Baby Not Gaining Enough Weight

Morphio25 on 29/08/2022 - 16:12
Last edited 16/09/2022 - 10:03

Hi OzB,

Not sure if anyone here can offer any advice. We've been told by our GP that our baby has been classed as 'Failing to thrive' as she's not putting on weight at a quick enough pace. She's on the weight chart but only just, at like the 3rd or 4th percentile for her age (14 weeks).

She is formula fed and we are feeding her as per the instructions on the tin. She's currently being fed 140ml 7 times a day. The recommendation is for 6 feeds over 24 hours but we were told by CAFHS to do a 7th feed as she tends to leave anywhere between 10-30ml in a bottle most feeds. Unfortunately she is still not putting on weight at a fast enough pace.

We had an outpatient appointment at our local hospital (Flinders Medical Centre) scheduled for next Monday (5 September) but they've just rescheduled it to 10 October apparently due to a shortage of available doctors to see us. As a result my wife is extremely stressed out as she feels like she is failing our child.

Any parents out there have any hints/tips or advice that they can offer us? I suggested that she make a GP appointment to get a referral to another hospital and she has got an appointment next Wednesday but I feel like even if we get a referral the chances of us getting in to another hospital before 10 October are slim to none anyway. Is a private paediatrician the way to go perhaps?

Thanks

UPDATE: We got a referral to see a private Paediatrician. It cost $160 OOP but he was worth seeing. Did all the normal checks on our girl and has given us referral's for bloods, urine test and an ultrasound on her head. Those tests will be completed today and we have a follow up appointment in a fortnight for the results. In the meantime he has approved us thicken her formula. We're now doing 3 scoops of powder in 120ml of water where it would normally only be 2. She's responding well and we hope to see some pretty good weight gain in the next week or two.

Thanks everyone for your suggestions. I linked my wife this post and she is very appreciative for all of you that took time to reply.

Toys & Kids

Comments

  • kipps on 29/08/2022 - 16:17
    +42

    I’d get a referral to a paediatrician.

    If mum is stressed out get her to see a GP potentially for a mental health plan. You don’t want to miss undiagnosed post natal depression.

    You’ve got this.

    • jjjaar on 29/08/2022 - 18:22
      +8

      Absolutely this re: mental health plan.

      Your wife is not failing her child.

      There is this expectation that when people give birth they will just instantly know how to do everything and be able to solve everything. That is absolutely not true - and that’s ok!

      We used to live in much more close knit communities, where we had access to help from all angles. Now we tend to do a lot more in isolation, making parents even less sure about what is happening.

      If you are unable to get a mental health plan quick enough, do either of your employers offer EAP? This is usually available for partners too. The wait for counselling through these services is often very short so you could be in touch with someone in a day or so.

  • Hybroid on 29/08/2022 - 16:18
    +4

    I am not a doctor, I know nothing about this, but have you considered trying a different formula brand/mix/product? Is allergy testing a thing for babies?

    There's lots of info here:

    https://www.healthline.com/health/baby/baby-not-gaining-weig…
    https://kidshealth.org/en/parents/failure-thrive.html

    Maybe a registered paediatrician or dietitian specialising in babies is a better option to consider?

    • Morphio25 on 29/08/2022 - 16:22

      Yes, that's who we were booked in to see at the local hospital. Unfortunately they rescheduled it. I'm wondering if it'll be possible to get a referral to see a private paediatrician prior to October 10 or whether the wait time to be seen is similar to that of a hospital.

      • Hybroid on 29/08/2022 - 18:08
        +3

        What about trying different formula?

