Failure to Thrive - Pead referral at 13 months

[starangelk]

Hi all

A bit of history - DD is 13 months old and weighs 8.4kg. She eats well, is on cows milk twice a day and meeting all developmental milestones. She got a cold in February that hasn't shifted and I've been taking her to the GP monthly to check it hasn't gone to her chest. Her chest is always clear. We were given a script for dimetapp and told that due to her going to daycare a few days a week, it wasn't the same cold, just that she kept catching a different one over and over. She got an ear infection that led to a perforated ear drum a couple of weeks ago and was put on antibiotics. We had to go back today to check her eardrum had healed - which it had however there was still a bit of puss behind her ear so she needs another course of antibiotics. The Gp wanted to weigh her to check the doseage to prescribe and then basically freaked out about her weight. He went from her birth weight 3.7kg and said based on that she should weigh at least 10kg now. I don't actually believe in those scales that much however when he showed me that she was now very very low and had dropped 4 bands, I was a bit concerned. I know she doesn't weigh much but she looks solid and is doing everything she should. She eats super well, everyone comments on how much she eats so I guess it is strange that she isn't putting on weight.

I am gluten intolerant so I am wondering whether she may also be. I waited until about 10 months to introduce gluten and she seems fine with it. Or maybe she is just not putting on weight because she's had this cold for so long? The gp seemed to think her being sick was a result of her low weight and not the other way around.

My question is - has anyone else been in this situation? Should I be keeping a food diary or anything in preparation for the appointment? I guess I just assume the Pead will think she doesn't eat well which is really seriously not the case. The ladies at daycare said she eats the best out of all 8 children and the most and they don't know where she puts it. They are astonished. We did Baby Led Solids so I think that may have helped.......not that it is helping her weight.

Any advice/thoughts/suggestions are welcomed.

[HotI]

i would think she is spending alot of energy fighting off the infections and so doesn't have a lot spare. Not sure if you weighed her regularly, but has her weight gains been consistent since birth, or is there a point where the weight slowed?

FWIW, my DD was born 3.7kg and at 15 months is 9.2kg. She has gone from 75th percentile to 10th for weight. I am trying to give her little quiches and higher fat foods, but i also recognise that she is just so active and has always been a slow weight gainer. I have read the food you pack for your little one for care, and i don't know how much more you could add, the food is gourmet!

[starangelk]

Thanks Hoti, I really appreciate your thoughts and kind words. I have to admit, I'm a bit teary over the whole thing. Not sure whether its preg hormones or just feeling of guilt that I'm not doing something that I should be. I got given a chart and these are the figures:

Birth 3.7kg
7 weeks 5kg
4 months 6kg
6 months 6.5kg
8 months 7.5kg
12 months 8.2kg
13 months 8.4kg

I have made an appointment with the mothers and babies clinic at the hospital who have mw/lc's etc to chat to about things as the pead appointment isn't until October. But apparently as she has dropped more than 4 bands on the scale, we are classified as urgent and on the waiting list. I think seeing the MW at the clinic will help me feel better but right now, I just feel really sick about it. I tried to tell the gp I thought she wasn't putting on weight because she was sick but he said he thinks she is sick because she has low weight. Go figure.

[Little Chicken]

So sorry Star, what a shock for you. Your idea of a food diary is a good one though, so you can say to pead this is exactly what she eats every day. Doctors like that kind of thing because then they have a rough idea of the calories she is taking in daily. It is something they can strike off the list straight away iykwim? Has your GP ever taken any blood tests to see what her immune function is like?

[starangelk]

Thanks LC, I will do the food diary I think. I just don't want to seem like a psycho parent. Before I saw this GP today, no one has ever said anything about her weight, let alone BT's etc etc. The Gp today mentioned BT but said that the pead would do that if he thought it was neccessary. I said "some kids are just small right? I was a very small child" and he said "yes, but we want to rule everything else out too."

[Mak]

I think a food diary including how much (and what) she drinks will give the paed a good head start anyway. If you or your DP are slight or were as kids then perhaps that is also worth noting also, if your parents have any info too that could help.
AB's can make your tummy pretty upset too so maybe that has not helped. Certainly if she seems to be eating lots and is happy and alert - minus the ear infections then surely that should make them happier??
One thing that may be relevant is not using low fat dairy etc - kind of the opposite to what most people do.
xx

ETA I have a friend whose 5yo has just hit 16kg and another whos 3yo twins were only 10kg at ~ 20months also so I think it is not unusual but worth following up ITMS

[trishalishous]

DD was FTT from 2 months till 8 months (when she had consistent gains, rather than losses ) and we kept a food diary, and i took Domperidone to boost my supply and BF every 2 hours during the day.
Shes 14 months and 10kg, after weighing 4kg at birth, (dropped to 3.5kg at 1 week)
She was sick recently and lost 500g, but we've finally got the weight back on! The Paed has NEVER suggested that she was sick due to low weight, but he put ME on bedrest and back to exclusive BF until she could tolerate solids again.
Shes only the 3rd % for weight but the 97th% for height.
Im not sure if your LO was FF (or if formula is more calorie dense than cows milk?) but Id reintroduce a BF/FF each day, as well as adding avacado, fish and olive oils to her diet.

