15 months, Failing to Thrive

MaygenDL0ve

I'm looking for some advice/help.

Our 15-month-old identical twin boys have been diagnosed w/ failure to thrive. They have exclusively breast fed and have always been low on the scales (AAP scales, around 4th percentiles). Stool samples indicate they have abnormally high amounts of fat. The finally saw a Pediatric GI specialist yesterday and he is checking their pancreous for enzymes. He also said to give them 16 oz of pediasure/day each. We've tried this before w/ no luck. He said to take away ALL their fluids including breast milk and they will cave after a couple days and start drinking the pediasure. I'm so worried about this; we co-sleep and breastfeeding is the only thing that comforts my boys and makes them happy. How can I do this?? They nurse before both naps and before bed, and several times at night.

pitterpatter129

I wouldn't...  I would get a second opinion.  You could syringe feed pedisure too like medication just to get some in them for now or use an SNS system with the pedisure.  That's a tough situation - ((hugs))

catlackey

Like PP said, I would get a 2nd opinion and try feeding them the pediasure through a syringe. Starving a child so they will be forced to eat doesn't seem to make a lot of sence. Good luck.

mamababyrn

I agree. I don't think you should stop feeding a baby that is failure to thrive. Do they eat any solids or just BM?

Mira06

I too would get a second opinion.  I would not take away any nutrition from babies with failure to thrive just to hope they would eat something else. 

MaygenDL0ve

racheleo:

I agree. I don't think you should stop feeding a baby that is failure to thrive. Do they eat any solids or just BM?

Yes, misuse of the words EBFing.. started solids at 5 months  

MaygenDL0ve

AmyG*:

https://www.aafp.org/afp/2003/0901/p879.html

 

this covers a few things that you might want to do.

like a 3 day food diary, to see what they are actually eating

I'll suggest that you

add in higher calorie foods (avocado, oatmeal, meats, cheeses, butter, etc)  make food count higher in fat and calories a bit but including what they like to eat.  once a day try oatmeal with fruit stirred in a scoop of formula and made with mik kind of super nutrition.  or cereal like cheerios stirred into yogurt and eaten with spoon or fingers.

offer foods more often, 3 meals, 3 snacks in addition to all the nursing that they want.  offer foods in the high chair but a few things in a spot in the kitchen for drive by toddler eating-of course being sure to watch for choking hazards.  If they are a bit picky (most little ones tend to be for a bit) give them opportunities to get messy with food, dip things. offer something you know they like at every meal and if they refuse don't run back to the kitchen to make them something different, cause then you'll turn into a short order cook and they may begin to refuse more foods just so they have more control.  at this age they like to have a bit of control over their foods.

 

consider teething meds if you are getting molars and that is effecting eating.

offer the ensure type drink in a sipper cup, open cup or straw cup.  Consider chocolate or strawberry flavored ensure, understanding that the added sugar and flavoring doesn't counter the effects of the added nutrition.

if they don't like that, cause it tastes a lot like yucky formula, try ovaltine, or carnation instant breakfast stirred into their milk.  if you think cow's milk may be an issue, use almond or rice milk for a while and see if they'll take that instead. 

I think you'll be ok. rule out anything wrong, add in extra foods if they'll take it, check for allergies.

and then keep nursing.  why would you deny them that super concentrated multivitamin?  most docs don't think of breastmilk that way, but you know it's good for them.  don't wean for this without a lot more evidence.

 

also I'll ask have they always been fairly low on the growth curve or did they just drop low recenty?

 

 

Amy, thank you.  This is all wonderful advice, just the type I've been looking for.  They've always been small but have recently dropped to the 1st percentile when we introduced milk at 12 months.  THey've dropped, gained, dropped gained, but never risen above the 1st percent ever since.  I'm starting to re-introduce milk this week, starting w/ milk proteins in pediasure, then cheese after 4 days of no allergic reaction.  Crossing fingers, it's all so much work!!  Thanks again..