      • boxtrot19 on 30/08/2022 - 14:46

        Hi…I am sorry that youre experiencing issues with FTT. It is by far a fairly commonplace thing, yet of course, a wprrying one for you both. I am a former Sick Childrens Nurse & Clinical Nurse Consultant, and ocer tine have taken care of a great many such babies & infants who have needed some time in hospital, mostly for stabilisation & proper assessment. It can be far from easy for new parents to manage this issue, and it may become an important necessity for it to be managed & assessed in a hospital setting. -It can also be useful to assess for any malabsorption issues baby may have going on by way of explaining the FTT….really, as disrupting as a hospital stay can be, it does provide that baseline assessment to establish the root cause of things. Of course, I hope this will be unnecessary for you. An alternative would very much be to get your GP to write a referrall for an urgent consult with a Paediatrician/Neonatologist plus/minus seeing a Paediatric Nurse Practotioner, who again will ve able to support you all through this. Its hard to see the end outcomes right now, but I truly feel that, right now, with some decent support, your worries & anxieties will be lessened & best outcomes assessed & outlined for you. It really is a very common issue and very seldom does the fault, if there is one, lay with the parents. Your baby would benefit from proper & professional assessment & management, and will rhen go on to benefit from same.
        I hope some of these words might help you, but please be assured that the right help is out there, if the right people point you toward the right people. I wish you well with all things, and only wish I could assist more.❤️

  • theacekiller888 on 29/08/2022 - 16:22
    +2

    If the doctors are not worried with urgency, don't be stressed about it. But to have peace of mind, its not a bad idea to go with a second opinion (either another GP or a private paediatrician). I'm not working in the medical field but that's just based on my experience.

  • SmiTTy on 29/08/2022 - 16:29
    +10

    I can't offer any solid medical advice (and im not a medical practitioner - so i'd suggest you DON'T follow my advice anyway!)

    However, I've been in your situation. My baby fell OFF the charts completely, and also diagnosed with "failure to thrive". And as much as everyone told me to "don't worry" … you can't just "not worry" about what your child is going through ! But … in hindsight … they were kind of right. Even though my baby was always off the charts , he turned out just fine. Yes he is still scrawny - but when I was a kid , I was also the smallest kid in my class so unfortunately im sure he's just inherited my bad genes. Currently - he's a happy kid at school, talking, active, eating (albeit still not as much as we'd like him to) .

    What I would share from my experience :

    • Continue to stay close with your doctors - have regular check ups and heed their advice. At some point when your bubs a little older, you might be asked to go see a nutritionist/dietitian (like my kid) who will help you through more feeding advice.

    • My kid has quite a lot of allergies - including nuts, dairy, egg and many others. Dairy is obviously a big one because we were feeding him formula which he didnt take to very well . it took us a long time before we realised and found the right one for him after lots of trial and error. Anything the wife ate probably also affected him through breast milk (eg nuts, eggs… ). So since he didnt feed well because of the allergies, he didnt put on weight very well. May be worth while talking to your doctor about potential allergies and doing a test.

    • Try your best not to stress out about it - babies are resilient . If your doctors are not alarmed , you shouldn't be either. If your doctors are concerned - they will give you steps to take (FYI We had a doctor ask us to admit our baby to emergency because of his "failure to thrive"…. i didnt feel the need but we did it anyway. Emergency Doctors did a health check and sent him home telling us not to be alarmed) .

    Remember - that growth charts are just averages. It doesnt mean your baby is not healthy - it just means your baby isn't the average (not in a bad way). Rely on your doctor to tell you , not a chart .

    Good luck .

    • mskeggs on 29/08/2022 - 17:21
      +11

      Remember - that growth charts are just averages.

      Somebody HAS to be at the 3rd and 4th percentile, that is the way stats works.

      If you are a 6ft prop forward and your partner is an Amazon, I would be concerned. If you are, for example, a slightly built from an asian background, then what might be "that's a bit low" in a population of mainly slightly built people, becomes "that is right near the bottom" when you include all the people across the Australian community.

      Also consider the ABA advice line https://www.breastfeeding.asn.au/breastfeeding-helpline. Yes, you are bottle feeding, but they know everything about getting babies well fed, and routinely deal with babies who aren't good eaters. In my experience the counsellors there are big proponents of breast feeding, but also understanding of the stresses new parents go through, and should be able to offer good advice.

  • Muzeeb on 29/08/2022 - 16:34
    +4

    Trust the doctors and follow their guidance and instructions.

    If in doubt get a second opinion.

    I'm guessing that this is your first child. I completely understand the anxiety around this.

    Stay strong internet friend.

  • PissLUR on 29/08/2022 - 16:40
    +6

    go to a child health nurse nearby.

    • larndis on 30/08/2022 - 07:49
      +3

      This! Child health nurses are experts in feeding, not sure how it works in your state but in Canberra they have daily drop in sessions. They will also weigh baby and track growth, and can advise on other services available. They provided me a lot of support when my older baby dropped off the growth chart.

