10 month old not gaining weight

Failure to Thrive (for Parents)

What Is Failure to Thrive?

When growing kids don't gain weight as they should, it is called "failure to thrive."

Failure to thrive is not a disease or disorder itself. Rather, it's a sign that a child is undernourished. In general, kids who fail to thrive are not getting enough calories to grow and gain weight in a healthy way. When kids can't gain weight, they also often may not grow as tall as they should.

Kids need to get enough calories to learn and develop well. So kids with failure to thrive might start to walk and talk later than other kids, and can have trouble learning in school.

What Causes Failure to Thrive?

Different things can cause failure to thrive, including:

• Not enough calories provided. Sometimes a parent or caregiver measures or mixes formula incorrectly, so an infant doesn't get enough calories. Problems with breastfeeding or starting solids also can cause failure to thrive. Some families have trouble affording enough food for their children. And sometimes parents miss their children's hunger cues.
• The child eats too little. Some children have trouble eating enough food. This might be due to a developmental delay, being a very picky eater, a medical condition that affects swallowing (like cerebral palsy or a cleft palate), or a condition like autism in which kids don't like eating foods with some textures or tastes.
• Health problems involving the digestive system. Problems with the digestive system can prevent a child from gaining weight. Conditions like gastroesophageal reflux (GER), chronic diarrhea, cystic fibrosis, chronic liver disease, and celiac disease can make it harder for kids to absorb enough nutrients and calories to gain weight.
• Food intolerance. A food intolerance means the body is sensitive to some foods. For example, milk protein intolerance means the body can't absorb foods such as yogurt and cheese, which could lead to failure to thrive.
• An ongoing medical condition. Kids with conditions involving the heart, lungs, or endocrine system might need more calories than other kids. It can be hard for some to eat enough.
• Infections. The body can use up a lot of calories as it fights an infection. And kids who don't feel well might eat less than usual.
• Metabolic disorders. These are health conditions that make it hard for the body to break down, process, or take energy from food. They also can cause a child to eat poorly or vomit.

Sometimes a mix of things leads to failure to thrive. For instance, if a baby has severe GER and is reluctant to eat, feeding times can be stressful. The baby may be upset and frustrated, and the caregiver might not be able to get the baby to eat enough.

Other times, doctors aren't sure exactly what causes the problem.

How Is Failure to Thrive Diagnosed?

Many babies and kids go through brief periods when they don't gain as much weight as expected. But if a child continues to not gain enough weight or loses weight, doctors try to find out why.

They'll ask for a child's health history, including a feeding history. This helps them see if underfeeding, household stresses, or feeding problems might be causing the problem. A dietitian or other health care professional also may track the calories in a child's diet to make sure the child is getting enough.

Doctors measure a child's weight, length, and head circumference at each well-child checkup and put the results on a growth chart. Children may have failure to thrive if they weigh less than most kids their age or aren't gaining weight as quickly as they should.

Doctors might order tests (such as blood tests or urine tests) to check for medical problems that could affect a child's weight and growth.

How Is Failure to Thrive Treated?

Treating kids who fail to thrive involves making sure they get the calories needed to grow. The care team also will address any causes for poor weight gain they find. A child's care team may include:

• the primary care doctor
• a registered dietitian
• occupational therapists to help with sensory or coordination problems
• speech therapists to help with any sucking or swallowing problems
• a social worker if a family has trouble getting enough food
• psychologists and other mental health professionals for any behavioral issues
• specialists (such as a cardiologist, neurologist, or gastroenterologist) to treat health conditions that could affect a child's weight

Usually, kids who have failure to thrive can be treated at home. They'll also have regular doctor visits to check on weight gain. Doctors often recommend high-calorie foods and, for babies, a high-calorie formula.

Doctors also might recommend:

• spacing out meals to make sure children are hungry
• avoiding "empty" calories like juices and candies
• offering foods of certain textures if sensory issues are a problem
• other strategies depending what's causing the failure to thrive

Weight gain takes time, so it might be several months before a child is back in the normal range.

Some children with failure to thrive might need care in a hospital. They'll be fed and watched around the clock for several days (or longer) until they gain some weight. After leaving the hospital, the child will continue treatment at home.

