Dear Doctor Mama,

My daughter is 15-months-old and she’s not growing as expected. She started out at a normal weight, but was diagnosed with failure to thrive (FTT) when she was 1-year-old, after she lost weight for three months in a row. We’re also very concerned about her short stature.

At her last pediatrician’s visit, she had finally gained some weight and grown a little bit taller. Those changes got her out of the FTT zone, but we’re still planning on visiting some more specialists to try to uncover why she’s growing so slowly.

We’ve been giving her 2 servings of Pediasure every day to boost her calorie intake, but I’m not crazy about the sugars and artificial flavors in it. Do you know of any good substitutes or have any other suggestions to help her gain weight?

Thank you,

Worried Mommy in RI

danibabii08 (flickr)

Dear Worried Mommy,

Thanks for your question. It must be so frustrating to see your little one go through this and not have any answers yet! I’m happy to hear that she is gaining and growing. Let’s try to keep her going in that direction!

What’s FTT?

The American Academy of Pediatrics defines failure to thrive as “inadequate growth or the inability to maintain growth, usually in early childhood.” But FTT isn’t really a diagnosis in and of itself. Instead, it’s an indicator of undernutrition that can have many different causes.

In general, FTT can be caused by

• inadequate caloric intake (child isn’t eating enough; examples: acid reflux disease, lack of access to food, cleft palate),
• inadequate caloric absorption (something is preventing proper digestion of foods; examples: celiac disease, metabolic disease, food allergy), or
• excessive caloric expenditure (calories are being burned too quickly; examples: thyroid disease, chronic infection).

For people whose babies aren’t falling at the right place on the growth curve, meal times and doctor’s visits can become stressful events.

Boosting baby’s calories naturally

One thing you can try to help your daughter gain some weight is to add coconut milk to your her diet. It has a sweet taste and creamy texture, making it a nice addition to smoothies and other drinks. You can also use coconut oil in your cooking; just be careful not to overheat it.

SingChan (flickr)

Coconut oil is a great source of medium chain triglycerides (also known as MCTs). These fats have earned a special place in the nutrition world because they can be absorbed without going through the normal route of fat absorption in the intestines. People who have difficulty absorbing nutrients (like those with celiac disease or cystic fibrosis) are able to absorb MCTs. Boosting your baby’s fat absorption will also aid in the availability of fat-soluble vitamins, like vitamins A, D, and E.

There is a good alternative to Pediasure, too. It’s called Pediasmart. Here’s the one I recommend: Natures One Pediasmart Organic Dairy Supplement, Vanilla. It’s nutritionally comparable to Pediasure, but uses only organic ingredients and contains no artificial colors, flavors, or sweeteners. It is also gluten free and suitable for children with lactose intolerance.

One of the sugars in Pediasmart is from brown rice. Amid concerns about arsenic contamination in rice products, the company pledges that the brown rice syrup used in their products has gone through a filtration process to assure arsenic levels in the final product are below the level of detection.

I hope that’s helpful and I wish you and your baby the best of luck!

Warmly,

Doctor Mama

Disclaimer: The information contained in this blog is for educational and/or informational purposes only, and is not intended to diagnose, treat, or prevent any condition. If you have any concerns about your own health or that of a family member, you should always consult with a healthcare professional.