Sunday, February 17, 2008

Failure to thrive???

I went home for lunch today..and whenever I picked up Afiq..I felt that he was slightly lighter than before...I couldn't find what was wrong at that moment. After my lunch I asked hubby to bring us to the clinic so that I could weigh Afiq.
At 1.45pm we were already at the clinic, I weighed him myself...and I was shocked to see his weight! He was 5.7kg the last 3 weeks and today again it was 5.7kg! OMG.. what had happened to my Afiq...he was not gaining any weight since the past 3 weeks!
My instinct said that it might be due to his inadequate feeding given by my helper...(arghhh you are going to get it..).

I just want to share something about this condition called "Failure to thrive"(FTT) in this post.
Growth failure, or failure to thrive (FTT), is actually a descriptive term and not a specific diagnosis. In other words, it is not a disease but a condition that you may see in a child with certain disease.
On average, infants gain 1 kg/mth for the first 3 months, 0.5 kg/mth from age 3-6 months, 0.33 kg/mth from age 6-9 months, and 0.25 kg/mth from age 9-12 months. Term infants double their birth weight by age 4 months and triple their weight by age 12 months. (In my case, Afiq should gain at least 0.5kg/mth..which he failed.).
However to confirm a child is having FTT a growth chart must be plotted and serial measurement should be done. At this point I don't consider Afiq as having FTT...but if there's no action taken, then later he might go into that condition.

Causes of FTT is divided into 3 categories
1.Nonorganic FTT
2.Organic FTT
3. Combination of both nonorganic and organic
To make it clearer I shall list down some of the causes in each categories which I got it from emedicine

Nonorganic causes
Poor feeding or feeding-skills disorder
Dysfunctional family interactions
Difficult parent-child interactions
Lack of support (eg, no friends, no extended family)
Lack of preparation for parenting
Family dysfunction (eg, divorce, spouse abuse, chaotic family style)
Difficult child
Child neglect
Emotional deprivation syndrome
Feeding disorders (eg, anorexia, bulimia)


Organic cuses
Prenatal causes
Prematurity with complications
Maternal malnutrition
Toxic exposure in uteroAlcohol,
smoking,
medications,
infections
IUGR
Chromosomal abnormalities
Postnatal causes
Inadequate intake
Lack of appetite (eg, iron deficiency anemia, CNS pathology, chronic infection)
Inability to suck or swallow: CNS or muscular
Vomiting (eg, CNS, metabolic, obstruction, renal)
Gastroesophageal reflux and esophagitis

Poor absorption and/or use of nutrients
GI disorder (eg, CF, celiac disease, Schwachman-Diamond syndrome, chronic diarrhea)
Renal: renal failure, renal tubular acidosis
Endocrine: hypothyroidism, diabetes mellitus, growth hormone deficiency
Inborn error of metabolism
Chronic infection (eg, HIV, tuberculosis, parasites)Increased metabolic demand
Hyperthyroidism
Chronic disease (eg, heart failure, BPD)
Chronic inflammatory conditions (eg, inflammatory bowel disease, lupus erythematosus)
Renal failure
Malignancy

(bare with all the medical terms guys..copy paste je the causes ni..anything you don't understand just ask me..hehhehhe if I knows the answer lah!)
Finally I came to a conclusion that Afiq is actually had not been given enough feeding by my helper...(nonorganic cause)
I am very frustrated because I've told her many times on how to prepare the milk, how many mililitre of milk for each feeding, how many times per day should he be given the milk..and bla bla bla....At this point of time I still have no resolution for the problem...but I will monitor her closely on how she feeds my baby tomorrow...Afiq please gain some weight....or he just want to be like her mother...heehheheh

8 comments:

Farah Deen said...

Nat, i noticed that afiq wasn't chubby anymore as he used to be.I saw him when he was about 2 months...chubby!That was why I told u that day he has lost weight.I know-it is so difficult to rely on your helper. We can only inform her the do's and don'ts but how far can you rely on her!? Buat spot check in between is see how things work! hope that ur afiq will gain weight -biaq mak dia penat dukung...heheheh. I think you should also increase his milk intake per feeding.

Noushy Syah said...

