Poor Weight Gain in the First Year (and The Value of Instincts and Second Opinions)
Four years ago, I became a mom to the sweetest little boy. When he was placed in my arms, I counted all his perfect little toes and fingers and felt so thankful. At the time, I was working at the local children's hospital as a speech-language pathologist. I evaluated and treated children with a wide variety of genetic disorders, disabilities, and developmental delays. Day in and day out I saw children fight illnesses and rare neurological disorders.
When I became pregnant, I tried hard not to worry about all problems my child could be born with or acquire, but it was difficult. I breathed a sigh of relief when Xander was born healthy. I shook away more nerves when he passed his newborn hearing screening. Little did I know his medical problem would slowly arise in his first year of life. I never would have guessed my child would have feeding problems, leading to issues with weight gain.
Xander breastfed well from the beginning. However, around his 4 month old check up, his nurse practitioner was a little concerned that he was on the very low end of the growth curve. She determined that we would wait and see if Xander would gain a bit more weight over the course of the next few baby well appointments. At six months of age, he then transitioned to baby foods without any difficulty. From six months to around 11 months, he happily consumed any pureed food I put in front of him and continued nursing, yet his weight gain was still extremely slow. I started to worry and wondered if my breastmilk was providing him enough calories. At that time, the nurse practitioner assured me that I was doing a great job and she would continue to monitor his growth carefully.
Xander was introduced to solid foods around his first birthday. As a feeding therapist, I felt pretty confident with the process of introducing solid foods to my own baby. It turns out, he hated all solid foods. When any sort of food with texture was placed in his mouth he would immediately gag and cough. He wanted nothing to do with the foods we were eating during mealtime. As a first time mom who wanted nothing more than to see my child to succeed developmentally, it broke my heart to watch him struggle with transitioning to solid foods. I also continued to worry about his slow weight gain.
At Xander's first year baby well appointment, the nurse practitioner was extremely concerned with his poor weight gain and difficulty transitioning to solid foods. She ordered blood work and a few appointments with specialists, including an appointment with a gastroenterologist. At this point, I was completely worried that there was something very wrong with my baby boy. From food allergies to reflux, I brainstormed a long list of various diagnoses that could be resulting in his slow weight gain and feeding difficulties. This was a case of when too much knowledge is a dangerous thing as a parent.
A few weeks later, Xander was seen by a general gastroenterologist, who was not specialized in pediatrics. The doctor recommended Xander be seen by a nutritionist and a speech-language pathologist for a feeding evaluation. Talk about a slap in the face! I was baffled that a doctor would recommend that I bring my child to be seen by a total stranger for the exact thing I do for a living. In hindsight, I realize it's better to have a second set of eyes on a problem, but I was not thinking rationally at the time. The only recommendation the GI doctor gave us that seemed to make sense was to give Xander supplemental drinks, such as Kids Boost, to increase his overall caloric intake. Needless to say, my husband and I left the appointment feeling upset and more confused than ever. We were both in agreement that we needed to seek a second opinion, this time with a pediatric gastroenterologist.
A few weeks later, Xander was seen by a GI doctor, who specializes in children with poor weight gain and feeding disorders, through the Children's Hospital network. The overall experience was so much better. Instead of focusing on Xander's growth curve, the doctor took into consideration multiple factors, including the stature of myself and my husband and the fact that developmentally Xander was thriving. He was not panicked and ready to call in more professionals. Instead, he told his to relax and wait it out. He encouraged us to continue introducing solid foods, but not to make a huge deal out of it. He gently reminded us that all children develop at different time frames. I left his office feeling relieved, instead of like a failure as a mother and professional.
Xander slowly started eating more solid foods around 15 months and gradually transitioned to all solid food. He now is a thriving four-year-old, who still is on the low end of the growth curve. He eats a wide variety of foods, but is just going to be a skinny kid. My experience with his struggle with weight gain during his first year of life taught me to trust my instincts. It also taught me the value of seeking a second medical opinion.
Have you ever had to seek out a second opinion for your child's health? Or did you second guess yourself and go along with what the doctor said anyway?
Image via Mindi Stavish