How Can Parents Help?

It can be hard to learn that your child has failure to thrive. No matter what's causing it, there are ways to help and support your child. You can:

• Follow the advice from your doctor or the dietitian.
• Take your child to all recommended doctor visits.
• Call the doctor if your child develops new symptoms, like frequent diarrhea or vomiting.
• Learn about any medical conditions that the doctor finds in your child.
• Talk to the doctor or a therapist if you feel stressed or frustrated about problems with feeding your child.

Reviewed by: Larissa Hirsch, MD

Date reviewed: February 2020

Cystic Fibrosis (for Parents) - Nemours KidsHealth

What Is Cystic Fibrosis?

Cystic fibrosis (CF) is an inherited disease in which the body makes very thick, sticky mucus. The mucus causes problems in the lungs, pancreas, and other organs.

People with cystic fibrosis (SIS-tik fye-BROH-sis) get lung infections often. Over time, they have more trouble breathing. They also have digestive problems that make it hard to gain weight.

What Are the Signs & Symptoms of Cystic Fibrosis?

CF can cause symptoms soon after a baby is born. The first sign a baby might have cystic fibrosis is an intestinal blockage called meconium ileus. Other kids don't have symptoms until later on. Cystic fibrosis can be mild or severe, depending on the person.

Symptoms of cystic fibrosis include:

• lung infections or pneumonia 
• wheezing
• coughing with thick mucus
• bulky, greasy bowel movements
• constipation or diarrhea
• trouble gaining weight or poor height growth
• very salty sweat

Some kids also might have nasal polyps (small growths of tissue inside the nose), frequent sinus infections, and tiredness.

How Is Cystic Fibrosis Diagnosed?

Newborn screening tests catch most cases of CF. If the screening test is positive, or if a child has cystic fibrosis symptoms, doctors do a painless sweat test. They collect sweat from an area of skin (usually the forearm) to see how much chloride (a chemical in salt) is in it. People with CF have higher levels of chloride.

Most children with CF are diagnosed by the time they're 2 years old. But someone with a mild form may not be diagnosed until they are a teen.

How Is Cystic Fibrosis Treated?

Kids with CF will have it all their lives. Doctors use different medicines depending on a child's needs. But all people with CF need to:

• Loosen and clear mucus. There are different ways to do this. The doctor might recommend a child:
  • get regular exercise
  • use an inhaler or nebulizer
  • do breathing exercises and cough on purpose
  • wear a therapy vest that shakes the chest
  • have chest physical therapy (when a parent or trained person bangs gently on the chest or back)
• Prevent or fight lung infections. Washing hands well and often, avoiding people who are sick, and staying at least 6 feet away from others with CF can help prevent infections. Taking preventive antibiotics also can help.
• Take enzymes. Most kids with CF need enzymes to help them digest food and get nutrients from it.
• Eat a high-calorie diet and take vitamin supplements, when needed.

What Causes Cystic Fibrosis?

Cystic fibrosis is caused by a change (mutation) in the gene that makes cystic fibrosis transmembrane regulator (CFTR) protein. To have CF, a baby must get two copies of the CF gene, one from each parent.

What Happens in Cystic Fibrosis?

In CF, the body makes abnormal CFTR protein or none at all. Without normal CFTR protein, the cells lining the pathways (tubes) inside some organs make thick, sticky mucus rather than the normal thin, watery kind.

Thick mucus can trap bacteria in the lungs, leading to infection, inflammation, and breathing problems. Mucus also can block the path where digestive enzymes flow between the pancreas and the intestines. This makes it hard for a child to digest food and get the vitamins and nutrients they need from it.

Thick mucus can also affect the liver, the sweat glands, and the reproductive organs.

How Can Parents Help?

