight keeps falling off. His height is in the 50th percentile, but wt is not keeping up and he hasn't been on the charts since about 6 mo of age. He only gained 1 lb 4 oz in 3 mo and is only just over 18 lbs. She said at the 50th percentile, he should weight 25 lbs! She would like to see a 2-3 lb wt gain by his next appt in 3 mo or he will need to be deemed a failure to thrive.

I started him on solids at 7 mo, but he has never developed a ravenous appetite and I'm usually hard pressed to get him to eat much. He is very picky and I find I have to trick him to eat more. He loves avocado though (which is great) and I have to pretend to be scooping from the avocado, even though it's a different food on the spoon, just to get some other stuff in him.

I try to give him whole milk yogurt daily for breakfast. It usually takes him lunch and dinner to finish it up. It's maybe 1/4 c of it or less. I mix in applesauce usually. Then, I still have the challenge of getting him to eat what I've made for lunch and dinner. I make his baby food, so most is frozen purees of various beans, fruits and veggies, supplemented by some store bought baby food for variety. he gets chunks of fruit and cut up green beans too.

I just bought whole milk to give him in a sippy cup which his ped suggested.

Ironically, I previously posted about my concerns about his lack of eating as I was totally stressed out reading about what other kiddos his age were eating and the majority seemed to think that I shouldn't stress about it and that BM was sufficient for his needs. Well, unfortunately, that may not be my particular case because I would presume he would otherwise still be thriving. Of course, we can only surmise it's because he is not getting adequate nutrition and it's not some other underlying issue. His ped suspects it's simply food.

I am a vegetarian and probably don't get as much protein as I should be getting, though I do supplement with whey protein powder and protein bars. Now that I think about it, I probably do get a decent amount of protein. I also eat lots of nuts. However, I've always had a low fat diet, aside from all the nuts. In fact, I was just planning on cutting the nuts out because I was gaining weight from snacking on them too much. Everything else I eat is fat free.

His ped also said that all the brain growth takes place in the first 2 years of life, and that it was a concern if he wasn't getting adequate nutrition, but that there was still time to make up for it up until he turns 2. She assured me that no permanent damage has been done. But still, it worries me that his brain may not have developed as it could have if it were well fed essentially, and no one can know for sure whether it's full potential has been hampered.

His ped also said that his milestones accomplishments are the equivalent of about a 9 mo old based on my answers to some standard questions. He is not walking yet. Can't point out any body parts when prompted despite us pointing out his nose, eyes, ears, etc for months now. He apparently should have a vocabulary of 3-5 words by now, but only says mama and dada and doesn't know what they mean, which doesn't count apparently. He doesn't make an effort to walk when I try to hold him up and walk him, whereas most kids his age will put weight on their feet, something like marching in place.

He had done 3 mo of weekly physical therapy between 4-6 mo of age, but it was worthless because he would cry hysterically the whole time. We pulled him out and he eventually caught up.

I also just had an Early Intervention rep here last month and she deemed him normal and not needing any assistance.

His issues could be due to him not getting the proper nutrition, as I googled and read that lack of vital nutrients could cause developmental delays. However, he has not been around other babies (just joined a play group), so that could be a major part of the developmental delays as well.

In any event, I feel like a failure as a mom. I research like crazy about baby stuff, but yet, he's still going through this because of me. And, being a stay at home mom, where I interact with him every day, how could this happen right before my eyes?

Just wanted to see if anyone else has experienced this, what may have caused it, and what you did to resolve it.
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#2 of 75 Old 08-06-2010, 01:46 AM
 
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I'm sorry; that sounds really rough. I don't have any direct advice but was wondering if some sort of developmental delay could be causing the lack of interest in eating/low weight? Or if some underlying issue might be causing the eating/weight problem and the perceived delays? Perhaps your pediatrician could recommend a specialist to see? (Or I could be totally off-base, but it's just a thought... in any case, I hope things get better for your family soon).
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#3 of 75 Old 08-06-2010, 01:55 AM
 
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I am sorry you are going through this. It sounds like you are such a caring mom, and I am sure you doing well by your LO.

However, you may be right that your baby (and you, since you are breastfeeding) need a lot more fat in your diet. I know it can be tough to get on a vegetarian diet (speaking from experience). Do you eat eggs? If so, perhaps you can get some eggs from chickens raised outside in the fresh air where they can eat bugs and run around in the grass - the fat from such eggs is supposed to be very high quality and good for brain development. I don't worry about fat making me or my children fat. Good fat (that is, real fat, not stuff made up in a lab somewhere) is healthy, and children need a lot of it. We eat fairly good doses of organic butter, coconut oil and eggs. It is expensive, but if only the kids eat it the cost isn't bad.

