Failure to thrive

[ringaroundtheposey]

I am still a student, but I sat in on a consult with a ped dietician the other day for a 1 yr old with failure to thrive, the little one went from 17lbs 12 oz to 17 lbs 1 oz in a short time and has shown no growth for two months, the parents eat no processed foods, main diet is fruit and veggies, The dietician recommended tube feeds, I was wondering if this was not overkill? do they usually just jump to tube feeds? the parents seemed to have a healthy diet and such I just don't really understand the whole failure to thrive thing, the kiddo looked good, not really skinny or anything and parents seemed well educated on feeding their child, so why would they drastically go for tube feeds?

[morte, LPN, LVN]

how did the kiddo come to be in the "system"? out of parental concern.....or the doc report....there are prejudices against vegetarianism......were the labs off?.....not meeting other milestones? or just CYA

[ringaroundtheposey]

32 preemie that has been followed by a ped. lost weight stopped walking etc

[morte, LPN, LVN]

32 preemie that has been followed by a ped. lost weight stopped walking etc

i would be more worried about the stopping walking....interesting....too bad you havent gotten more feed back here.....since i am not a peds person, but am interested in nutrition....

[Mimi2RN, ASN, RN]

No milk products in this baby's diet? No complete proteins or fats? Sounds like it is on a downhill slide. I can see why they want to start tube feeds. If that is the only problem, the baby is probably not getting enough calories to maintain weight, never mind grow. Did mom breast feed and has weaned him?

[nkara, CNA]

the babies diet is just fruit and veggies?

[rn/writer, RN]

Babies and young children need diets that include digestible proteins, fats, cholesterol, calcium and other minerals and vitamins. Without the proper building blocks, they don't grow. But even worse, they don't develop neurologically as they should. The brain and nervous system require certain fats to allow myelination to take place. When breastfeeding ends, a diet that includes dairy products can supply the necessary ingredients, but a diet of mainly fruits, veggies and whole grains does not. One of the difficulties is that foods that might contain the right kinds of proteins are often bulky, and kids become full before they have consumed enough to meet their growth and energy requirements.

Here are a couple of links to an article that was in the NY Times and the author's response to letters that vegans wrote about the article:

http://realbabyfood.info/veganbabiesatris.html

http://realbabyfood.info/response1.html

People who want to raise their kids to be vegetarians (and especially vegans) need to educate themselves to make choices that will not harm their children. Good intentions are no substitute for accurate information.

A baby that stops growing, and even more important, stops walking, sounds like a child who may be in danger of more serious complications. I hope that a good evaluation is done and that the care providers and the parents can avoid being adversarial and find ways to help this baby resume normal growth and development.

[BabyLady, BSN, RN]

My sister-in-law had a baby (15 years ago) that they diagnosed with failure to thrive.

I also know, personally, that she lied to the Pediatrician on the child's diet to cover up for the fact that she had the child on a radical, restrictive diet because she feared the baby would have a weight problem like her...gave it skim milk at an insanely early age...etc.

She was smart enough to know the right answers to give...they put that child through all kinds of tests trying to figure out what was wrong.

I think the Pediatrician...the reason they went to tube feedings...is that if the child starts gaining wait on the tube...then they KNOW that they need to take a good hard look at what the parents is reporting.

It also allows them to rule out the fact that if the child gains weight on tube feedings...they know that there is no physiological reason why the child won't gain.

It's input/output.

[ringaroundtheposey]

ahh I see, sorry about the confusion lol nope the babe's mom has her family on an healthy diet no processed foods but meat and alt are in the intake, just found it all really strange lol

[*ac*]

There are two take-home messages here. One is that if the baby's not growing, the brain's not developing!!!

Second is that most FTT is social.

We cannot put the baby's brain at risk while we try to fix this, therefore a trial of tube-feeds is totally appropriate.

[rachelgeorgina]

I work with a lot of kids that are tube fed as a result of failure to thrive.

I guess it's worth remembering that enteral feeding is not permanent. If bub isn't getting enough nutrients then bub won't grow and develop (which, obv, is important.) I dont see why "jumping to tube feeds" is a bad thing when the baby's entire life and development is at stake.