Failure to thrive ?!?!

[blandino]

We had a new DC boy start today. We haven't physically seen him since they interviewed when he was 3/4 weeks old. He is now 8 weeks old, and this morning when DCM dropped him off, she mentioned that he was getting cereal in his bottle because the Dr. was concerned he wasn't gaining enough weight (I will write about the cereal thing below). DCB was still in the carseat when mom told me, but when my assistant and I took him out, we were shocked. He is so incredibly small. I truly felt like I was holding a baby that had just been delivered.

When DCD came to pick him up, we chatted more about his weight - and at his 2 mo check up last week - he had only gained 7oz since birth. Hypoglycemia test came back positive & negative (ran test two times). DCD said before they jump the gun and assume it's something worse, they are going to try the cereal for a week.

My first thought was it looks like failure to thrive. Has anyone dealt with anything like this ? Any suggestions I could give the parents ? The family is super sweet, and we would love to be as supportive as we can.

Also, clearly I am not a pediatrician - but adding cereal to his bottles (to me) would seem to fill him up faster - but I don't think that would help anything since the faster he gets full - the less formula he consumes and the less often he is hungry, and I don't get how that would help with consuming more calories and putting on weight ?!? Today he only drank 4.5 oz of his usual 6oz bottle, since it had cereal in it. Seems odd to me. The Dr. is only trying it for one week - so at least the Dr. isn't going to risk it for longer than a week. Then I guess, they move onto testing for other things...

[jojosmommy]

5Tbls of cereal adds 60 calories depending on what kind. 60 calories for a ftt kid can be essential. My dd has been prescribed a formula mixture in which we add additional scoops of formula powder to the typical amount of liquid to increase calories per ounce. The doctor will probably suggest this if need be.

Is the kid having other symptoms?

Malabsorption issues could bein play here.

[kendallina]

My daughter was diagnosed FTT at 9 months and we did months and months of testing, only to come up with nothing.

My only suggestion was to make sure that you maintain really good communication with mom about what he should be eating and how much. Also, I would recommend that you ask (or require) mom to get a doctor's note whenever the doc gives her new feeding instructions, just to make sure that you have all the details and are as up to date as possible. It's really scary when it's such a young little guy. I hope he's okay.

[blandino]

Not many signs, but he is only 8 weeks old - so there is no real milestone to be delayed on. And we have only had him 5 hours, so it is hard for me to say if he is irritable/excessively sleepy. I will tell you, he doesn't spit up - so I would rule out a milk protein allergy (DCB is on milk based formula).

My best friend is an RD, and she suggested a malabsorption issue, as he was taking in an adequate amount of formula.

My thought about the cereal, is that it is causing him to drink less formula, so that 1 tbsp of cereal per bottle is stopping him from drinking 2 oz of formula, which is going to have about 40 calories. I am obviously not a ped, but I just thought it was strange logic. But if it is a malabsorption issue, i could see him putting on weight from the cereal - so in that way it makes sense.

[Scout]

My breastfed son only gained I think 8 oz. from 2-4 mos after I returned to work. He would only drink 10 oz all day when I was gone. I was away from him from 6:30-4:30! The pediatrician asked if I wanted to do maybe one bottle of formula per day. I didn't, so I pumped my arse off even more than usual(4x a day was the norm) to get him an extra bottle to supplement at our last night feeding. A lot of women run out of milk after a long day of work & family. Thank goodness it worked! He gained the weight he needed. He is still small & at 17 mos just hit 20 lbs but, is perfectly healthy...just my peanut. 5% but, all mine!

edited to add: Is he on formula or breastmilk?

[daycarediva]

I would think the cereal would actully be detrimental. When my ds was released from NICU and needed to put on some weight, they gave us a recipe for adding more formula so that it was 25cal/oz instead of 20 (if I remember correctly, it's been 10 years!) and he needed that for 3 months.

I am not a pediatrician, but I always thought cereal was a filler food, and the real nutrition/cals came from formula.

[countrymom]

I think the cereal is acually doing more harm than good. If I remember it has to do with the body not being mature enough to handle food yet.

also, they do sell formula that may have more nutrients in it. Also, how often is this child fed.

I would feed every 2 hours, maybe 2 or 3 oz at a time. When my niece was born this is what they had to do to gain weight on her. You need to feed more often but less.

[MNMum]

What type of formula is he on? Most is 20 calorie/oz. There are others that are 22 or 24 calories/oz. Why wouldn't the doc opt for this? The rice cereal may help with weight gain, but not in the most appropriate manner.

[SunshineMama]

I think the cereal is a really bad idea. Babies that young are not physically mature enough to digest it properly. I would increase formula is he will take it. Also, I would be baby wearing that baby all day long. A FTT child needs attention above and beyond what a normal baby needs. I'd forget about worrying about spoiling the baby and focus 100% of helping that baby thrive. He needs love and touch to encourage him to eat more and thrive. Poor little thing

[jojosmommy]

What type of formula is he on? The medical formulas are much better and can be mixed in greater cal quantities. Most doctors can get access to a sample or can write a RX so that mom can get a sample.