Keep up the good mothering!

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#4 of 75 Old 08-06-2010, 02:03 AM
 
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Is it possible that the delays may have to do with prematurity?

You didn't list many fatty foods in what you described. I'd think about how to get more fat in - will he eat nuts?

The World Health Organization has different growth charts that are more based on BFing than the regular charts (although it isn't exclusively BF babies). You can find them online and see how they compare to his growth curve for another source.

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#5 of 75 Old 08-06-2010, 03:49 AM
 
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DD was almost eight pounds at birth and since six months has been running 5-10 percentile for weight and 65th for height. She bf's on demand and eats a wide variety of solids, but not much. She eats organic roasted chicken, eggs, whole milk yougurt, peas, watermelon.. We have done some extra weight checks, but the ped has mostly been reassuring that my little lady is just little.
The developmental delays are something else. My friend has 14 month old twins born at 30 wks and they seem to be similar to your son in terms of development. These delays have been attributed to prematurity and they are involved in an early intervention program that includes therapy in their home.
I just wonder if the developmental stuff can be comepletely explained by nutrition. If it were me I would want to explore other causes for it and I would look into the possiblity of having someone work with your baby on the walking and talking, ect...
E.

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#6 of 75 Old 08-06-2010, 04:43 AM
 
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My full term daughter wouldn't gain weight. Born at 10th percentile, she dropped to 5th. She nursed constantly and was always restless. She wouldn't touch solids until 11 months, and ate like a bird thereafter. We did a variety of medical tests, all negative. Unlike your child, she didn't drop off the 5% line, so in the end I had to stop worrying. She weaned at 2-1/2. She will always be 3" shorter than me, and there are some mild behavioral issues - mainly that she runs a year or two behind her peers in development, a problem that will solve itself. I don't mind having a late bloomer!

I ate mostly low fat and vegetarian, with a meat or fish dish a couple times a week. I was convinced I was doing the right thing. But today I have come to believe she needed better nourishment during pregnancy and nursing than I gave her, and her behavior was signaling that need. If I were to re-live those months, I would eat a diet high in natural fats during pregnancy and nursing: lots of real butter, whole milk, eggs, and yes, animal fat: grass-fed cows, free-range chickens, no hormones or antibiotics. Wild caught fish.

This flies against what so many people say, esp vegetarians. I respect those views. But you are very worried, and I have to offer the idea for you to think about. I wish someone had talked to me this way. The circles I ran in all said a healthy mother's milk was always sufficiently nourishing, and no alternative thought was ever voiced. So, I will never know if I could have helped my daughter by changing my diet.

Perhaps you could experiment, eat a high-fat diet for six weeks and see if he puts on weight. At least you would know. It might make no difference. If it works, he'll be back on track, and you can return to your preferred diet after he is weaned.
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#7 of 75 Old 08-06-2010, 04:48 AM
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A baby doesn't have to be in the same percentile for weight and height - if that was the case all babies would be the same shape! DD has always been much higher for height than weight, for most of her first year she was between 25th and 50th for height, but below 3rd for weight. That's ok, as long as they keep gaining.

I checked the WHO chart, and if I read it right, your son is above the 3rd percentile for weight, so definitely on the chart. If I were you I'd chart him on the WHO chart, perhaps the drop hasn't been so much there, a lot of babies don't gain much when they get closer to a year. Maybe he's just tall and lean?

And with the developmental delays, for several years I nannied for a little boy who had been born prematurely. While he was and is a wonderful little boy, and is now doing great in school, he was very delayed. 15 months isn't actually late for not yet walking, it is on the scope of normal, the little boy I cared for walked around 18 months, I think (for what it's worth, so did my SIL, who wasn't premature or delayed at all). He didn't talk at all until he was over 2, and for the first 6 months only rarely, and about six words or so (Moon, Saw, Hammer, Cat, Mamma, Daddy). Then, just as his appointment with EI came up, he exploded with 50-100 words in a week. He was still difficult to understand for a long time, as there was pronunciation issues, but he was constantly, if slowly, getting better. By 5 he was like every other 5 yo.