To help your child:

• Follow the treatment plan. Help your child stay as healthy as possible. Give medicines as directed, serve high-calorie meals and snacks, and follow instructions for clearing chest mucus.
• Offer encouragement. Help your child find pastimes to enjoy, like art, music, reading, or learning to cook. It's important for kids with CF to get exercise, so also look for ways your child can stay physically active. Maybe you can do some of them together.
• Turn to the care team. Your child's care team can offer practical tips on living with CF, and information about clinical trials, support groups, and new therapies.
• Learn all you can about CF. Experts are always working on new treatments to help people with CF have a better quality of life and live longer. Online, turn to resources like the Cystic Fibrosis Foundation website.
• Teach self-care as your child gets older. Start early to help your child understand and manage CF. Encourage an older child or teen to handle some parts of their health care, like disinfecting equipment or asking questions at doctor visits. Ask the care team about ways you can help your child get ready for things like going to college or getting a job. Learning about cystic fibrosis and its care helps kids and teens become confident adults managing a chronic health condition.

Reviewed by: Larissa Hirsch, MD

Date reviewed: July 2020

Why a child does not gain weight: Top 5 main reasons

Do you ask yourself why a child does not gain weight every day when you look at your baby's thin arms and legs? We will help you find the answer to it and tell you what to do so that the arrow of the scales starts to rise up.

For many mothers, the ideal baby is a plump butuz with chubby cheeks. If the baby is thin from the cradle, then in most cases this causes concern for parents. Sometimes absolutely in vain! It is often enough to change very little for the little one to start gaining weight. And most importantly - to understand the reasons for the lack of weight of the baby.

See also: "5 rules to keep your baby healthy"

Reason 1: Your baby is not gaining weight because he is not eating enough milk.

This is possible even if the baby spends half a day at your breast. There may be several reasons: the little one does not suckle well, falls asleep while eating, you do not have enough milk. To find out how much milk the little one drinks at a time, weigh it before and after feeding, and write down the indicators. Then be sure to show your records to the pediatrician.

If it turns out that the baby eats less than the norm, the doctor will teach you how to properly attach the baby to the breast, if necessary, recommend drugs that increase lactation. In some cases, the doctor may recommend supplementing the baby with formula (if the baby is less than four months old) or vegetable puree (after 4-5 months).

REMEMBER ! A formula-fed baby may also not eat enough. Sometimes a baby needs a larger portion than recommended for his age. If the baby is not gaining weight well, write down how much mixture he eats per day. Your pediatrician will review your notes and may recommend increasing the dose or changing the formula.

Reason 2: The child is not gaining weight because he does not like the taste of new foods.

Many babies categorically refuse to change their breast or bottle for a spoon. They refuse fruit and vegetable purees, cottage cheese, cereals. If the baby is naughty and refuses to eat from the first days of the introduction of complementary foods, do not worry. Be consistent and offer him complementary foods every day - sooner or later, the baby will taste adult food and enjoy it.

REMEMBER! Never give up and refuse to introduce complementary foods. After six to seven months, one mother's milk is not enough for the normal growth and development of the crumbs. The baby needs more calories, vitamins, nutrients. If you do not introduce complementary foods on time, the baby's immunity may weaken and even develop anemia.

Cause 3: The child is not gaining weight because you did not properly formulate the diet.

And you don't even know about it! Maybe your little one's diet lacks fat? You should add 3-5 g of vegetable or butter per 100 g of vegetable soup. If the baby is not gaining weight well, this amount may be higher. Thin peanuts are also recommended to add oil to cereals and some desserts.

Also, the cause of underweight child can be monotonous diet and too much sugar in the dishes that you offer the baby (sugar impairs the absorption of nutrients by the body).

REMEMBER! If your baby is slender, do not give him juice often (especially with pulp). They are quite high-calorie: in 100 ml about 40-60 kcal. After them, the child may refuse the main meal.

Cause 4: The child is not gaining weight because he is very active.

If a baby cannot sit quietly in one place, he constantly crawls, rolls over, actively waves his arms and legs, then he naturally spends a lot of energy on this. Accordingly, fat does not have time to be deposited, because the calories received with food are quickly consumed.

REMEMBER! If your smart baby slowly gains weight, but rarely gets sick, develops well and is in a great mood, there is nothing to worry about.

Reason 5: The child is not gaining weight because he is sick.