[Aligater]

I was refered to the pead for FTT at 9 months (well DD2 was) And now at 19 months she has just hit 8.6kg. We got a diagnosis of Cystic Fibrosis in April but that was after alot of testing. She was tested for coeliacs and many other things. It is possible that your LO has the gluten intolerance and she is small because of that

[Sterla]

My DS basically didn't really gain any weight between 12-18 months, staying at around 10kg. It was at this time he also had sickness after sickness (it was during winter). However, after 18 months he started gaining again, and now at 2.5 years is 13kg.

[Rivlas]

I went and got DD2 book from over 20 years ago and at 12 months she was only 9.450kg and at 2 11.8kg. She was a very active child. Nothing was ever said about her weight as she ate well and was growing.

Remember every child grows differently so it's not fair to lump them all in the same basket.

[RainbowBrite]

I think you can look at a few positives...she is gaining (it may be slowly but she is gaining), she is happy and healthy, she is developing well and she is eating so getting nutrients.
DS4 is/was FTT, he is currently 7.3kg at 18mths (he has not been on the charts for a long time). We have had every test under the sun to see if there is a problem...tested for CF, metobolic disorders etc.
We are under a dietitian at the hospital and have been for some time.
They got really concerned when he started losing weight...but at the moment our pead is reasonable happy because he is happy, healthy and doing well developmentally...just tiny
He seems to have a fat intolerance and that may have something to do with it.

I really understand your concern and but she may just be a little girl with a really good metabolism.

[~*Niadalla*~]

At birth DS was 4.02kgs. At 12 months he was 8.4kgs. Not once was anything ever mentioned about his weight requiring further investigation.
He is 4 next week and he'd be lucky to be 16kgs. He's tall, skinny, full of energy and very intelligent.

Honestly these kids are all so different.

I think if a child is happy, healthy eating and drinking well, hitting milestones within the appropriate age 'limits' (although again, each child is different) then there really shouldn't be too much cause for concern.
If you are worried, you could maybe keep a food diary if you feel it might help?

[aussienic]

I had a similar issue with my DD aside from the sickness.. She was perfectly healthy but weighed 8.9kg at 19 months.. She hadn't gained a thing since 6 months of age.. I wasn't concerned as she was active, ate well and was meeting all her milestones just fine

CHN wanted to get a blood test to find out what was wrong.. My GP agreed with me that she was fine but tiny.. We had to increase certain foods and was given a month to see some sort of weight gain.. One month later (after increasing yoghurt, cheese and milk which she didn't like as she was BF) she gained 200 grams

Long story but she is now a very exciting 15.1kg at 3 yrs and 8 months (that is what my boys all weighed before they turned 2)

[YoYo]

Oh honey please don't stress. Darcie has only just cracked 9kg after hovering over 8.5kg for about the past 6 months. I thought it was odd at first as max weighed 12kg at 12 months..... Weight doesn't mean everything. As you said x does everything she should be, and apart from colds and dodgy ears she would be perfect, and she eats well.

You're obviously doing a fab job. A gorgeous little girl who loves to socialize and is a happy little soul (I've seen pics!!) so try not to let it upset you.

Don't forget a little thing called genetics plays a part in how our bodies are built and neither you, nor your dh are the size of a house from what I've seen!

Go easy on yourself and just enjoy your baby girl and I hope all the lurgey germs leave her soon! Xx


Sent from my iPhone using Tapatalk so sorry for mistakes!!

[trishalishous]

Don't forget a little thing called genetics plays a part in how our bodies are built and neither you, nor your dh are the size of a house from what I've seen!

I agree! they weren't too worried about our DD, as Im tall and I WAS skinny, as long as she had a gain at each weigh in. Shes always been active and alert, just is a skinny minney

[Ca Plane Pour Moi]

Looking at DS - birth 3.75kg (75th centile), 12m 8.5kg, 14m 9kg (9th centile). Currently 14kg, has been since he was just over 3 (he's now 4.5yrs). The puts him on the 2nd centile: so still perfectly normal. There are children out there lighter than him still.

He eats like a horse and has the same metabolism as his parents had. What a shocker! If anyone were to refer him for failure to thrive at 13m I would laugh and point out he eats, he develops, he is as skinny as expected given genetics.

[Lisa B]

I just thought I'd comment on the tests that my DS is having as he hasn't been gaining on the normal curve. Our paediatrician is great, she is reassuring but at the same time very thorough in her approach.

We've had a stool sample to check for how he absorbs nutrients as I'm reporting quite a reasonable BM intake (I EE so I know how much he has).

I'm also coeliac and you can get a Buccal Swap taken (they run a brush inside their cheek at pathology) to see if they have the genetic mutation for coeliac disease. If it's positive it means they have the potential to develop coeliac disease in their lifetime. This test can be bulk billed!

If you LO has been having gluten for the last 6 weeks they can also take a blood test to check for coeliac antibodies.

The slowed weight gain for my DS just might be him finding his centile after birth (he was on the 75th for weight at birth) due to his genetic imprint for body size - my family is mostly on the thin side.

[RainbowBrite]

That is great news, a second opinion is always a good thing.
You must be relieved and able to relax a bit more now.

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