He also had huge food issues, he was very little, and his parents had been very pushed to make him eat and gain from an early age, so by the time I met him, at nearly 2, all the issues had compounded to make him a little boy who hardly ate at all, who had huge texture issues and was almost frightened of food and mess. Food issues, however, are apparently common with preemies. We worked on it, played with food, cooked together, with no pressure (and I made him vegetable juices for a while, which he loved), and over the next year he came so far, and by 3 1/2 his favourite lunch was a creamy (milk and buttery) vegetable soup (of his own choice from ice cube frozen vegies), usually pumpkin, sweet potato, courgette or broccoli, with some beans, cooked and frozen for protein, in which he'd dip slices of bread!

Is he strong? Is he happy? Does he seem healthy in other respects?

Oh, and as a mother of a baby who WAS really underweight for a bit, how is his head circumference? Is it growing appropriately (following whichever line, as long as it is increasing properly)? We learnt that THAT is a true sign of when a child may not be getting enough nutrients.
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#8 of 75 Old 08-06-2010, 07:12 AM
 
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I actually had to scroll up to make sure I didn't write this. All of the responses I am finding very comforting.

My baby is also 15 months old, 6 weeks early and has all the same issues though she gets formula (sadly). So I guess she is getting decent vitamins and fats from the formula but still the same as yours. Isn't avocado pure good fat? Mine refuses it. Anyway, she's not walking, pointing nor talking, Though mine despises eye contact (I avoid eye contact too). She is just now eating though it's a very slow process and i have to supplement with puree and formula.

When she was born she was not on the charts.. she slowly came up and was right in there at like 25 percentile. At 12 months she just stopped growing it seemed and only gained 2 pounds in the next 3 months which kind of worried me but she has a belly so not really. She had dropped to like 10th percentile. So reading this is helpful.

My dr said there was absolutely nothing wrong with her weight. I can't be sure on her height b/c she flipped out when being measured for that. But he said as long as she's on the chart things were great. Btw she is 20 pounds at 15 months.

Actually I have her last growth chart here taken at just barely shy of 15 months. These are estimates as the chart just shows lines and dots

20 pounds - 15th percentile
30 inches - 40th percentile
44.5 cm head - 15th percentile
weight versus girth 25th percentile

Though I am not the person to reassure you since I am a worrier and I haven't been getting much hope relayed to me on here. We're going to see a neuro and get her evaluated by a special autism center.
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#9 of 75 Old 08-06-2010, 09:27 AM
 
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My daughter was "diagnosed" with FTT at 15 months when her steady growth stopped. She then went off the charts. She had gained a total of 1.5lbs in a 10 month span. At 15 monhts she weighed 15lbs. She was 8.6 when born. BF on demand and ate avacado like it was the best thing ever.
We even went to the growth clinic at the childrens Hosp., and they said to give her butter??? after I told them dairy gives her the runs...
I sarted to give her Iron supplments, Iron if it is low can affect weight gain..and brain development. She started to slowing gain weight after the iron. Since you are a Veg. and do not eat a ton of protien your Iron-you sons Iron could be low. This also affects sleep. I found my DD sleeps better since the Iron as well.
All along her development was where it needed to be so I was not to worried.
IF they do diagnose you or you just want some support this webistt/community is for growth issues and they are awesome! they will even connect you with a member who's child is where you child is so you can talk with someone in your spot.
http://www.magicfoundation.org/www
I hope it helps.
mariah
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#10 of 75 Old 08-06-2010, 09:29 AM
 
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Mama, I am so sorry you are having such a rough time. I also wonder if his developmental delays were not somehow caused by his prematurity? Have you had him evaluated for any type of sensory disorders, or neurological issues?

My nephew was very similar to your DS at that age. At 14 months he wasn't even crawling (just army crawling), not talking, and weighed about 15 lbs. He was not BF'ing, but drank cow's milk and ate solids. His issue was partly because he was not getting enough calories, but more because they were not being offered to him enough. Once they started feeding him more often (he didn't refuse the solids and would self-feed, unlike your DS) and he fattened up, he started walking and talking some, etc. He still is delayed though at 27 months.

I would suggest concentrating on getting fats in him. Straight avocado and yogurt, add coconut oil to everything, you can even give him coconut milk to drink. It has a lot of the good fats in it. Peanut/nut butters, beans. If he doesn't like to eat food, you could mix up a smoothie for him with yogurt, fruit, avocado, coconut oil, etc in it.

It really rubs me the wrong way that your ped would suggest that you may have caused him brain damage by BF'ing and not forcing solids on him. She should look into the issues more. It seems to me there is more going on than just him not getting enough fat. An underlying issue seems to be causing a lot of this, IMO.


