No parent wants to hear the term “failure to thrive” while at a child’s checkup. This can happen to both babies and toddlers.
Many new parents assume that they did something wrong or their breastmilk is inadequate, but that isn’t the case for most babies. If you fear that your child isn’t thriving while breastfeeding or you recently heard the term from a medical professional, this guide will help you understand what failure to thrive really means and what you can do to help your child grow.
If you’re a parent or grandparent and haven’t heard of this term, it’s important to learn about the symptoms and possible solutions. The faster a child receives help, the faster they can recover and rise up on the growth percentile chart.
What Does “Failure to Thrive” Really Mean?
A baby or toddler fails to thrive if they don’t meet specific weight and length milestones. By four months old, babies are expected to at least double their birth weight. They should triple their birth weight before their first birthday. That rate of growth is believed to support development of the brain during the first year of life.
If your baby receives a diagnosis of failure to thrive, it simply means that their weight and/or length is below expectation. They may fall within the bottom of the growth percentile chart, and a doctor may consider them undernourished.
That doesn’t meant that you’ve done anything wrong. It may not even mean that your breast milk is somehow inadequate or deficient in nutrients. There are a variety of factors that can lead to a baby or toddler failing to thrive, and we’ll look at some of the most common causes in just a moment.
Symptoms of Failure to Thrive
It’s important for all parents to recognize the symptoms of a baby who is failing to thrive. Seeking help early on will prevent a lot of suffering for the baby while minimizing the risk of permanent damage to the developing brain and other organs. Fast intervention can also help parents take control of the situation, relieving a lot of stress and anxiety.
The following list is a good example of what you may notice if your child isn’t growing at the expected rate:
- Unexplained fussiness or crying
- Missed or delayed development milestones (sitting up, walking, etc.)
- Abnormal sleepiness
- Lack of vocalization
- Avoiding eye contact
Some parents may realize that their baby isn’t as pudgy as they once were, but they may assume that the baby is growing longer and thinning out as a natural part of the growth process. It’s also commonly assumed that an under- or malnourished baby will cry a lot and show signs of distress, but research has shown that some babies seem perfectly content even when they aren’t receiving adequate nutrition.
Some babies may show signs of failure to thrive as an infant while others may start out healthy and later start to lose weight. If you know that your baby isn’t as active, alert or reactive as they once were, it’s worth a trip to the doctor for a checkup.
You may also notice that your baby seems happy and satisfied with feedings but is losing weight. In that case, it doesn’t hurt to have a doctor check your baby’s growth rate. It’s always better to seek too much attention than to delay the attention that your baby needs.
What Causes Failure to Thrive in a Breastfed Baby?
Why do babies fail to grow at the expected rate? It comes down to their inability to either eat, hold down food or absorb and utilize the food once it is ingested. One plan designed to diagnose failure to thrive in babies recommends looking at the following areas for potential problems:
- The mother’s ability to produce milk that is nourishing.
- The transfer of milk from the breast to the baby.
- The quantity of milk consumed by the baby.
- The quality of milk consumed by the baby.
Notice that this list requires some examination of the mother and child, especially when the baby breastfeeds exclusively. No parent wants to know that their breast milk or a problem with their nipple is causing their baby to miss out on much-needed nutrients, but it’s important not to blame yourself. You’re doing the best thing for your baby by breastfeeding, and many problems with breast milk and the breasts are easily fixed.
Take a quick look at some of the most common causes of failure to thrive in breastfed babies. We’ll also discuss the best solutions for each problem.
Problem: The baby’s feeding schedule doesn’t allow adequate time for the baby to nurse to satisfaction. Perhaps there aren’t enough feedings offered throughout the day or the baby isn’t given enough time to empty both breasts.
Solutions: Readjust your breastfeeding schedule to include more feedings throughout the day. Allow your baby to feed until he or she is satisfied or both breasts are completely empty.
