Tuesday, August 10, 2010

Nicholas' Failure to thrive now has an answer

Failure to thrive is something I didn't want to hear but it's exactly what I did hear when our doctor saw us last Wednesday. We've been working very hard with nursing and Nicholas was doing VERY well. He nursed every hour and a half to two hours was sleeping through the nights and napping once during the day. He was also having bowl movements a couple of times a week which was a big improvement on what he'd been doing before. All the signs pointed to a baby who was eating enough. But was he really getting enough ?? Amid all the nursing and the few bottled supplements and the addition of solids there was a lot of spitting up happening. He spit up most days several times a day after eating. Usually fourty five minutes to an hour after a meal even though he had burped well. He seemed satisfied after each and every feeding and was not unduly fussy throughout the day.

Imagine the shock of both my husband and I as well as our doctor and lactation consultant when at our six month well check Nicholas had gain just a little more than half of what he should have gained and had not grown in length or head size at all. I couldn't believe it. I just didn't understand and couldn't stop the tears of frustration as the doctor explained the implications of his poor growth to my husband and I and questioned us on how much and how often he ate. He failed to gain enough at his four month appointment but then gained eight ounces in two weeks when we were sent home and told to supplement. That was about the time the spitting up had started. Now we were back to not having gained enough, again, in spite of feeding him more often and seeing him nurse well.

If a mother cares to research failure to thrive she will find that there is no exact definition on what causes it only specifics on how to spot it. It's very frustrating. Often they simply up the babies intake and assume that baby wasn't eating enough to gain. They look at family dynamics to make sure there is no neglect going on for obvious reasons. A doctor may also need to do blood work to pin down any underlying medical condition. They are also physical reasons such as tounge tie that can lead to poor weight gain and growth in newborns and infants. I would assume this is not the issue with our baby as he is already six months old. Surely a tie would have been noticed.
Preparing to do blood work our doctor asked me to pump my breast milk and feed Nicholas only from a bottle so that his exact intake could be measured and be factored into any additional exams or lab work. If I was unable to pump to enough (considering I haven't ever been very good at pumping) I was to make up the difference in formula. A mom's gotta do what a mom's gotta do and so I give Nicholas a little hug and heaved a big sigh. Right on cue Nicholas spit up all over me. The amount that ended up on m shirt caught our doctor's attention. The fact that he did it again about two seconds later had the lightbulb going on in our heads and I asked if that could be the problem since he's been doing it more for about a month. The answer was a loud YES! She gave us a script for Zantac to try and see if that would help at all. I was still supposed to pump but he was to get the zantac twice a day in the bottles.

His weight exploded. It been five days and I just weighed him at 12lbs 2 oz, an almost two pound gain. Shocking. He barely spits up now at all so long as he gets the meds at regular times and has begun eating solids like a champ. This week is carrot week and so far he's liking them along with oatmeal.

The only downside to this whole story is that the problem wasn't pinned down until now and that with the instructions to pump only I am losing my supply. I have never responded well to pumping only and each day I pump less and less. I am trying to keep to the doctor's advice of pumping only but I have cheated several times. I nurse Nicholas every morning when he wakes up and then feed him a bottle and I nurse him to sleep every night. The night that I attempted to not do this he screamed and screamed and screamed until I did. So he WANTS to nurse just as much as I want to nurse him. It's a little frustrating to not be able to give your baby what he wants and what he needs. Hopefully we can recover from this but I can see us being forced to go to formula. A little sad in a way.


  1. I'm really sorry to hear you're losing your supply. I'm glad that you found out why he wasn't gaining well. You'll gone down a long, hard road and have come a long way. You deserve a pat on the back for sticking it out despite opposition and little encouragement!!! I say we celebrate! We need to get together again....

  2. yes, we totally need to get together again. Nicholas needs a playdate and it would be fun to socialize with somebody who doesn't spent most of their time with drool hanging out. :)