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Thread: 8 month old with no change in weight - failure to thrive

  1. #1

    Default 8 month old with no change in weight - failure to thrive

    Hello,

    Oh my, where do I begin..

    My 8 month old dd was recently diagnosed as a failure to thrive baby by her pediatrician. At her 6 month check up she was 16lbs, and is still currently 16lbs. She is being referred to a nephrologist and a gastroenterologist because of concerns seen on her blood tests. From what the pediatrician said, she's not absorbing her nutrients as she should be, she's hypoglycemic, and her kidneys are not functioning as they should.

    She also has eczema - we took her to an allergist at 6 months of age, where we found she had food allergies to soy, wheat, tree nuts, garlic, milk and sesame seeds. She is currently bf, and because of this I have limited my diet to avoid any allergens from being passed into the breastmilk. Consequently, my caloric intake has decreased which has also decreased dd caloric intake. My supply has decreased as well, so I have tried supplementing with formula, but she won't take it. I'm currently drinking mothers milk tea, but no significant increase in supply.

    From what the pediatrician says, dd has to eat more and recommends incorporating formula in wherever I can. With my milk supply dropping and her not wanting the formula, I feel as if I'm at an end on trying to provide her with the best I can, and it's not really helpful at home either with family saying 'I told you so' when it came to formula feeding (I was convinced mother's milk was best and I had a good supply up until the diet change). She eats solids, but does not show a lot of interest, especially when I mix it with formula. She will take a little bit of formula from a cup, but does not like the bottle (even if it's ebm). She's a lively little gal though, no signs of lethargy. Ideally I would like to increase my supply, but does anyone have any recommendations to formula feeding - or even bottle feeding in general?

    Thank you!

  2. #2
    Join Date
    May 2006
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    20,607

    Default Re: 8 month old with no change in weight - failure to thrive

    Welcome to the forum!

    Some questions for you:
    - Has proper weighing procedure been followed at all checkups (baby weighed nude, using the same scale as last time)?
    - Is there a possibility that someone recorded the weight incorrectly at the last checkup?
    - Has your baby continued to grow in length and head circumference since her last checkup?
    - Is your baby meeting her developmental milestones?
    - Is your baby very active, doing a lot of reaching/rolling/crawling/etc.?
    - Has your baby been tested for iron and zinc deficiency, or had a lead level done?
    - How many times per day does your baby nurse?
    - Does she nurse during the night, or is she sleeping all night long?
    - Is your baby getting a vitamin supplement?
    - What makes you think your supply isn't what it should be?

    Sorry to answer your questions with more questions! It's just that FTT is a serious diagnosis which is supposed to be based on multiple factors. Crossing percentiles on a chart is not in and of itself a reason to diagnose a baby as FTT.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3

    Default Re: 8 month old with no change in weight - failure to thrive

    Ok. If your milk production is diminishing due to you not eating enough, then you must eat more. Oatmeal? make it with rice milk or water, that is a galactagogue. You can find gluten free oatmeal...

    Mothers milk tea is simply not going to do it in many cases. Have you looked other galactagogues? Fenugreek is a common one that seems to work in many cases, I think you can get it in pill or tincture form-there are many others. Also, milk production responds to milk removal. The more often milk is removed from the breasts, the better for milk production.

    It sounds as if the doctors suspect your child is sick. A baby who is sick may not be gaining due to being sick. Not (necessarily) because the baby is not getting enough to eat. Breastmilk is nutritionally superior and more effectively absorbed into the system than any formula. I am not saying do not do formula if it is medically needed, I am just suggesting that if baby needs more, the more that would do the most good is more breastmilk.

  4. #4

    Default Re: 8 month old with no change in weight - failure to thrive

    as far as reluctance with bottles, at this age I would suggest a sippy cup or even an open cup, and don't push it. A healthy child who needs to eat is hungry and will eat. A child who is not hungry due to being ill or a nutrient deficiency (low iron etc as mommal suggests) needs treatment for the illness.

  5. #5

    Default Re: 8 month old with no change in weight - failure to thrive

    Thanks mommal for the reply and questions!