  • Stopback on 29/08/2022 - 16:52

    See if you can find breast milk

    • cookie2 on 29/08/2022 - 22:14

      Actually good point. If you can supplement with breast milk, may be worth a try to see if there's any improvement in weight. If can and wanting to be done ofcourse.

  • AndyC1 on 29/08/2022 - 17:05

    See if there is a centre like the following near you. Your local council or hospital may be able to help with getting in contact with one if there is one near you:

    https://www.healthdirect.gov.au/australian-health-services/2…

  • gaz3342 on 29/08/2022 - 17:16
    +3

    I would try different formula as a start.

  • deyani82 on 29/08/2022 - 17:34
    +3

    Had similar experience with my son, we went to a local child health nurse clinic and they gave us feeding schedule & monitored his weight weekly. He always stays below average weight but nothing to worry about, he's healthy and thriving.

    My local chemist also have amazing child health nurse, she calmed me down when I was anxious about the smallest things.

    Maybe ask around if there's a local child health nurse nearby?

    And I would ring around private paediatrician to see which one is available before 10 October before your wife see her GP so she can get a referral to this paed. A lot of paediatricians have long waiting list.

    There's one paediatrician that provides unlimited online consultation for $9.95 per month, i think it's called Kids Consult.

    All the best!

  • Benoffie on 29/08/2022 - 18:18
    +5

    If in doubt, even if stressed or worried, just head to the WCH.

    It is possible that bubs may need a gavage if they're not feeding well. This can last a while until the weight stacks on.

    Has bubs been checked for - tongue tie, appropriate oesophageal reflex, reflux etc? Can also be that bubs simply doesn't have the strength to suck.

    None of these things are an indication of a failure of parenting. Reassure Mum that she is doing her absolute best 👍

  • ozbs25 on 29/08/2022 - 18:36
    +1

    There's definitely help available. We went to an early feeding and support drop-in clinic when our baby was young. They can help you in a lot of different ways and you should be able to see a nurse pretty much straight away. I'm not sure where you are otherwise I'd try to have a look but I'm sure if you look for child health services or something similar you'll find there are many places around. These services should be run by the government and should be free.

    Edit: And just to add, our baby was and still is small for his age. Some of his measurements were off the charts low. We were told to try to increase the amount he was eating early on and try to follow the nurses instructions. One night soon after he ended up vomiting so much that we thought we had to take him to the hospital. It was quite scary. I think we had to kind of dial it back a little and kind of ignore what that nurse was saying. Maybe we went to a different clinic/nurse after that? It's all a blur to be honest. He is doing well now, seems happy and healthy. He is just a bit on the small side. His mother is small. Her whole family is on the small side so it's not a surprise he isn't the right size according to the charts.

  • ihbh on 29/08/2022 - 18:39
    +2

    She's on the weight chart but only just, at like the 3rd or 4th percentile for her age (14 weeks).

    Questions to provide context:

    • How tall are you and your wife?

    • Is the child skinny or chubby or in between? If you're not sure being first time parents, go to a playgroup/support group and look at the other babies.

    Something to try - feed the child according to her schedule. If the child cries, trying giving her a feed and see if she'll take it and then stop crying. Breast fed babies don't feed to a schedule - they do it when they are hungry. Note, she doesn't have to finish the bottle, that's fine.

  • DR-JEKL on 29/08/2022 - 19:05
    +1

    our daughter was in high percentile for length/height but low percentile for weight. My wife stressed to the max and our daughter was never big on the bottle. As per DR's advice healthy babies will consume what they want dont force it. Fortunately our daughter was fine just how she was as a baby and a toddler really.

  • Slinky0111 on 29/08/2022 - 19:29
    -4

    I have never Read the recommendation on the side of the tin when bubs should eat. Made up formula can be put into the fridge upto 1 after after making the bottle and kept in the fridge for 24 hours. So even if bub doesn't finish the bottle you can keep and reuse. Don't be scared to over feed bub.

    This is just from personal experience. We have done on demand feeding for 3 kids and never had set feeding/bottle times and they have no eating/feeding/issues disorders.