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#11 of 75 Old 08-06-2010, 09:54 AM
 
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My DS is 15 months and weighs 19 pounds even. We just hit that mark yesterday. He is listed as FTT by his GI, but we know he will be small looking at his daddy and myself. At 12 months, he was under 17 pounds and hadn't grown in 5 months. In the past three months, I've been very diligent with his fat and calorie intake.

He gets eggs cooked in coconut oil every morning, a morning snack, lunch (meat of some kind and veggie), afternoon snack, and dinner (meat, fruit/veggie). We also have him on DHA:EHA supplement for brain development and Floradix iron & herb supplement (anemia and weight problems can go hand in hand). Now, he doesn't always eat all his food, but DS is a snacker. He bfs at least 12x a day so he still loves the ta-ta milk. We don't do cow's milk, but I do make him smoothies with fruit and hemp milk. (DS is casein, soy, gluten, and nut free).

We've had a great improvement with his weight gain and growth the past three months. While he's still not on the CDC growth charts for weight, he is no longer falling further down and is slowly getting closer to the chart.

Anyways, I just wanted to offer encourgement that the weight gain can happen. It likely won't happen at the pace your pedi wants, but you can do little things that might help. Plus, you might check with EI for an evaluation as it can't hurt and might provide some more tools for you. Remember all our babies develop and grow within a wide range of normal.

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#12 of 75 Old 08-06-2010, 09:56 AM
 
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I'm glad your ped is being watchful but not alarmist yet, that's good to see!

A few questions...did you ped say what the next step would be if you can't get some weight gain in the next 3 months?

Have any labs been drawn? Iron, lead, that sort of thing?

What are his genetics? Your height/weight, his dad's height/weight, your siblings, aunts, uncles, grandparents, etc? And not just as adults, but as children (if known)?

Your Ped gave you a simplified explanation of how nutrition effects development. Here's a little more detail on it. Calories and nutrients first go to cognitive development, then physical growth, then other areas of development (gross motor, fine motor, etc), then fat stores. My son has been labeled FTT since he was 4 weeks old (he's now 3.5) so I've been down this road unfortunately.

Given that order above, a dr gets concerned when they see a baby with little fat stores and developmental delays, because that suggests that cognitive development could be at risk. Unfortunately it's not always easy to identify cognitive development impacts, sometimes the symptoms don't show up for years (perhaps not until school age).

BUT...that doesn't mean that there IS cognitive impairment!!! Only that there are signs that the dr should be watchful.

In my son's case, at 11 months old we finally found a reason for his growth issues, he has a chromosomal deletion, a syndrome called Velocardiofacial Syndrome or DiGeorge Syndrome. He also has numerous medical conditions and birth defects that are impacting his ability to grow normally. (he was 17lbs at 1, 20lbs at 2, 24lbs at 3)

My son's case is rare, I'm not saying your son has a genetic syndrome. But there are lots of underlying issues that could cause growth and development issues that might not have as many outward signs. Just recently a little boy was diagnosed with a form of dwarfism over on the Special Needs Parenting section, and two others have been diagnosed as having constitutional growth delays, and one other has a growth hormone deficiency. That's just here, on MDC, in the last few months.

I would focus on healthy fatty foods without being forceful at all. I'd also contact your area's Early Intervention Services (called Birth to Three or something along those lines...ask your Ped) They will do a free developmental assessment on your son and will get him therapies if he qualifies (and often they are free, my son got physical therapy, occupational therapy, speech therapy, and feeding therapy for free until his 3rd birthday. He also got into a special needs preschool for kids with developmental delays when he was 2 where he got more intensive therapy 4 mornings a week).

Good luck!

Mommy to BigBoy Ian (3-17-05) ; LittleBoy Connor (3-3-07) (DiGeorge/VCFS):; BabyBoy Gavin (10-3-09) x3 AngelBaby (1-7-06)
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#13 of 75 Old 08-06-2010, 10:08 AM
 
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Mine slimmed down about that time too. How active is he? How is his BM's ( formed or runny)

"if" it were me I would try to put some fats in his diet Make some full fat yogurt smoothies ( you can add ALOT to a fruit smoothie like olive oil , flax seed oil etc). Like the others said I would get some blood work done but some kids just arnt big. My DH was barely at the 3 %

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#14 of 75 Old 08-06-2010, 03:18 PM - Thread Starter
 
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To answer all the individual questions posed…

He eats, but won’t eat much or he turns his head away and is just plain picky. I’ve tried to hold off on BFing until he eats, but sometimes that is all he wants and he starts to cry if I don’t nurse him.