    - proper weighing procedures have been followed throughout all her check ups. Same room, same scale, weighed nude. She's plateaued at 16lbs, +/- 2-4 oz since her 6 month check up.
    - there could be a possibility that someone recorded the weight incorrectly, but in between her 6mo check up we've taken her to an allergist (5 times within the last month) where she's been at a stable weight as well.
    - I'm not quite sure if she's grown in height and head circumference; I will call and double check (I should've asked!)
    - I would like to think she is meeting her developmental milestones. She smiles, laughs, talks and sits. She can prop herself up on the sofa during floor time and just started crawling as of yesterday! No lethargy, but she takes 3 naps within the day. Each lasting around 30min to sometimes almost 2 hours when I'm home with her.
    - she is an active baby, always wanting to play and not showing a lot of interest in foods. Whenever she is at the babysitters she doesn't sleep (is this bad? She's there for 5-10 hours on some days and doesn't nap at all sometimes).
    - she's had the CBC and the complete metabolic panel done, but the doctor didn't mention any of those and I'm not sure if they're included in the panel - I will check with our pediatrician; we are also waiting on some more blood tests per the pediatrician. We just know that she's low in glucose and bicarbonate.
    - when I'm home, I try to get in as many feedings as I can. Every 2-3 hours. So maybe about 6 feedings during the day, plus some at night. When she is at the babysitters she doesn't drink a lot. There will be good days and there will be bad days. There's been a time where she was at the babysitters for almost 10 hours and only drank 4oz (plus a little bit of solids). But then there are days when she's with my husband for the same amount of time and drinks 12oz. (We've been having a problem with her eating at the babysitters; the reason as to why I was concerned about her weight gain).
    - she nurses roughly 3 times at night, but I don't know if she gets any milk at all because she nurses for 5 minutes and goes back to sleep; I don't hear her swallowing anything to try and confirm if she is. My letdown has been pretty slow. There are times where I would have to wake her up to feed her because I get worried she didn't drink enough during the day.
    - she is taking a daily vit d supplement
    - I used to pump 5oz per pumping session every 2-3 hrs on my rotations, but now being home with her for the past 2 weeks, I've only been able to pump 2oz (before feeding her). I don't pump as much at home because I just bf her instead, but for some reason, I feel as if she's not emptying out as much as the pump would. There's times where she'll want to feed and will be at the breast for no more than 5min - and latch off and is not interested. I try to latch her back on, but she does the same thing again where she is not interested and latches off. Maybe because the letdown is slow, or because there's not a lot of milk? I'm not sure. I've tried pumping after feeding her as well, but nothing comes out (I'll even dry pump for 10-15min with nothing coming out; hand express and less than 1ml comes out).

  6. #6

    Default Re: 8 month old with no change in weight - failure to thrive

    Thank you Meg for your response!

    I just recently found out that this could be the cause! I've lost close to 10lbs in the last 2 months because of the restricted diet I am on. I feel as if there's not much I can eat - it's pretty much been quinoa with chicken and salads. I've been eating oatmeal for breakfast everyday for about 3 months. Drinking coconut water as well. I just went out to buy the fenugreek pills today to try them out.

    The pediatrician says that from the blood tests, our daughter was starving our daughter's not able to absorb nutrients well so the doctor recommended that we supplement with formula for more nutrients. I spoke with our daughters allergist and she mentioned that poor absorption leads to nutrient deficiency and food allergies (and reverse is true too). They are suspecting renal tubule acidosis due to the low bicarbonate levels in her blood. I was wondering what I could do in the mean time while we wait for an appointment to see the specialists...

    Thank you so much for your inputs!!

  7. #7

    Default Re: 8 month old with no change in weight - failure to thrive

    The pediatrician says that from the blood tests, our daughter was starving
    Ok. If your daughter's pediatrician actually used the word "starving," I am very shocked. Your child is not starving. Starving children lose weight. A lot of weight. It takes tremendous weight loss for a normal weight 6 moth old to be starving. A starving child is lethargic because the baby is trying to conserve energy. I am sure you have seen tragic pictures from places of famine of actual starving children. Does your daughter look anything like that?

    I cannot give you medical advice. I have never heard of the issues your child is having. But I do know that if a child is getting ENOUGH breastmilk, they do not need to be supplemented with formula because breastmilk is packed with nutrients! If your child is low in some specific nutrient, can't baby be given a supplement of that nutrient?

    You say you have low production, and I am not going to question that, but Your pump output does not sound problematic to me. However, if you wish to increase your milk production, I suggest pump AFTER nursing baby, not before. Please visit www.kellymom.com for good info on increasing milk production. Remember that pumps need periotic trouble shooting as well.
    was wondering what I could do in the mean time while we wait for an appointment to see the specialists...
    If it were me, what I would do is I start looking for a breastfeeding supportive and knowledgeable pediatrician for a second opinion, just to be sure the medical advice was coming from someone who is supportive of continuing breastfeeding even if baby does need supplements.

