Is my baby gaining enough weight?

May 26, 2021

As a parent, worrying that your child is not growing normally can be frightening and overwhelming. If you haven’t yet, speak with your little one’s healthcare professional about your concerns and ask their opinion. They can show you where your child is on the growth curve for weight, length, and head circumference. If your son or daughter meets certain criteria, they may be diagnosed with Failure to Thrive (FTT).

Failure to Thrive (FTT), also known as malnutrition, is a diagnosis a pediatrician might give your little one after comparing their growth to standard infant growth. Hearing the word “failure” in association with your baby can strike up a lot of emotions, including the feeling of hopelessness. Thankfully, FTT does not have to be a permanent set back but a temporary one. In this blog, we’ll discuss what to do if your little one has been diagnosed with FTT or if you suspect that your little one will be diagnosed.

Does my baby have Failure to Thrive?

As mentioned above, Failure to Thrive is a diagnosis that is often used for infants and children in order to compare their measurements to other babies and children their age. If your little one is diagnosed with FTT, it basically means that they’re not growing in weight, length, or head size according to other infants their age.

Most pediatricians won’t diagnose your little one with FTT after one weigh-in. Once the pediatrician notices that your little one’s weight is lower than expected, they might repeat the weigh-in for 1-3 weeks or a month, depending on the age of the child, prior to diagnosing them with FTT. Your pediatrician’s initial concern might sound like: “Your baby is measuring lower than the 5th percentile” or “I want to keep an eye on your baby’s weight for the next few weeks or month.”

With FTT, oftentimes there is an underlying cause as to why your baby is not reaching infant growth standards. Let’s explore a few causes of FTT.

What’s causing my baby’s Failure to Thrive?

Insufficient calorie intake can be one of the main causes of FTT. There are many reasons why your little one might not be getting enough calories, such as bottle strikes and increased caloric needs. Based on the standard of breast milk, most infant formulas provide about 20 calories/ounce. There are some instances where your little one might need more than 20 calories/ounce. In these cases, the slight increase in calories can lead to positive benefits in their weight and reverse their FTT diagnosis. However, it’s important to note that increasing calories-per-ounce should only be done under medical supervision.

There are other factors that can contribute to FTT such as malabsorption. Simply, malabsorption means that some nutrients aren’t absorbed by the gut as well as they should be. If malabsorption is a factor, your pediatrician will inform you on the next steps you should take for your little one.

Lastly, if your little one has other medical conditions that could cause FTT, your pediatrician should make that clear. There are instances where your little one is not able to consume or tolerate enough volume of formula or breast milk to meet their calorie needs. In these cases, your little one still needs enough calories to thrive, but they need the calories in less volume. This looks like having a 4 oz bottle with more calories than the average 4 oz bottle.

Each baby is different and might require different approaches in order to promote healthy progress. With the help of your pediatrician, you can create a health plan to address your concerns while providing the best care for your little one.

Talking with my baby’s healthcare provider about management approaches

Proper and adequate nutrition is very important for the first two years of your baby’s life. Most pediatricians take the diagnosis of FTT seriously and will address it early in order to promote catch-up growth. Most often, the addition of a calorie- and nutrient-dense formula like Fortini Infant can be used to provide tailored nutrition specifically calibrated for infants with FTT.

After giving yourself a moment to reflect on your baby’s diagnosis of FTT, here are some questions to ask your pediatrician at your next visit in order to create the most effective plan for your little one:

  • Does my baby have FTT or are they at risk for FTT?
    • If yes, what might be causing it?
  • What does FTT mean for my baby’s future?
  • How can we address FTT and make sure my baby grows properly?
  • How many calories per ounce would be best for my baby?
  • Can I continue to provide breast milk and supplement my baby’s diet with additional calories?
  • Would my baby benefit from a formula designed for FTT, like Fortini?

How can I monitor my baby’s progress?

Now that you have created a plan with your healthcare provider it is important to continue to monitor your little one’s progress. We’ve created a digital parent guide with a growth tracker which can help monitor your little one’s weight. We also encourage you to monitor the symptoms you observe and to note your observations of how your little one is tolerating any formula changes.

While Failure to Thrive can feel like a gut punch, having the tools you need in order to address your concerns can create a clear path forward for you and your little one, so you can comeback from faltering to flourishing.

Lu Akinribade, MA, RDN

Lu works on our Medical team as a Nutrition Specialist. In her role, she works closely with Nutricia North America’s catalog of products and answers questions and provides guidance for healthcare professionals, consumers, and parents.

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