I do eat eggs (and cheese). I have two a day actually. I also tried feeding him eggs, but he just spits them out. This morning, I scrambled an egg, and the pieces just ended up on the floor. I tried to mix in tiny bites with his avocado and he detected the texture and spit it out.

He did end up having about 4 oz of a broccoli/zucchini medley from Earth’s Best. I added a tsp of olive oil to that as well.

For fats, I had been adding a ½ tsp of ground flaxseed to his breakfast of yogurt, but inevitably, it took him the whole day to finish it. And I probably need to increase the amount. An adult serving is supposed to be 1 tablespoon a day, so I calculated that a ½ tsp is what he would need. I thought ground would be better than the oil for the added fiber and texture. I guess I need to try for maybe a teaspoon.

Yes, his delays are likely tied to his prematurity. He had been lagging behind by about 2 months in terms of head control, sitting unassisted, and crawling, several months ago, but did learn those skills eventually.

I haven’t tried feeding him nuts, per se. His dad has a peanut allergy (not life threatening though) and a slight allergy to almonds, so I was trying to avoid all nuts for a while. The science is conflicting on whether to withhold nuts or feed them when an allergic parent is in the mix. I think I will try almond, cashew and walnut butters. Isn’t it unsafe to feed whole nuts due to choking at this age? Plus, he doesn’t have molars yet. Only 6 teeth in front.

I’ll have to compare the WHO charts to the CDC charts. I did print them out, but haven’t charted his growth on them yet. Where does the time go each day??

My son was doing weekly PT (Oct-Dec), but he had sensory issues and stranger anxiety (still does) and it just was a waste of time and money, as he would cry the whole hour. He just doesn’t have the temperament for it. I had an EI person at our home last month and according to her questions, he doesn’t lag behind. Odd. They don’t offer any feeding therapy through their program either.

He has had food issues (textures) due to his prematurity. I hear that is quite common as they end up with oral/sensory issues due to what they went through in the NICU (he was on a ventilator for a couple of days, oxygen canula the rest of his 3 week stay).

I just kick myself that my nutrition really fell off after he was born. I wasn’t taking in as much protein and fats. I eat only organic veggies, fruits, eggs, bread, etc…and have always been very health oriented.

I was eating a ton of nuts I thought the past few months. I was going through probably 4 oz of pistachios a day (I think 1 oz is the recommended daily limit) and that didn’t impact his weight gain, and prior to that a couple of handfuls of walnuts or almonds a day. It impacted my weight though so I stopped buying them. I didn’t know about his weight concerns then though. I just bought some walnuts and almonds yesterday, along with cashew butter. I suppose the trick is to now give them to him directly rather than try to get fats into him through BM.

I also take a handful of vitamins a day, including a high potency fish oil, so I presumed that would get to him via BFing.

He also takes polyvisol with iron daily and has since he was 3 wks old. I’m not sure why he hasn’t been tested for his iron levels. I thought that was part of their 12 mo check up. I just put a call into his ped this morning to inquire about that as it hasn’t been done. He hasn’t had any blood work at this point in time. I suspect that would be at his 18th mo appt if this continues.

His ped didn’t say I may have caused brain damage. That was misunderstood from my posting. I googled failure to thrive and found this info on a Merck site:

http://www.merck.com/mmhe/sec23/ch267/ch267j.html

“Prognosis
Because the first year of life is important for brain development, children who become undernourished during this time may fall permanently behind their peers, even if their physical growth improves. In about half of these children, mental development, especially verbal skills, remains below normal, and these children often have social and emotional problems in adulthood”.

THAT freaked me out. His ped was very reassuring in trying to convince me that there was no irreparable damage and there was still time (up to 2 yrs of age for brain growth) to get him up to speed. I just have my doubts that at least some damage wasn’t done.

His dad is 6’2” (but the anomaly in his family) and slender. He’s has always exercised daily. My DH has a brother who is 5’2”, so that is a possible factor in this puzzle. I’m 5’4” and 128 lbs.

I had an amnio done at 5 mo, so not sure if that rules out ALL genetic abnormalities.

He has 1-2 BMs per day, which are formed like patties typically. If he hasn't had enough solids, they are more runny.

So, my plan is this:
Buy flaxseed oil, a DHA/EPA children’s fish oil and feed lots of avocados. I will also buy tahini (ground sesame seeds) and other nut butters. I will have to thin them out somehow though so he doesn’t choke on the chunkiness. I will also attempt to get more high fat dairy (milk, cheese, yogurt) in him, though I have been struggling with the yogurt daily. I also worry about doctoring up his food to the point where they taste disgusting and he won't eat them. The polyvisol with iron is awful, but I can only get it in him in his food. I can't imagine just squirting it in his mouth straight. He would gag and spit it up.

