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Thread: Advice Please - Failure to Thrive in my Infant!!

  1. #1

    Default Advice Please - Failure to Thrive in my Infant!!

    History:

    Baby was born scheduled C-section on 5/21/12. 7lb 10oz. She initially lost about 15% of her body weight and had some issues, but then she was gaining fine and was around 20% in weight on the charts. Then she had some issues with weight, then she was fine...it's been a back and forth game with the pediatrician.

    She's exclusively breastfed and seems completely satisfied after every feeding. She laughs, she smiles, she's advanced developmentally. She's my third baby and certainly the happiest I've had. The problem: she spits up excessive, ridiculous amounts.

    Her GI is extremely concerned with her weight. Not only is her weight small but she's stopped growing in height completely. The GI said that next her head will stop growing and will cause mental retardation. At 7 months today, she is 12lbs 5oz. I think she's .4% on the weight chart. The GI doctor has her on 3 reflux medicines and can't stop the reflux. She had an Upper GI and sonogram that showed reflux. Tuesday she had an endoscopy with multiple biopsies to see if she has some sort of malabsorption problem like her brother. 3 weeks ago we started feeding her an ENTIRE avocado per day in addition to all her nursing sessions and it did nothing for her weight.

    The GI doesn't want me to stop nursing because the baby is so happy and developing so well. Most "Failure to Thrive" babies have severe developmental problems and delays but my baby is doing great and she's never been sick. At the same time, we have GOT to get more nutrition into her. She nurses and then just spits up 10 times and all her milk is on the blanket! The doctor said that, ideally, we'd stop the spitting up but because she hasn't been able to do that, even on the strongest medicatinos available, we have to make sure that what DOES stay down is higher-calorie.

    So, the GI's plan is for me to nurse all she wants and then give her 2 ounces of breastmilk mixed with an elemental formula (that would be double the calories in the same volume). How do I do that, though? Do I nurse all she wants and then pump? Because then she wouldn't be getting the cream. We've tried it several times since her doctor appointment and she doesn't want it, either. She's full! And I hate wasting breastmilk! She just spits up more. How do I keep my supply up while providing her the nutrition and calories she needs? How do I work the logistics of nursing all the baby wants AND pumping? (I have freezer milk I can use, I'm just trying to figure out how to make this work long-term....since it's coming to that). We're really close to having a feeding tube.

    Edited to add - I did all the standard things you do with a baby with reflux. We sleep her at an incline. I removed dairy, soy, gluten from my diet. We burp her well. We took her to a chiropractor. None of that helped.

  2. #2
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    Default Re: Advice Please - Failure to Thrive in my Infant!!

    I've read that you can make double cream bottles of BM - let the milk sit in the fridge and take the cream off the top and mix it into another bottle of BM. The other thought that I have is, has your baby been checked for tongue tie/upper lip tie? The dentist who clipped my DD's said he has seen babies be able to go off their reflux meds after having them clipped.

  3. #3
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    Default Re: Advice Please - Failure to Thrive in my Infant!!

    I wonder WHAT reflux meds your baby is on? My cousins baby was like this. We actually called her "teenies" because she was so small because she could never keep anything down. Zantac changed their life.

    Way too lazy for formula

  4. #4
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    Default Re: Advice Please - Failure to Thrive in my Infant!!

    If you find a solution, I would love to know. We have been going through a similar situation and at 4 months our son has fallen off the breastfed baby growth charts again. For awhile, I thought we were doing really well because we had made it to the 4th percentile but now we are back where we started. He is taking Pepsid 2x day for reflux.

  5. #5
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    Default Re: Advice Please - Failure to Thrive in my Infant!!

    Do you have overproduction? forceful letdown? Normally that is how a baby MIGHT get 'too much" foremilk and thus, not enough hindmilk., But that seldom causes a slow weight gain issue, usully such babies gain rapidly. I suggest not worry so much about that. All breastmilk milk is high in calories and fat.

    If you want to go for the pumped milk elemental formula plan, unless your gi suggested something different, I would suggest pump when it works for you and not worry so much about hindmilk/foremilk.

    How do you feel about this GI? How many doctors have you seen? do they all agree your infant is ftt? What are your instincts telling you the problem is?

    taking accurate height meaurements for babies are really tricky. Is it obvious to you the height is not increasing as well (via clothes fit, that kind of thing?)

    how often does baby nurse? Sometimes increasing the frequency of nursing sessions will decrease the amount a baby takes per feeding, and that may help with the frequent spit up.

  6. #6

    Default Re: Advice Please - Failure to Thrive in my Infant!!

    Quote Originally Posted by @llli*texaslady22 View Post
    Tuesday she had an endoscopy with multiple biopsies to see if she has some sort of malabsorption problem like her brother.
    Have you gotten the results back from the endoscopy? Do you suppose it could be some kind of hereditary issue?

    Have they ruled out pyloric stenosis?
    Karen
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  7. #7
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    Default Re: Advice Please - Failure to Thrive in my Infant!!

    I have a friend whose story sounds EXACTLY like yours. After months and months of vomiting and multiple reflux meds he started vomiting blood one night. They took him to Childrens hospital where it was discovered that he was allergic to milk, peanuts, and eggs. She unfortunatly had to stop breastfeeding and switch him to prescription formula. It took 10 months and multiple pediatricians and GIs to get to that point. GET A SECOND OPINION

  8. #8
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    Default Re: Advice Please - Failure to Thrive in my Infant!!

    If your child ends up having food allergies and you want to continue to nurse you can. Please come back for support on elimination diets if that is the case.

    Way too lazy for formula

  9. #9
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    Default Re: Advice Please - Failure to Thrive in my Infant!!

    Yes, get a second opinion. It sounds as if there could be an underlying medical issue that isn't being addressed, besides just reflux (since it isn't responding to reflux medications) or maybe he needs a different treatment for the reflux. It doesn't sound like it's a breastfeeding issue, per se. I agree with Karen that nursing more frequently may help, since baby may be less likely to spit up if taking smaller amounts of milk. I also agree with the suggestion to make double-cream bottles to help with calorie intake. Good luck, let us know what happens. I'm sorry you're dealing with this, it must be very stressful.
    First-time mama to Joshua, 10/29/11. 29 months and going strong! for 14 months; now finished with pump weaning!

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