Hello Mary:

Be sure you can write your own evidence-based parameters for failure to
thrive. It is possible they will differ from the case file parameters that
led to the FTT diagnosis.

I have learned that, at least in my hospital, FTT is the official diagnosis
for what I would term "slow weight gain". Baby is eating and gaining, but
has dropped too far on the charts, or hasn't appropriately regained birth
weight. Never have I found that they look for the lowest recorded weight,
or weight at d/c from the hospital. I find it and record it on my report so
I can show another view of how much baby has really gained, FWIW to them.
And I am usually the only one to get detailed feeding and diaper info from
mom for at least the 24 hours prior to hospitalization. The record usually
shows "BF 15/15 plus 2-3 oz formula q 2-3 hours" just like mom was
instructed at discharge. When you go back in time feed by feed, it's a
different story.

Mom definitely needs help and direction with sufficient BFing, effective
latch, reading baby signals to know the difference between releasing to
rest and releasing for satiety, or to burp, or to allow stools to move,
then go back to breast. And she is reluctant to BF in the Peds Unit. Poor
latch and waiting for baby to cry before being fed all contribute to this
less than adequate weight gain.

It was explained to me by a Peds RN as a reimbursement issue. Insurance
will not pay for hospitalization for "slow weight gain", so the official
diagnosis is FTT.

Phyllis Adamson, IBCLC, RLC
Glendale, AZ
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> Does anyone know if there are rates of failure-to-thrive (as in a certain
percentage of babies receive dx ftt or are at risk)?  I'm trying to get
together some facts about the number of babies who get into trouble during
the first few weeks in particular.
 

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