The one thing I can’t control is his pickiness and seeming lack of appetite, though I really think he’s just being picky. He always has room for avocado it seems even when I think he just won’t eat anymore of what I'm feeding him. I am trying to work in the timing of BFing and feeding, which seems to be a factor as well. I have already given him cow’s milk as of yesterday, but he hasn’t drank much of it.

I'm also signing him up for playdates, as his ped said that would help with his development and social skills as he is around more toddlers and sees them walking, etc. So, I've checking out some of the local franchises (e.g. Gymboree, etc).

His ped said one next step would be to consult a dietician possibly. We didn’t discuss beyond that.
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#15 of 75 Old 08-06-2010, 03:25 PM
 
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Ok first off this is what has worked for ME and MY son and I know some people on here won't agree but.... My VERY high energy son eats much better when he is distracted. At meals times we put together puzzes, color, play with flash cards, and all the while I am feeding him. He simply has too much energy to sit still just for food (kwim) but if he has something fun in front of him (like the puzzle) he will usually eat. Oh, also my Ds loves his bedtime snack while he is playing in the bathtub. I've found he will eat pretty much anything in there. Yes, I know that my not work for everyone but hey ... at least he eats I don't want to see food become a battle ground and if this is what we have to do for now so be it.

It does sound like he needs more fat in his diet. Imo, there is nothing wrong with whole milk. You can also try to add butter, eggs, cheese, or nut butters to his diet. Is your LO on any supplements/vitamins? If not maybe you can check into some good quality ones.

Lastly, know this is NOT due to something you are doing wrong. As a Mama of a picky eater I know just how you feel. Please PM me if you want to talk more

Jess  SAHM to Daniel  (09/07) and Samuel  (06/10)and Katie Lee (11/11) Wifey to my "geek" : David  for 14 yrs. ( 4/09 @ 19 weeks).
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#16 of 75 Old 08-06-2010, 03:31 PM
 
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One more thing, those Poly Vi Sol Vitamins ARE gross> My Ds liked these much better


http://www.amazon.com/Natures-Plus-A.../dp/B000MBUJUI

Jess  SAHM to Daniel  (09/07) and Samuel  (06/10)and Katie Lee (11/11) Wifey to my "geek" : David  for 14 yrs. ( 4/09 @ 19 weeks).
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#17 of 75 Old 08-06-2010, 08:58 PM - Thread Starter
 
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I guess we can only speculate whether or not my Bmilk is lacking in any nutrients. I'm still a bit skeptical on that somewhat, though I can't explain why he is not putting on much weight despite nursing on demand. I'm not happy with my belly fat presumably from all the nuts I've eaten either...

It would be interesting to test my BM for nutrients. Wonder if that can be done?

I think it's more that since he is so high energy, he can't be on a predominantly liquid diet.

It's dinner time now, and thus far, he has had maybe 5 oz of food today and a few chunks of cantaloupe. He just won't eat much of what I'm giving him. He turns his face away, purses his lips, and puts his hands up to block. Guess I have to haul out another avocado if that's the only thing I can get him to eat.

I use the polyvisol because it has iron, which he needs, especially given that I'm a vegetarian and I plan on raising him as one too (including fish and dairy though--just no meat). I had looked at the health food store for alternatives, but I could not find a children's forumula which includes iron.
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#18 of 75 Old 08-07-2010, 01:10 AM
 
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I have a FTT little guy who recently turned 3. His growth sounds very much like your LO's. He was off the charts around 6 mos (we even use the BF infant charts) and hasn't been back on the charts since. We've tried all the fatty foods we could find: canned coconut milk, sweet potatoes with olive oil, avacado, nuts, nut butters, cheeses, whole milk, etc. He is finally just a hair away from the 1%, he is 24 lbs now @ 3 yrs. We reluctantly tried pediasure when he was 18ish mos and it did make a difference, but that stuff is expensive and really sugary! He was drinking 2-3 per day. I made the switch over to whole milk with carnation instant breakfast added in and he still drinks that at least once a day.

I don't think BM is to blame. My first and 3rd children were both chubby babies/toddlers. DS2 is just itty bitty. He does have a heart defect and was born pretty small (6lbs 4ozs and he was overdue). But his heart is fully repaired and his FTT stays. It is interesting that iron was mentioned because he dis have low iron for a while. We tried iron-rich foods and a cast iron pan and it stayed low so we supplement with an iron multi-vitamin and around the time we started with that is when he finally started gaining.