If your baby is developing well and suddenly stops gaining weight, you should talk to your pediatrician about it. Sometimes the cause of this phenomenon may be some diseases (for example, cystic fibrosis, celiac disease).

REMEMBER! Also, the presence of parasites in the baby's body can cause a deterioration in appetite and low weight.

Source 4mama.com.ua

Height and weight gain for children of the first year of life. Tables

Dear parents, your baby is growing and you are worried about whether he is gaining enough weight and height. For control, there are centile tables for assessing the physical development of children, weight and height indicators. At the same time, you must remember that each baby is individual, he cannot grow according to the textbook. These weight and height recommendations are based on an average number of children and 10% deviation is normal. In addition, the centile corridor from 25% to 75% is an average physical indicator. That is why they say: Physical development is mesosomatic, macrosomatic, microsomatic.

It is important that the weight and height indicators are in the same centile corridor, but no more than two adjacent ones. Then we can talk about harmonious development. If the gap is more than two centile corridors, the development is disharmonious. Then we can think either about an unbalanced diet or about a pathology associated with obesity (paratrophy), or protein-energy deficiency (hypotrophy). In addition, one should not forget about the constitutional characteristics of the child, about genetic predisposition. Therefore, in no case should you compare your child with a neighbor's. To talk about the health of a child, we evaluate his condition according to many criteria. This is neuropsychic development, laboratory examination data, anamnesis, heredity. How many times in my practice have I met children who gained 400-450 g in weight every month, by the year they barely gained 7.8-8 kg. But at the same time, children already at 10 months began to walk, pronounce syllables, and follow complex instructions.

We'll talk about weight and height gain for term babies. In preterm infants, rates of weight gain and height differ according to the degree of prematurity. In addition, children can be born with intrauterine malnutrition.

The tables for girls and boys are different in terms of numerical indicators, but at 1 year of age, these differences are quite minimal.

Centile tables for assessing the physical development of girls from 0 to 12 months.

At the same time, until the age of three months, the child adds 20-30 grams per day daily, respectively, from 140 to 200 per week. If we talk about the average weight gain by months, then it is only 600 g per month, since the child after birth has physiological weight loss (with urine, feces, transition from intrauterine feeding to breastfeeding during the adaptation period), approximately 10% of the weight, which is 200-300 grams.

More often, by 3-4 days, the child restores its original weight, and then there is an increase. But I had a case in practice when the child began to gain weight from the 20th day of life, while the girl was active, reflexes were alive, her appetite was good, she could withstand the night interval, stool 4-5 times a day, urination was sufficient, developed according to age. Therefore, do not worry. Our indicator is the well-being of the child. If the baby is active, eats with appetite, sleep is calm, the skin is clean, physiological functions are not disturbed, be calm, your baby is healthy and not hungry. You see from the table the range of weight per year is from 8 to 13 kg. This is the norm. There is no reason to run to the endocrinologist, genetics, to examine the child.

Or the opposite situation: in the first months of life, a child gains 1-1.5 kg while breastfeeding. If the baby does not have colic, he does not spit up, there are no gastrointestinal manifestations, he is active, the skin is clean, physiological functions are not disturbed - this is also the norm. Remember, as often happens, premature babies quickly gain weight and catch up with their peers by the year. And large babies gain weight more slowly. In my entire thirty-year practice, only two children weighed 14-15 kg by the year, although their parents were large and tall. By the age of three, they weighed almost the same, added only in height, the rest of their peers caught up with them.

It is believed that by 4-4.5 months the child should double the weight, and triple by the end of the year.

It happens that the increase in height and weight goes in leaps, seasonality, unevenness, and sometimes asymmetry of growth are noted. Pediatricians are concerned about the circumference of the head and chest, by 2-3 months they should be equal. Further, the breast grows faster. This is important so as not to miss the pathology.

The younger the child, the faster his growth. In the first 3 months of life, body length increases by 3 cm monthly, in the second quarter by 2.5-2 cm monthly. In the third - 1.5-2 cm, in the fourth - 1 cm monthly. The total increase in height in the first year of life is about 25 cm.

Centile tables for assessing the physical development of boys from 0 to 12 months.