Ohh Afiq...plz don't be like your mummy or auntie noushy....but Afiq we both definitely not FTT or IUGR..LOLZ!

Nat..you know sometimes I babysit my nephews when my sista inlaw has to go outstation(if it's w/end), even I told her I know how to prepare the milk formula but she seems insisting preparing it by herself....,and I think it's quite convenient as well, where there is a special container a tiffin career like but small and made from Tupperware where she placed the amount of milk formula in each sections for 6 feeding for example and with 6 bottles ready with plain boiled water since my nephew won't drink warm milk. Then when feeding due, I just have to pour the milk powder into the bottle and shake and wallaa..perhaps you should have that container-@Mothercare..eh eh promotion nih, UK made tehehhe..

Noushy Syah said...

p/s re-your boy refused to take veggies tuh, well I'm not an expert to answer but surely my experienced when I was younger do help...

Through law of attractions,kiddies love colourful food,thus mix-veggies like sweet corn(yellow)+green peas(green)+sweet potato(lavender)serve alone or with sandwich...the point is to make the veggies so appealing and inviting for them to eat.

Then for finger foods,slice the carrot/cucumber/celery cucuk hujung sekali dgn home made sausage(pure daging or ayam)

Try saute sweet corn +green peas with a lil butter and add some mushroom..I love it even now..hehehhe..tu kiddies punya food, ahakss

p/s I don't know if Asian kids would like that menu but for us here definitely yum yum.

natrah said...

Farah..I was very frustrated yesterday..just imagine when I came back for lunch Afiq was not given his milk since morning!!! Geram nya..I guess nothing wrong with him..just ct tu a blunder! org ckp semua tau tau tau...hish..I gave her another 2 weeks, if Afiq's weight remains the same...I'll find somebody else.Dia cuci umah je..gaji..POTONG!hehehehe sakit ati tau..
I now gave him 6-7oz of milk each feeding plus 2x mix with nestum a day..that is more than enough if she really follows what I did..problem is..tak dgq ckp org!Aiyooo..stress laaa dgn dia ni..

natrah said...

Noushy..
Firstly..you are really good..! now can take care of your own baby already lah...ehem ehem bila lg ni??

About Afiq,I guess the problem is not that she(my helper) doesn't know how to prepare or what...she just cannot follow my instruction! I even had a time table of his feeding and how much to give...she just didn't follow that..like I said to Farah...My helper tu BLUNDER..geram!the reason I tak straight away find another person to take care of Afiq because she is hardworking..from the moment she came in the morning until she go back in the evening..she just do her work..cleaning, doing laundry and etc..susah jugak la nak cari yg mcm tu..anyway,I gave him another 2weeks..kalau still the same..I'll send Afiq to someone else to take care while I'm at work.

natrah said...

Noushy.,
A good suggestion about the finger food tu..I haven't try it yet..others tu dah tak larat nk buat..makan nye tidak.

Sweet corn with peas tu dah buat tapi diorang ambil sweet corn je..yg hijau2 semua tinggal tepi ..LOL
anyway..thanks for the advice..definitely I'll try the finger food make it like kebab tu..

LadyJava said...

Wah I hear your story only I dah frust.. maybe like you say.. your helper too busy with other housework so tak really look after afiq kot..lagipun maybe he's not crying as well so she took "forgot" to feed him?? Whatever the excuse though tak boleh diterima... reviewing her again after two weeks is a good idea..

I hope Afiq's weight condition would improve. Cian dia.. nak besaq tapi ter- hamper pulak..

I can't give any suggestion in terms of what to do but even dulu while I was a being a mommy to my kitties, their own mommy tak reti nak jaga... i gave them milk every 2hrs you know.. at night even.. rasa macam emak sungguh that time...lolzzz

Do update us on Afiq ok sweetie :) Have a great weekend ahead ya!!

Noushy Syah said...

NAT, yeah I can understand how frustrated you are about Afiq's not gaining weight and am sure re-spot checking your helper is a good way to make sure she feed him on time etc.

Do update re-Afiq yea, and wish you all the best.

p/s Abt the refusal of the kids to eat veggies tu since you have tried all, perhaps another alternative is compliment them whenever they eat their veggies or give reward as necessary..it might help, we never know rite!