    • Bargain434 on 29/08/2022 - 19:57
      +2

      Just noting as I'd hate for the baby to get sick - if the baby has sucked the bottle the recommendations are to throw the bottle away after 1 hour (not reuse it) :)
      https://raisingchildren.net.au/newborns/breastfeeding-bottle…

    • Hasquarl on 29/08/2022 - 20:55
      +4

      Dietitian here. Just wanted to jump in to echo what Bargain434 said. Don't keep milk from bottles that have been sucked. Discard after 1 hour.
      You can indeed make up bottles of formula and keep in the fridge for 24 hours as long as they are unused.

  • Bargain434 on 29/08/2022 - 20:00

    Does she seem hungry for an 8th feed? I'm not sure if this applies to your child so perhaps ask first, but at times the quota listed on the formula bottle isn't enough. We know someone who was not putting on enough weight when parents were following the quota guidelines and they were advised to feed as much as the baby wanted (until the baby stopped feeding) by the Paediatrician. The baby was finishing all bottles though, and crying after feeds (presumably for more).

  • jolee3 on 29/08/2022 - 22:41

    I have no personal experience with this but I still remember a close friend being incredibly stressed about her daughter being born light and then not putting on weight; I can only imagine how hard it must be. Her daughter is now a small but perfectly healthy 5 year old.

    Formula tin guidelines are very much averages, we were told in hospital to follow them but at the 4 week nurse check we were told not to worry and feed on demand. If your baby is leaving some in the bottle each time, maybe she
    just has a small stomach capacity and wants more feeds but less each time. Some breastfed babies feed very frequently in small amounts too. Wouldn't hurt to try offering, as they say if you overfeed a baby they will spit it back up so you'll know pretty quick if they didn't need it.

    If you're concerned then definitely worth trying to see a private paediatrician - it could be totally fine but it will give you both peace of mind.

    Just want to say your wife is definitely not failing your child and you should always reassure her of this - sounds like the both of you are doing all the right things in asking the questions and seeking advice. Best of luck.

  • kawinuyo on 29/08/2022 - 22:42
    +2

    My kid was always on the 5th percentile… But both her dad and I are pretty petite ourselves, so try not to stress yourselves out too much by looking at just one set of numbers because there are obviously going to be the full range of percentiles and not everyone is going to be average. Your wife is jot failing her child but will need reassurance from those around her, sometimes those things just eats away at you because it feels like you're suppose to be in control but you arent. Some things to help reassure you, is she energetic, is she meeting her other early milestones etc. Good luck!

  • morse on 30/08/2022 - 04:15
    +2

    Sorry that you’re having these challenges. It’s so stressful as the parent of a newborn hoping you’re doing the best for them. Failure to thrive (awful name, but widely used) can happen for a variety of reasons. Some babies are just small. Sometimes not enough calories. Other times they might have a medical issue, intolerance or something else going on.

    I would definitely try and see someone sooner rather than later. If the hospital appointment has been pushed back it might be worth calling to ensure they know the background to the referral as sometimes this is an administrative decision that hasn’t been checked clinically (it might also be fine clinically). Also let the referrer (GP) know it has been pushed back and see if they are concerned. Unfortunately private paediatricians are super expensive and often have a waiting list too. The public system also has the benefit of having things like dieticians, nurses, physiotherapists and speech pathologists attached to them.

    It’s worth also thinking about everything else going on for your baby and wife. Is bub developing well otherwise? Sleep okay? (It’s normal for it not to be at this stage). This is the endorsed website that most health professionals in Australia refer to and has good info https://raisingchildren.net.au/babies . I’d stay away from too many other sources as it can get confusing.

    Definitely stick with the advice you’ve been given and up the bottles. Depending on how your child is you may also be able to start solids on the early side (no sooner than 4months and only if ready - check with a health professional), but some people find their kids do better with solids https://raisingchildren.net.au/babies/breastfeeding-bottle-f…

    If only to put your mind at ease I’d try to get seen sooner. Personally I’d be calling Flinders Medical Centre and ask to have the decision to push back the appointment reviewed. An extra month at this age is a long time to wait. Check back in with the GP and Child Health Nurse regularly. You could also call this number, explain the situation and see what they say https://www.wch.sa.gov.au/patients-visitors/children/medical… . I have no idea what their catchment area is or service offers but this is how I’d play it. You call up and they’ll likely say something along the lines of “do you have a referral?” You say “no, but I’m trying to find help for my 3 month old baby who I’ve been told has failure to thrive. I’ve been referred to Flinders medical centre but my appointment has been pushed back another month and I’m quite concerned and wanting to see if there is anything else available, how do I go about being referred here? Do you see babies?”. This may not work out, but has worked for me in the past. Alternatively let your GP or their practice nurse do this calling around.

