Saturday, February 12, 2011

Failure To Thrive

Callie has been tiny since the day she was born.  At birth she was 5lbs, 5oz.  The day we left the hospital she was exactly 5lbs.  They made us go out and buy a new carseat that would better accommodate her tiny body before releasing her.  Here she is at the beginning:

During her first year, Callie was exclusively breastfed.  And I mean exclusive since she did not start solids until 12 1/2 months (up until then she was unable to take in food by spoon).  Her growth was slow and when she would take pumped bottles, I would add Similac NeoSure formula to them to boost the calories.  She weighed 15lbs, 8oz at her 12 month checkup this past November.  I was asked to bring her back monthly for a weight check.  At 13 months she weighed 15lbs, 10oz.  At the beginning of January I started a very detailed food journal.  I recorded every calorie she consumed and worked very hard to feed her as much as possible every day.  I shopped the grocery store aisles for baby food with only 100 calories or more per jar (FYI, BeechNut Mixed Fruit Yogurt and Cinnamon Raisin Granola each have 180 calories per jar), bought the yogurt with the highest calorie content (FYI, LaCreme packs 140 calories per little cup), and tried feeding her things like mashed avocados.  I went into her last weight check two weeks ago expecting to see a gain.  Needless to say I was very disappointed to learn she had only gained 1 oz in 6 weeks... She was only 15lbs, 11oz.  At that point she was formally diagnosed as failure to thrive.  Failure to thrive is a description applied to infants or children whose current weight or rate of weight gain is significantly below that of other children of similar age and sex.  Callie has fallen off the bottom of the growth chart and is no longer following a curve.

We met with a nutritionist who instructed me to "think fat" and add cream, oil, and/or butter to all of her milk and food.  That was two weeks ago.  Since then I have been doing just that.  Let me tell you, it has made me realize I should never cook with heavy whipping cream!  That stuff packs 50 calories per tablespoon.  I have continued to keep a food journal and am happy to report that I am seeing new daily calorie highs.  Our highest to date is 852 calories and I was so happy the other night when I added up the numbers.  This time I am REALLY hoping to see a decent gain at her next weight check on March 1st.  

We feel her Topamax is largely to blame for this issue.  Topamax really takes away your appetite and I can see this happening with Callie.  She never wants to eat.  She will never express that she is hungry.  I gently make her eat all her meals.  She tolerates, but does not enjoy eating.  Her PMG is also to blame.  She has oral motor issues that make it harder to feed.  She often pushes food out with her tongue and is not able to chew more solid snacks.  I remember Owen gobbling up Cheerios, puffs, and any soft foods at this point, but Callie is unable to do this.  She has, however, made huge improvements over the last two months.  At Thanksgiving she could not even take a spoonful of baby food and now she is taking in two to three servings each day.
We have an appointment with a GI doctor and new dietitian in March.  Hopefully we can get this all worked out and get her back on a growth curve before long.  Regardless I think she will always be small and that is okay.  I was always told good things come in small packages.


Lori Miraldi on February 23, 2011 at 1:00 PM said...

I forgot how tiny she was when you first brought her home. I know it doesn't always seem like it, but she has grown a size and strength.


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