    Also, this may not be possible, but I am thinking that if your child is truly not getting enough to eat, and won't eat much at the babysitter, it may be time to find alternative care arrangements at least until this is figured out.

  8. #8
    Join Date
    May 2006
    Posts
    20,607

    Default Re: 8 month old with no change in weight - failure to thrive

    our daughter's not able to absorb nutrients well so the doctor recommended that we supplement with formula for more nutrients.
    It sounds like the pediatrician suffers from the misconception that formula has more nutrients than breastmilk. If you're going to supplement, there's no reason not to supplement with your own expressed milk- and the pumping it would take to get that milk would help increase your supply, making it more likely that your baby would get more milk when she nurses.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  9. #9

    Default Re: 8 month old with no change in weight - failure to thrive

    Hi, was thinking about this last night. here is what I was wondering.

    So, I know you saw an allergist. How sure are you that ALL the items listed are culprits in your child's excema? Or might some be worse than others? also, was there any other symptoms of allergy aside from excema.

    Unless you can figure out how to add more 'safe' items into your diet, I think your severly restricted diet is possible compromising your health. And if the issue you are having with your baby's weight gain is also being affected by that, it is also greatly affecting your babies health.

    You are being faced with the choice of giving your child formula, and since your child is allergic to both dairy and soy, that leaves you with hypoallergenic formula. I suggest you read the ingredients of such formula. Again, any formula contains calories and if a child truly needs more calories, that is an option. But there is no way any formula is nutritionally more complete than your breastmilk. The only time breastmilk alone may not be sufficient (or breastmilk plus solids) is if both you and your baby is depleted in some specific nutrient which again, could be given to baby (and you) as a supplement in order to normalize the levels. I also wonder what solid foods you are giving baby. Are you giving baby only chicken and quinoa?

    So I am thinking of two possible ways to help with your diet problems.
    1) see a nutritionist who can help you find a way to eat a balanced diet with the restrictions, or find a website or book that can advise you. Have you visited a health food store wand talked to the folks there to help you find items that meet your criteria? This area is not my forte at all but I wonder- What about beans? rice? fruit (includes avocado) turkey? Pork? (Are you avoiding beef?) If tree nuts are out, What about peanuts? (for you, not baby directly)
    2) Discuss with your allergist the issues you are having and ask if it would be ok to add back in some of the forbidden foods or food groups or parts of food groups. Maybe unfermented milk is a problem, but a little cheese and yogurt ok, etc.
    Last edited by @llli*lllmeg; May 4th, 2014 at 12:38 PM.

  10. #10
    Join Date
    Mar 2014
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    Sweden
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    Default Re: 8 month old with no change in weight - failure to thrive

    Hey momma,
    I too have a sick 8Mo and it irritates me every time I read about formula recommendation. First off, your baby is stagnating but not loosing weight. And that's because she is probably sick. And guess what, she is not loosing weight because she gets your breastmilk. Guess what else, your supply might be reduced because your lo nursed less due to the illness aside from you being on a restrictive diet. I am on one too, it happened to me. You wrote that your lo is smiling, crawling and otherwise happy. She is burning up more calories at this age too, and she will be eating more once you have a definite diagnose and a proper treatment. Just pointing out the obvious here but you need extra calories. Have you concidered to start pumping regularly to increase/maintain supply if you feel that she never finishes breast? Did you try a different teet when offering bottle, like faster or slower flow? In my experience, introducing new things to a sick baby is not the best idea. Are you trying to give her hypoallergenic formula since she is allergic to dairy and soy? Those taste bad to an older baby, especially of they are used to a sweet breastmilk (try it yourself). If you decide you really have to supplement with this formula, add a little vanilla sugar to increase the chances of success, dont mix with breastmilk though and definitely don't force feed
    Instead, feed her what she likes the most and give her as much of your milk as you can. I personally started pumping when my baby received her diagnose. She gained one pound in 2,5 weeks once she started to feel better and started eating more solids. Perhaps yours will too! So don't think about numbers now, think about your lo's recovery. Sometimes pediatricians are too eager to blame it all on breastmilk supply. I would ask for second opinion.
    Last edited by @llli*undergroundmuse; May 5th, 2014 at 04:16 PM. Reason: stating the same as pp

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