Also, our ped isn't super worried because DS seems to have stayed on his own curve all along. There were periods of plateaus but for the most part he's maintained his small curve.

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#19 of 75 Old 08-07-2010, 08:41 AM
 
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I just wanted to add something that also helps get calories into my DS, especially in these busy toddler days. I keep a drawer of PlumTots and Revolution Foods organic pouch foods for DS. He will sometimes open the drawer and get one for me to open, but I also frequently hand them to him when he's running around the house or in his carseat. He loves these, and he can suck the food out the packet, which doesn't require him to sit down to eat or find the plate of food. Of course, my DS loves his purées (doesn't like most whole food bites), and the purées are actually quite tasty with no added sugar and organic produce.

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#20 of 75 Old 08-07-2010, 02:13 PM - Thread Starter
 
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I'm just struggling to get him to eat much solids. Yesterday, he had about 4 oz of a jarred broccoli/zucchini puree, a few chunks of cantaloupe and banana, and maybe 3 Tbl of fresh avocado. He wouldn't eat lunch (nursed him to sleep). For dinner, he had about 4 oz of yogurt and again maybe 3 Tbl of avocado. I bought fish oil and added that to his yogurt as well. I also gave him maybe 2 Tbl of hummus, which he tried for the first time.

It just is not enough in the way of calories to support his activity level apparently.

I am also hard pressed to get him to drink much whole milk from a sippy cup. I have a straw sippy cup that he uses, but he takes a couple of sucks and that's it.

I don't know how I'm going to get any weight on him.

He has never shown any interest in what we eat. Never tried to pull food off our plates, etc.

This morning, he had just 2-3 tablespoons of full fat yogurt, to which I added 1 tsp ground flaxseed, 1 tsp of fish oil, 1/2 tsp of wheat germ, and his polyvisol with iron, and about 1 Tbl of avocado. He ended up crying because he was ready for his nap so he ended up filling up with BM again. So, I'll have to wait and try again at lunch time.

My DH thinks I shouldn't stress over this and he thinks our DS is fine. The dr. was not an alarmist, but she was concerned about his weight and mentioned her concern about a possible FTT diagnosis if he didn't put on more wt and that was all I needed to hear to turn into a worrier about this situation. I feel so helpless when he just won't eat much.

I guess that combined with how she said he is lagging behind and would be categorized at the 9 mo old level with where he is at now developmentally are all I needed to hear to make this sound serious enough to warrant concern. I just don't want to over react, but if the dr is concerned enough...

So, I don't know what to think. Either he is right where he needs to be and he will catch up or we need to intervene.

I went through a lot of stress when he was lagging behind in his motor skills back in the fall and he eventually caught up within a couple of months, so not sure if this will be a similar situation.


I'll have to check into those food pouches too. It's worth a shot.
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#21 of 75 Old 08-07-2010, 02:48 PM
 
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My son was diagnosed with FTT. I now see it as a blessing. I exclusively BF at the time and had the extraordinary fortune of consulting with a lactation consultant/nutritionist. Because he had the FFT diagnosis, this 10 month-long consultation was fully covered by our insurance. Unlike our ped (who admitted to having little expertise in nutrition specifically--and I appreciate her candor), she could see his "big picture" of BF and make specific recommendations to supplement my own diet and to introduce solids to him that were unconventional, to say the least, yet supported by research. Her guidance took so much pressure off of me--I, too, experienced all of those thoughts of failure you mention--and I could refocus on putting her recommendations into practice and getting my son on the growing path. He was way off of the WHO chart, and now sits comfortably at the 10th percentile for weight. Like your son, my son seemed fine to most people--he's a ball of energy and charisma. Yet I suspected something was wrong but couldn't put my finger on it. I fed him on demand and his latch was examined and determined to be fine, so "obviously" he must be getting enough. With the LC/nutritionist we were able to pinpoint the problem and propose a solution. She was able to test my BM if necessary, but after the first 90 minute visit, she knew that wasn't the problem. Sometime along he stopped doing the nutritive suck and only did the comfort suck and therefore wasn't triggering a letdown and my supply had dropped dramatically. Its rare, but I wasn't the first case she has seen.

