Failure to Thrive and Breastfeeding past one year

[nicholasmommy6]

Ok, so my son is 19 months old and has been diagnosed with Failure to Thrive (FTT.) He was growing fine until about 12 months. I keep asking his ped what was wrong and shouldn't we test him or go to a nutritionist or something just to make sure everything is ok. He kept saying no no lets just wait and see. At 17 months I insisted on blood work and everything came out fine. I then asked his ped to do a urine and poop test just to check that out to and the ped acted like I was just being dramatic. Thats when I started to look for another ped.

Well we went to the new ped today and she was shocked that the old ped didn't take action. She said this is not normal AT ALL and a bunch of other stuff. Well needless to say I am a little upset.

So long story short we are doing blood work and all of this stuff. I told her that my son will not take cows milk (not even chocolate) and I am still breastfeeding 4 times a day. When he wakes up, before nap, after nap, and bed time. She said that breastfeeding 2-3 years was just fine but that I should cut it down to twice a day because my breastmilk is not the qaulity it use to be. She says it was wasted calories and more for comfort (which she said was fine)

Is that true?

I really like this doctor but I don't agree with the breastmilk thing. I definitely do not produce what I use to even a few months ago. I never nurse him anywhere close to meal time either

Can you guys tell me what you think please? Thank you!

[rock__]

Why would the quality of your breastmilk go down? That seems silly. Yeah kids need more in their diet during the second year of their life. But they don't *need* cow milk. My kid's took a huge dive in growing the second year of life. But were still quite healthy. I did at some point start actively pushing DD2 to eat more, because she didn't eat much. So I would encourage her to eat before I'd let her nurse often. But that was because she was 2 years old, and in the third percentile, and ate like a bird.

[Camille]

She's full of crap about it being a waste of calories. BM has a comparable calorie and fat content as formula, and is better than cow's milk (which was designed for baby COWS to consume, not baby humans ;)).

No, your milk quality does NOT decline after x months of nursing. BM has more calories per ounce than solid food, for sure. I wouldn't cut back on the nursing if he's been diagnosed with FTT. BM is the BEST thing you can give your baby. Even after a year.

I know there are some other moms on here who had babies who preferred to nurse over eating solids until they were close to age 2. Hopefully one of them will speak up.

DD2 just turned a year and still nurses 7 -8 times in a 24 hour period.

[madelsmama]

She is wrong. Breastmilk after the first year is higher in calories and fat than it was during the first year. Yes, it's comforting, but it's still whole milk and full of immunities. IMO, cutting back on breastmilk is cutting back on his overall calories for the day.

http://pediatrics.aappublications.org/cgi/content/full/116/3/e432
http://www.kellymom.com/nutrition/milk/bmilk-composition.html
http://www.kellymom.com/nutrition/solids/toddler-foods.html

Does he eat other foods? What is his growth pattern been over the past 5 months?

ETA: Neither of my children drink cow milk either.

[tata]

I agree with Camille. Keep nursing, mama.

[nicholasmommy6]

Does he eat other foods? What is his growth pattern been over the past 5 month?

He has grown about 2 inches and has put on less than a pound in about the last 5 months. But keep in mind the sixth months prior than that he really didn't grow up at all. He is a horrible eater! I try alot of different things and he often isn't interested. It has been that way since he started on solids. Lately he has been putting food in his mouth, chewing it, and then spitting it out.

He is not even close to being on the chart in either height or weight

[jessiehannan]

sensory issues maybe? That he doesn't like the textures of the foods he is being given?

[Sputterduck]

A calorie is a calorie.

And breastmilk is whole milk and more digestible than cow's milk. So thank goodness your son has that to drink if he isn't growing well. It's probably helping him a lot.

[rock__]

Yeah, I agree. If he's actively not eating, then that makes the breastmilk all the more important.

[Nipple_nectar]

Could you give us an example of what an average day looks like, WRT eating solids?

I agree, I would not be cutting back on the breastmilk. If your baby is willing to drink smoothies, I would be mixing avocado with something he likes, maybe yogurt?

Sassy makes a feeder that is excellent for serving smoothies, http://www.amazon.com/Sassy-Baby-Food-Nursers-4oz/dp/B0012QWYTQ/ref=pd_bbs_sr_1?ie=UTF8&s=baby-products&qid=1237003538&sr=8-1

[nicholasmommy6]

Ok food for the day

-In the morning he ate almost a whole sausage patty, couple of bites of yogurt, and pedisure w/ whipping cream in it(doctor recommended.) That is rare that he eats that much so I was super happy about that!

-He ate a couple pretzels and gold fish midmorning

-lunch-he ate a few bites of a mixture of rice, beans, chicken, and tom. I offered him chips to dip in Guacamole think maybe he would eat it that way but not interested.

-after nap he ate two or three bites of yogurt

-for dinner he ate nothing!!! even though I offered him many different things.

-Before bed he took a couple sips of pedisure

-this is not a bad day actually. I offer him alot of stuff including fruit and veggies but he won't eat it. The yogurt he eats in plain yogurt with fresh fruit blended into it. The other day all I got him to eat was about a cup of yogurt THE ENTIRE DAY. A lot of the time he chews his food and justs spits it out.

[jessiehannan]

What does he drink other than BM?

