FAILURE TO THRIVE

Hello all, my son has been diagnosed with "failure to thrive" basically because of bottle refusal and not being on solids well. He is at the 3rd percentile. We have been on 24 calorie formula with duocal added to every bottle. He is only averaging 10-12 ounces formula per day and 1 jar of baby food. We were told to add things like oils, butter to food. How much is appropriate for formula and what works best.
Thank you,
Kelley

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Your sons eating habits sound alot like my sons. Have you seen a nutritionist? Is he seeing a ST or OT to help with feeding? My son is on 28 cal per oz but we havent tried duocal yet. Our nutritionist says that they need 60-65 cals per pound per day. She does have us giving him oil we give him 1/4 tsp 4 x aday and it adds 60 cals to his diet. I am not sure if there is a limit to how much you can give them or not but if you see a nutritionist they could tell you. As far as the butter I just add maybe 1/2 a tsp to whatever he is eating. In my case we dont eat many solids and for some reason he wont take his bottle with butter in it so the amounts vary based on what I can get him to eat. If your son can have dairy you can also try adding things like heavy cream and sour cream. Anything high in fat and as far as baby food only try to feed the higher calorie foods like sweet potatos that is what our nutritionist suggested. Also, you can ask about pediasure it has 30 cals per oz it may be an option we just started last week. Just take his weight and multiply it by 60 and see how many cals he should be getting and then calculate how many you think he is getting and see where you are at. It is soo hard to get all of them in in a day we rarely do and my son is still gaining weight slowly so just get as close as you can. Good luck and I hope this helps.

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Kelley,

Does your son have problems with reflux? I just mention it b/c around 5 months adjusted, my son Henry refused bottles, taking in no more than 10 ozs a day, resulting in a loss of 11 ozs over 10 days. It turned out that the doctors didn't think to increase the dosage of his reflux medication. Henry had gain 10 lbs since it was initially prescribed, and the original dosage didn't work. Luckily, the OT mentioned this as a possible reason for the bottle refusal, and I forced the doctors to reexamine the issue.

Our son had feeding problems early on. At 2.5 months adjusted, I insisted on a consultation with an OT (who specialized in feeding habits). She really turned things around for us. We also consulted a nutritionist around 3.5 months adjusted. She was helpful.

I hope that things turn around for your little one soon.

Best wishes,
== Kate

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Tyler has been tested for reflux twice. He does not have it. He has also had a series of workups to rule out anything mechanical. He was born with a left diaphragmatic hernia, it was repaired at 10 days old, he was 9 weeks early and had a grade 3 brain bleed. So far his motor skills are right on with his adjusted age. The doctors have no answer as to why he is all of the sudden refusing his bottle. He does have his two lower teeth coming in but I can't imagine that causing this much distress. It is very stressful. He also just started at babysitters after being home with me for 9 months, therefore it is even more difficult because I'm not there with him. Do you give him the oils by mouth/syringe, or bottle. What kind do you use??? Is there any advice you could offer that the OT gave you. He is in the Birth to Three program here. I am going to be requesting an OT as soon as I get a chance.

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Teething. When my son first started teething, he was horrible about drinking his bottle for a couple weeks. We gave him Tylenol, which seemed to help a little. We also gave him wet wash clothes to suck on b/c we were concerned about dehydration.

The only oil that our son gets is 1 tsp of Trader Joe's flax seed oil once a day. Not for weight gain, but for the Omega-3 properties. We tried putting it in milk, but the oil just rises to the top. We currently mix the oil into one of Henry's veggie purees with rice cereal at lunch time.

We've worked on different things with the OT. When Henry was 2.5 months adjusted, he wasn't sucking efficiently. It would take an hour to get 2 ounces in him. The OT showed us a different way to hold the bottle and provide jaw support that helped change his bottle drinking overnight.

When he started refusing the bottle at 5 months adjusted, it was the OT who thought that the bottle refusal was related to reflux.

Around 5 month adjusted (before the bottle refusals), Henry was lunging at food, so we introduced solids with the help of the OT. We started off with food on our fingers. We then put food on toys. Then, we moved to work with the spoon. She taught us never to scrape our son's chin with the spoon to retrieve food (known to cause oral aversions later).

When Henry wasn't progressing in his eating to "chunckier" solids, the OT worked with us again on feeding at 8 months adjusted.

Anyway, I wish you the best. I've heard that STs sometimes also specialize in eating behaviors as well. Our OT was worth her weight in gold. I only wish that we had found her earlier than 2.5 months adjusted.

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I agree with Kate about the oil I have heard of people adding it to the bottles but it does go to the top and Drake wouldnt take it. It made the bottles worse. You can try it though and see what happens. I use olive oil but I was told I could use any kind they all give the same amount of cals. Our nutritionist said to put it straight it his mouth by syringe but naturally they dont like it so if I can get him to eat any food I prefer to add it to it otherwise I have to give it by syringe.

I dont really have alot to add about what the OT can offer Kate covered alot of it. One thing we do is brush inside Drakes mouth to make him tolerate the bottle better and to prepare for feeds. We stated out using a finger brush and just brush his cheeks, tongue and gums before feeds it actually has helped you can also offer solids on the brush. Our ST also has using vibrations now we use a vibrating toothbrush and he loves it. Again Good luck!

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My son is a former 26 weeker and when he first came home the doctor had us to put safflower oil in his bottle. We added a tablespoon to each bottle because there wasn't a lot of taste to it. My son is ten years old and still in the 5th percentile for weight but has always maintained his own curve and his pediatirician has been happy with this. Just try to make sure there are no problems in his mouth that are causing him to refuse his bottle and make sure the nipple hole is neither too big nor too small

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My daughter was a 26 weeker born at 1 lb 7 oz., now 30 months and 25 lbs, had exactly the same issues that you describe and was also diagnosed as "failure to thrive" We had dozens of tests done to try to find out why but we never could figure it out We used the calorie boosting technuiques ( oil, butter, heavy cream etc.) and she has finally made it onto the growth chart! It has been a long 2 1/2 years always being stressed out about her food intake but things are improving, finally! This site has been extremely helpful. Hang in there.

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Another high fat option if your son is able to start dairy products is the YoBaby yogurt. My DD started on it around 9 months actual and LOVES it. She eats it almost every day for breakfast still (now almost 19 months). If you got the green light for butter, I am sure yogurt will be okay. The infant ones come in very mild flavors like banana and pear. My DD is now on the yogurt with cereal with iron to help with that.

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Thank you all for your replies...

LauraKenney, your story does sound very familiar with the pre-e and all. I was hospitalized for a while after delivery too! This is so difficult......my complaint is this.....he did have a reaction to milk back some time ago....was finally put on neocate after several bouts with different formulas, had a biopsy done while on neocate (it has no milk) which obviously did not show a milk allergy (duh, he wasnt on milk for several months) but I am told to put all these things in his food.... butter, creams etc...I don't understand, wont this make his problem worse???. And on top of all, how exactly am I supposed to add this stuff if he doesn't even want to eat in the first place???? I'm starting to wonder if I don't need to see another GI doctor. I have decided today to cut back the calories to 22, not add the duocal and just start over with just formula and cut out the solids to see if he will pick back up with his bottle again. He didn't have this problem until about 2 weeks after they wanted me to make his formula 29 calories and add duocal to all babyfood. Today I started this, he did do a little better today, about 15 ounces, eating off and on throughout the day, not at particular settings. I think he has just gotten so full on all these extra calories in the last few months that he is truly not hungry anymore, did any of you ever experience this???? Hopefully tomorrow he will do even better.

Worried mom!

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