If your baby is falling asleep at the breast, take steps to increase his or her alertness. Feeding in an upright position, stripping the baby down to a diaper and touching the cheeks gently with a wet washcloth are all possible ways to increase the length of a breastfeeding session.
If your schedule doesn’t allow you to devote more time to breastfeeding, consider supplementing with a bottle. You may prefer to continue breastfeeding exclusively, but a bottle can deliver the nourishment that your baby needs while you’re working or taking care of other responsibilities. It’s better to supplement than to allow your baby to receive an inadequate supply of nutrients.
Problem: The baby is suffering from digestive issues that prevent him or her from holding down and fully absorbing breastmilk. Acid reflux, celiac disease and chronic liver disease are just a few of the medical issues that may prevent a baby from fully utilizing the breast milk that they consume.
Solutions: You should work with your pediatrician or family doctor to diagnose any digestive disorders that may prevent your baby from thriving. The doctor may recommend switching to bottle feeding at least part-time before doing further diagnostic testing. The goal is to see if your baby will gain weight and start to thrive with other forms of nourishment. If not, then testing for more complicated causes of your baby’s failure to gain weight may ensue. The solution to the problem is to diagnose and treat the condition causing the lack of weight gain.
Problem: The baby is showing signs of intolerance to a substance in the breast milk. The baby may not want to nurse long enough to consume an adequate supply of breast milk daily. They may also experience severe spitting up, vomiting or diarrhea, which leads to the loss of needed nutrients.
Solutions: The mom needs to analyze her diet and remove any foods that may cause intolerance or allergic reactions in her baby. Dairy is one of the biggest causes of food intolerance in babies, so that’s a good starting point if you believe there is something in your diet that doesn’t sit well on your baby’s stomach.
Problem: The baby isn’t latching onto the nipple properly and is thus struggling to withdraw milk easily.
Solutions: Working with a lactation consultant is always a good idea if your baby is failing to thrive. That’s especially true if your baby is continuously releasing your nipple, crying or showing other signs of struggle and frustration during feedings.
You may also notice that your baby wants to nurse frequently but doesn’t continue to nurse for a long period of time. They simply give up before they can consume enough milk to satisfy their nutritional needs. A lactation consultant can help correct any latch problems that your baby has, allowing your little one to breastfeed more successfully for improvements in growth.
Problem: The baby is infested with a parasite or has an infection that reduces appetite or interferes with absorption of nutrients.
Solutions: Your pediatrician or family doctor should check for infections and parasites when completing a workup to diagnose the cause of failure to thrive. The only solution is to heal the infection or eliminate the parasite so that your baby can fully absorb and utilize all nutrients received.
There are other potential causes for a baby’s failure to thrive. In some cases, the solution is to supplement with bottle feeding. That doesn’t mean that you have to give up breastfeeding entirely. If there’s a solution for the problem causing your baby’s lack of growth, then you may continue breastfeeding exclusively in the future.
If there is a problem with your breast milk or breasts that isn’t easily solved, ask your doctor if it’s possible to breastfeed and bottle feed. You may also pump your breast milk and deliver it in a bottle rather than using formula if the problem is with your breast or the baby’s ability to latch properly. You don’t have to give up on breastfeeding entirely.
- Is Baby Getting Enough Milk?
- Common Breastfeeding Problems and Solutions
- One Breast Producing More than The Other?
- 20 Ways to Increase Milk Supply
- Failure to thrive in the contented breast-fed baby, Canadian Medical Association Journal , Accessed Jan. 23, 2020. Link.
- Failure to Thrive, Kids Health, Accessed June 2, 2019. Link.
- Problem-Solving Formula for Failure to Thrive in Breast-fed Infants, Canadian Family Physicians. Accessed Jan. 23, 2020 Link.
- Using Kangaroo Care in a Clinical Setting with Fullterm Infants Having Breastfeeding Difficulties, American Journal of Maternal Child Nursing: July/August 1999 – Volume 24 – Issue 4 – pp 190-192
- Failure to Thrive – A Practical Guide, American Physician. Accessed January 23, 2020. Link.