[Sputterduck]

Pediasure is like... oil and high fructose corn syrup with vitamins right? ew

[jessiehannan]

Pediasure is like... oil and high fructose corn syrup with vitamins right? ew
Horribly nasty and disgusting. My Dh's grandpa drinks Ensure to gain weight.
:puke:
But if he will drink it and it helps him gain weight, good.

[Tweet]

Hmmm..I wonder if he's got some sensory issues. Did she give you a referral to a nutritionist?

[nicholasmommy6]

I totally agree about pedisure... I don't like it at all but when you are desperate because you can see you son getting skinnier right in front of your eyes you will do about anything to put weight on him.

We are waiting for the blood tests and poop tests to come back before we go to a nutritionist.

What is sensory problems?

[Amy_G_]

Sensory problems would be he doesn't like the feel of certain things. some kids can't handle say smooth foods with chunks unexpectedly in the middle. I can't think of any other examples at the moment.

I would add variety, try things he's never tried before, have him tested for allergies, add GOOD fats to his food (and Good for a little guy includes creme and butter as well as olive oil). I would use breast compressions to increase the fat in your milk--if you don't nurse very often the fat sticks to the milk ducts until toward the end of a feeding. If he nurses for a shorter time period, he may not be getting the higher fat milk as much as he needs.

Have you charted him on a breastfed baby chart to see where he fits?
Is he meeting developmental milestones even if he's not growing fast?

[PiccoloRose]

How much did he weigh at birth? At a year? Now?

Are you or his father petite (or were you as babies)? Are any of his grandparents petite? Genetics also play a role in his growth.

From KellyMom.com -

Some things to look at to determine that your child is getting appropriate nutrition:

*Growth: not necessarily on a curve, but gaining inches/ounces or parts thereof
*Meeting developmental milestones on or near target
*Activity level: alert, happy, active

As far as gaining, you said he is gaining something, just not very much or very fast. So I would really look at those other two things and see where he is at with milestones and his activity level.

I most certainly would NOT cut back on nursing now. It is NOT true that the quality of your milk goes down. Your milk is very rich in healthy fats, and for an underweight baby, that is what you want him to get. And like Amy G said, try to add other healthy fats into his diet.

My DD dropped off of all the growth charts by the time she was 6 months old. We had a horrible time with solids once we introduced them because she's got a ton of allergies. She also has sensory issues, which further complicated things. BUT... she was very happy and was meeting all of her milestones (many ahead of time). She most certainly was not a FTT baby, even though she barely gained any weight and was very slow to gain inches as well.

She didn't get around to eating solids good until close to 2 years old. Before that it was a carton of yogurt here, a string cheese stick there, a few bites of rice at dinner, some soup sometimes. While we pushed solids as much as we could, her main source of nutrition was still my milk until close to her 2nd birthday. After that her solids intake slowly increased. She started eating more meats, more fruits, more veggies, etc.


Why did the new pedi say he is FTT? Is he meeting his milestones? Is he happy and active? Weight is not the only thing to go by.

As far as the charts go, they are just averages. That means that they end up taking the high range babies who are over 20 pounds by the time they are 6 months old, the mid range babies who follow the chart curves nearly exactly, and the low end babies who are tiny and petite. It takes a FULL range of baby shapes and sizes for them to get those averages and make those charts.

[ima062002]

Wasted cals??? That is just bull. if he drank four glasses of cow's milk a day, would your doc have said the same? There is another reason for your son's slowed growth.

two of my three kids were born in the 50th percentile and dropped to the minus percentiles for a while (around 18 mo) and then stabilized at the 5th. my son, the older one, was tested for celiac and other disorders but i knew in my heart that he just didn't eat all that much. he was more interested in running around. he nursed a lot too. my dd2 was exactly the same. my dd1 was born in the 25th percentile and was overfed with the bottle (bm and some ff) and she mushroomed upwards. today she is almost 7 and back in that 20 percentile range, but she is 75th for height. my other two kids are shorties :)).

what i did was to make sure that every meal and snack is calorie ladden. my son didn't like avocado so one day i made guacamole (with one avocado, a handful of grape tomatoes, a bit of tabasco, salt, pepper and some onion) and offered that with lightly salted tortilla chips. he gobbled it up lol. so you might have to experiment with food until you find a way for him to eat it. other fattening foods are coconut (we buy frozen pieces, which my dd2 loves), sunbutter if you don't want to try peanut butter (which we did early on, but ds can't bring it to school). sunbutter is made from sunflower seeds. there is also almond butter and cashew; both look and feel like peanut butter and you spread them on bread.

don't worry about his not liking cow's milk. after all he is not a calf ;).

my younger kids grew very little from 15 mo to 2 y. my new pedi said that was typical for some and was cool about waiting for my dd2's second b'day without labeling her anything and lo and behold her growth had picked up some by then.

if your kid eats well, then maybe you want to ask for a celiac test and others if they haven't been done yet. but partially weaning him is not the answer. he might also be teething and you could try hyland's teething tablets before meals (about 20 min before) and see if his appetite picks up. they are homeopathic.

[ima062002]

i just saw your response - if he eats yoghurt shop around for greek yoghurt which is about twice as fattening as regular yoghurt.

http://www.fageusa.com/index.html#/products/classic/