After the 1 year check-up for Nicholas we were given the contact information for some specialists to help get his continual percentile weight loss corrected. The three appointments were with a nutritionist, constipation specialist and physical therapist. After the nutrition appointment Nicholas was labeled “failure to thrive.” Don’t Google it, like I did, it is all about abusive parents not feeding their children. By definition this means that Nicholas has dropped in weight percentile for longer than 2 appointments, for Nicholas it has been 4 appointments over 10 months, and his height is also starting to decrease in percentile. A very different diagnoses than when his doctor said he is fine since he is still gaining weight appointment over appointment.
What does this mean? This means everything we feed Nicholas has to be very fatty and caloric. They also want him fed solids before nursing to get him to switch so solid food is his primary nutrition intake. The goal is for him to gain 15 grams of weight a day, he was gaining closer to 5 a day. We had semi success the first few days, which fell over a weekend, with Rob getting up with Nicholas in the morning and taking him straight down to breakfast. When the week started again Nicholas ended up getting a black eye from the counter when I tried to weigh him then feed him solids instead of nursing. With this mishap we have opted to not fight the morning battle and he still nurses first, but gets solids before nursing the rest of the day. They also said not to cut back on his current nursing 6 times a day because he needs every calorie he can get.
The result of this new diet is a very greasy and shiny Nicholas. He just loves to run his hands through his hair so when they are covered in olive oil from his oiled up grapes it is extra spectacular. We have been adding guacamole to his quesadillas to put more fat and grains in his diet (picture above). When we weren’t looking at dinner one night he opened one up and smashed it against the back of his head. After dinner when we found it and the melted cheese had congealed again in his hair. We had to pull pretty hard to get all of the pieces free. Really gross and we were about ready to give him a buzz cut for his first haircut after this.
With all of the oil and grease I opted for sugar instead today. Sugar covered strawberries, so much sugar they were white in color. Even though we had agreed we would try the oil route instead of sugar, I was getting desperate to have a less messy meal. Well if you look at the sugar crystals in his hair you will see this is one of the biggest messes Nicholas has had to date. It required an immediate strip down and wipe wash then direct to the bathroom sink for a sponge bath followed by another bath that evening. We will now be sticking with the oil/butter route and just recycle all of his oil stained 12 month clothes worn during this weight gaining adventure.
All of the messy meals have been worth it! At the weight check appointment, two weeks since his last weigh-in and one week on the new diet, Nicholas gained 1 pound 2 ounces and was now in the 25th percentile (from the 17th percentile). This was fantastic news since he had only gained a little less than a pound total over the 3 months between his 9 month and 12 month appointment. The doctor told us to keep up the high fat diet until his 15 month appointment in June.
Even better news, with this new diet Nicholas’ is no longer constipated or screaming for the hours before and during a poop. Apparently he just needed the extra fat and calories in his diet. We cancelled that specialist appointment and each person we talk to is shocked that adding the fat to the diet appears to have fixed the problem.
The physical therapist specialist is to help him learn to drink from a cup. He still only drinks an ounce or two a day in total of water or milk from a cup. We need to increase this both to increase his calorie and liquid intake, but also if we want to start wean from nursing. She thinks his tongue could be tied so we have been given exercises to help get him to lift his tongue up to touch his top lip. These results haven’t been as dramatic (ie no change) in the amount of liquid he is consuming, but we will keep trying and stay optimistic.