Failure to Thrive

What does the condition called "failure to thrive" mean?

Failure to thrive is a condition in which your baby stops growing or loses weight -- specifically, dropping below the third percentile in weight. It's most common during a child's first three years, but is of particular concern during your baby's first year because it can lead to both motor and cognitive developmental delays.

A baby's failure to thrive can be caused by several factors. It can be because she's sick or not getting enough nourishment, and in some cases it happens because a baby is not getting enough close physical and emotional contact. Failure to thrive can also be caused by:

• Illness -- babies lose their appetite, too

• Excessive vomiting or diarrhoea from an illness

• A weak sucking reflex -- your baby isn't emptying your breasts

• Low breastmilk production

• Your baby gets sleepy and falls asleep before she gets enough milk

• Either a cleft lip and palate or a tongue tie

It can sometimes be difficult to get a breastfeeding routine established, especially if you have several other children in constant need of attention. This is why it's so important to have plenty of help at the start.

Susan wasn't sure if she had fully established breastfeeding before she left the hospital with Jana, her first baby. She wasn't certain if Jana was latching on properly or not, although Susan continued to offer a breastfeed whenever Jana seemed to want one. Susan's health visitor became concerned when Jana did not put on weight as expected and asked Susan to keep a note of how many wet nappies Jana produced in one day. The trouble was, as Susan found, that some modern disposable nappies absorb any wetness so efficiently that it was very hard to tell if the nappies were damp or not. Susan had been assuming the nappies were wet when they weren't. Once the problem was diagnosed, the health visitor made sure Susan and Jana were managing breastfeeding properly and suggested some supplementary bottle feeds. This resolved the temporary crisis. Jana began gaining weight, and Susan began to feed more often to build up her milk supply.

I'm worried this will happen to my baby. What can I do to prevent it?

If your baby is diagnosed with failure to thrive, try not to blame yourself; the problem is usually easy to remedy. Your midwife or community nurse will work with you to find the cause. Your doctor and Natural Health Professionals can also help. We want to get your baby back on track immediately to avoid long-term developmental and health problems. But rest assured: Once you know how to correct the condition, it won't be long before your baby's gaining weight at a healthy rate.

Can failure to thrive be treated?

Diagnosis is the key. Your doctor or Community Nurse will probably be the people first involved but we can also help to determine the reason for your baby's failure to thrive. He or she may watch you breastfeed or bottlefeed to see if your baby's jaw is working correctly or to see if she's having trouble sucking. Your baby could have thrush or hand, foot, and mouth disease, which can make sucking painful.

Your baby may also have neck pain which will affect his or her ability to feed from both breasts equally. Cranial strains developed during birth may also affect your baby's ability to suck from or create a seal on your nipple. Cranial Osteopathy is a gentle and effective way to deal with these issues with most problems resolving between 2 and 6 treatments. (see also Library articles "Giving your Child a headstart in Life", and "Cranial Osteopathy")

The treatment could be a matter of simply breastfeeding your baby more often to increase your milk supply or adding some supplemental bottle feedings. There may be supplements you need to take to build up your milk suuply as well.

Occasionally intestinal problems may be diagnosed, such as an allergy to a certain formula or an intestinal infection. We have found that sometimes a baby can develop digestive problems from intolerance to some of the early childhood vaccinations. This can be easily checked with Electrodermal Screening and corrected with Homeopathic style medicine.

Treatment with Probiotic formulas may also be beneficial for intestinal health and treatment of conditions such as Thrush. Our Naturopath can advise you on this.

In very rare cases, failure to thrive can lead to a diagnosis of more serious diseases.

How can I make sure failure to thrive doesn't happen again?

Congratulations for getting your baby back on track. It's understandable that you're nervous, but you can take control of the situation. Keep a log of when your baby breastfeeds and for how long, or note how much formula she took at a feed. Bring the log with you when you visit the baby clinic. You know your baby best.

If your baby's under three months old and is being exclusively breastfed, you'll know if she's getting enough milk with these signs:

• She wets eight or so nappies a day

• She has several mustard-coloured bowel movements every day

• You can hear her sucking and see her moving her jaw

• Your breasts feel softer after a feed than they did before

If your baby tends to get sleepy during feeds, try to keep her alert by tickling her feet, undressing her, engaging her in some quiet play between breasts, or sitting her up to wind her. If she doesn't finish feeding on both sides, empty your breast by pumping and store the milk. You need to keep up your milk production.

Bring your baby to be weighed once a week if you feel nervous, but make sure that the health visitor always uses the same scale for accuracy. This will help reassure you that your baby is growing and that she's healthy and happy.

And how did Susan and Jana get on? "Jana started gaining weight immediately, and the rest of her check-ups were normal," Susan says. "The supplementary feeds got her back on track, my milk supply increased, and within a week we were able to leave the supplementary feeds behind us. My health visitor recognised the problem and helped us sort it out, and for that I'm very grateful."

There are a very few women who cannot produce enough milk for their babies, so if you have any concerns at all, speak to your chosen health professional sooner rather than later so they can check the situation, put your mind at rest, or suggest alternative strategies

• *link to breast feeding help