*Hi Jaye, *
*Here's some info from this website
http://www.emedicine.com/PED/topic738.htm*
**
*"*Growth failure, or failure to thrive (FTT), is a descriptive term and not
a specific diagnosis. Although definitions vary, most authors use this term
only when growth has been noted to be low or to have decreased over time.
For instance, some authors define FTT as height or weight less than the
third to fifth percentiles for age on more than one occasion. Other authors
cite height or weight measurements falling 2 major percentile lines using
the standard growth charts of the National Center for Health Statistics
(NCHS). Still others state that true malnutrition (weight <80% of ideal body
weight for age) should be present to state a child is failing to thrive. All
authorities agree that only by comparing height and weight on a growth chart
over time can FTT be assessed accurately.
*Normal growth in term infants *
To recognize abnormal growth, one needs to understand normal growth. The
average birth weight for a term infant is 3.3 kg. Weight drops as much as
10% in the first few days of life, probably as a result of loss of excess
fluid; however, birth weight should be regained within 2 weeks after birth."
They give median growth as 0-3 mos, 26-31 g/day; 3-6mos, 17-18 g/day; 6-9
mos, 12-13g/day.

If you have some serious concerns, or want to share some insight, then with
mom's permission, you could call the doctor. That's what I would do if I
thought the baby needed a closer look or more followup. If the doctor did
not do so, and I still believed the baby needed closer medical care, then I
would recommend a second opinion or a change to another doctor altogether.

It would be interesting to see the growth charts. This is not something I do
in my role as hospital LC, but the primary doctor does and this should be
quite informative. I would be looking at all the stuff you already are
looking at, like feed frequency, pacifier use, s/s of feed or respiratory
distress, intervening illness, allergy s/s, and mom's health, milk
production, medications/drugs, etc.

Good luck with this case,
Laurie Wheeler RN MN IBCLC
Mississippi USA

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