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Failure to Thrive

Many parents look forward to going to their child's well baby checks and finding out how big their child is getting.  One of the biggest things a mom wants to see is where their child is on the growth chart.  But when a child is having growth issues, doctor's visits can be filled with worry and anxiety.  When looking at your child's growth chart you should see a continuous upward pattern.  Some kids may be smaller than others but their weight gain should follow a pattern. 


If you notice your child losing weight, not gaining weight, or dropping to a lower percentile in her weight pattern, there might be reason for concern.  Children that are significantly below their expected weight, generally in the fifth percentile or lower, may be diagnosed as failure to thrive.  However, if there is a sudden drop in weight, regardless of what percentile your child is in, there may be reason for concern.

Usually when a child has growth issues it is related to a feeding issue.  The child may not be getting enough calories or have issues with digestion or malabsorption.  It is important to determine the factors for why a child is having growth issues.  There are many reasons a child can have poor weight gain including chronic health issues, poor milk supply for breastfeeding moms, improper mixing of formula, illnesses, reflux, inadequate nutrition because of neglect or poverty.  Failure to thrive can also be an indicator of other medical problems such as hormone imbalances, food allergies, or digestive problems. 

For infants that are breastfeeding, there are many factors that could contribute to poor weight gain.  Breastfeeding moms should seek out assistance from a board certified lactation consultant.  A poor suck, scheduled feedings, improper latch, or having a premature infant can all contribute to an inadequate milk supply.  Sometimes mom's supply is fine but baby is having difficulty with sucking/swallowing, which in turn, can cause supply issues and poor weight gain.  Even if mom has a poor supply or baby has a poor suck, this can often be corrected with proper help.  Working closely with a lactation consultant should help improve supply and/or sucking issues.

If your child is diagnosed with failure to thrive or is having weight gain issues your doctor may order tests.  Failure to thrive can be an indicator of a serious health condition such as cystic fibrosis, diabetes, or heart disease.  If it is thought to be a feeding issue, she may suggest ways to increase the calories in your babies diet.  Do not give baby or child nutritional supplements like Ensure without consulting with your doctor first.  She may recommend higher calorie formula or supplements for breast milk.  You may be referred to a feeding specialist to work with you on improving your child's nutrition. 

Adequate nutrition is important for mental and physical development.  If you are concerned about your child's weight contact your pediatrician.  If there is a medical issue surrounding the weight issue your doctor can provide you with information and treatment options.  If your child has a normal rate of growth and developing normally this is not cause for concern.  Some children are just smaller than others, particularly if their parents are also small in stature.  However, if you are worried that your child is underweight discuss your concerns with your pediatrician.

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