I write all this to say that you can drive yourself nuts trying a million pieces of advice--I know I did. I was extremely lucky to find the right expert with enough time to sit with the two of us and understand our situation and properly diagnose the problem and then create a plan of action. A LC/nutritionist could be exactly what you are looking for (IF one is near you!).
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#22 of 75 Old 08-07-2010, 06:02 PM
 
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did the ped give you a percentile for his head circumference? you might want to check that. if his head is in the normal range I wouldn't worry at all.

generally I think that if you are offering lots of fats, and your kid is old enough to eat solids but isn't into them, it's unlikely he is malnourished?

go luck hon. try not to get too crazed about it. I thought your approach of stirring olive oil into the veggies was a good idea. I had one off the charts baby who was only into green veggies, and that's what I did too-- I olive oil in the veggies, and he still accepted them.

hugs. it will be ok.
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#23 of 75 Old 08-07-2010, 08:34 PM - Thread Starter
 
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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.
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#24 of 75 Old 08-07-2010, 09:54 PM
 
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Quote:
Originally Posted by lkmiscnet View Post
I had looked at the health food store for alternatives, but I could not find a children's forumula which includes iron.
I'm pretty sure the kids version of Floradix has iron in it.

Kate, mom to 7 year old Djuna and 4 yr old Alden. Missing our good friend Hal the cat who died June 2, 2010

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#25 of 75 Old 08-07-2010, 10:24 PM
 
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That's GREAT that he is on the chart and that he keeps growing. Maybe your doctor is using different charts. Bring yours in.

I do think that if your doctor is considering a FTT diagnosis you should go to the feeding clinic. It might help, it might not, but it can be a child safety issue (CPS type thing) for FTT, so I'd think it would be prudent to show that you are willing to do things to try to make a difference.

Also, if he's at the 3rd percentile for weight it is good that he is on the charts, but I don't think you have to worry about being "moderate". I mean, don't feed him a bunch of junk food, but good fat is good for you and for a little kid it is NOT bad for him AT ALL.

JMO.

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#26 of 75 Old 08-08-2010, 12:17 AM
 
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I can't say I'm surprised at all. Weight gain slows down a lot after they get mobile. I'm more surprised they'd consider a FTT diagnosis for a child who is gaining weight. It's not like he's not gaining or is losing. I'd get a second opinion personally. Just take him to a different dr, bring the growth charts with his weight/height/head circumference since birth, don't mention the FTT thing & see what's said. Your dr sounds like she is under the mistaken belief that height & weight need to be in a similar/same percentile.

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#27 of 75 Old 08-08-2010, 12:25 AM
 
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Can you try nursing him 2 more times a day, offering before he has asked or when he hasn't even asked?

I have read that nursing on demand (and only on demand) is actually a weaning technique. That is actually how I got my 2 year old to wean back before I knew as much as I knew now, by only nursing her when she asked to. Bit by bit, she asked less and less, and we stopped, before she was really, truly ready.

Anyway, I imagine that would be a good way to get more calories into your child and make you feel much better.
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#28 of 75 Old 08-08-2010, 02:13 AM
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But that's great! If he is following his curve (more or less), he certainly isn't failure to thrive!

Maybe it is just that his ped is using the old charts that are based on formula fed babies, and on which a lot of babies seem to drop percentiles in the second half year an onwards?

Just offer him healthy food (which includes lots of fats for a little one!), and relax. If you are relaxed and make food fun, it is more likely he will enjoy eating.

I would probably find another doctor and ask for a second opinion, bringing the charts, and do mention his prematurity!
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#29 of 75 Old 08-08-2010, 02:38 AM
 
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Agree with PP who said that height/weight don't need to be the same percentile--my child is always about 50% height and 5% weight. The developmental stuff might be a little more concerning, but I didn't walk until almost 18 mo. myself! If you're worried, though, trust your gut and revisit the early intervention idea.

Just wanted to throw in a few more food suggestions. My ped. advice was to concentrate on high value foods (like the avocado that your child likes), so I have been there! Also, I give her the polyvisol with iron because she was borderline anemic and also low iron can decrease appetite. I usually put the does in about 1/3 c. orange juice.
Other things she likes:
Pesto, with cheese and nuts
beans (often in form of salsa)
quesadilla with guacamole
tuna salad
salmon (also smoked salmon)
Ham, hamburger, grilled chicken
Tofu (marinated, curried)
String cheese (Haven't found a full fat one but you could try)
Eggs--I scramble them in a generous amount of butter
yogurt smoothies
(also various fruits/vegs, but I always give her at least one of the above at every meal--and serve it first when she's hungry)
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#30 of 75 Old 08-08-2010, 02:41 AM
 
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Also, agree with double checking head circ to make sure it's the same percentile.
Also, bread in olive oil is a favorite.
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