    Finally if for any reason you are concerned and not getting the help you need you can go to ED. Say for example if she’s losing not gaining, excessive crying, excessively sleepy. you are worried about dehydration or milestones go backwards and you’re not getting any help from the GP. It’s definitely not ideal and will be unpopular, but unfortunately it’s how some people get into the system. I would go here if it comes to this https://www.wch.sa.gov.au/patients-visitors/emergencies/chil… Mother’s instinct is a decent indicator to go hospital, so if you do feel bub is unwell trust that instinct.

    You and your wife are definitely not failures in anyway and are doing what you can to get the help you need. All the best with bub.

  • Potatosaurus on 30/08/2022 - 08:18

    Get a referral from your GP to see paediatrician Sanjay Sinhal. He works out of Flinders and Ashford. Without a referral, you won't get the Medicare rebate

  • sovrayn on 30/08/2022 - 09:17

    Had something similar with our firstborn. He was only drinking EBM, no formula.
    Our GP recommended a paediatrician at the nearest Children's Hospital and after a bout of testing, they put our son on a feeding plan that included formula. If I recall, correctly it was something like one bottle per day. Obviously, every situation is different but once we started him on that he turned around and now he's up around 95th percentile across the board.
    I would be looking to get to a paediatrician as soon as possible.

  • ganchan on 30/08/2022 - 09:20

    How old is your child? Is their weight following the growth trajectory?

    My kid was born less than third percentile but we feed them on demand - minimum every three hours until the kid reached four months, sometimes even every 2 hours. Small amounts, 60ml or 90ml formula every time. If they finish the bottle, we offer more.

    The formula might not agree with the child - consider something new.

  • James tee on 30/08/2022 - 11:57

    Had the same thing. Took baby to emergency department and got it sorted out straight away.

  • Ramrunner on 30/08/2022 - 15:25

    Is there still gluten in baby fomula trhese days?

    Sorry if it's a stupid question but my niece was Coeliac but not diagnosed and the fomula at the time (more than 18 years ago) had gluten in it and she failed to thrive also.

    UNTIL she was finally properly diagnosed at 3.5 years and taken off gluten. All good now.

  • cupcake on 30/08/2022 - 16:15

    Firstly, I would change the baby's formula. Go for Australian made formula with no nasty chemicals. It is so much nicer and better for the baby.
    Now, is the baby drinking all of the formula? Or spitting it up after each feed? Is this your first baby? Don't forget to hold the baby up over your shoulder and burp the baby after each feed and it won't spit up.
    You will be able to start the baby on purees as well in a few weeks time.
    Good luck.

  • whatthecrappin on 30/08/2022 - 16:27

    depends on the chart too. Not wanting to pull the race card LOL but I told the doc - genetically we're not vikings, probably a bit short, what race is it based on? so what if we're in the lower range (happened to a mate of mine as well)

    on another note I weigh 84 slightly obese for my height (I cant remember the actual numbers so take it with a grain of salt). I told the doc - lets go to the bottom extreme of healthy. I can tell you now - if I lost 30kg I aint gonna look healthy LOL

    This is just another way of looking at it btw. I think as a parent you'd know if your kid is underweight, crying, not eating etc. granted its hard when its the first kid (no one knows whats going on!). its a balance, so you "may" be worrying about nothing

  • GnarlyKnuckles on 01/09/2022 - 00:26

    It sounds to me like your baby is being fed enough, and you have not mentioned that they puke a lot, so I assume they are 'keeping the milk down'. This indicates that there may be an absorption problem. I.e. the milk is going in, but it is not being thoroughly digested before it goes out the other end. If there is an absorption problem of some sort it is likely quite a mild one, because your baby is clearly doing OK in the grand scheme of things. There are tests that can be done to assess absorption/digestive capacity, and it's my guess that when you see a paediatrition about this (which I think you should do, rather than seeing GPs/etc.), the first thing they will do is look into getting some of these tests done.

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