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Failure to Thrive: Why Growth Charts Are Important

How growth charts can help indicate failure to thrive in babies and children.

What is Failure to Thrive?

Failure to thrive doesn’t mean you have the smallest or skinniest baby on the block (though you might). According to Children’s Hospital of Philidelphia Failure to thrive “is defined as decelerated or arrested physical growth (height and weight measurements fall below the third or fifth percentile, or a downward change in growth across two major growth percentiles) and is associated with abnormal growth and development. The reason for failure to thrive is inadequate nutrition.”

I find myself constantly trying to explain to people that we are not worried about Apollo being small, but about his lack of growth. Looking at his growth chart here shows the problem so much better than words.

How Failure to Thrive Looks on a Growth Chart

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They say a picture is worth a thousand words. Well, sometimes a growth chart is too.

You can see that at birth, two weeks, and three months he was at 50th percentile…then at 3 months he drops down to the tenth percentile and by seven months he’s off the chart completely. The doctors consider a drop of more than two percentiles to be worrisome. And if you look at months seven through eleven, he keeps getting further and further away from the lowest percentile on the chart.

Yesterday afternoon he had his weight check appointment. The great news is he has gained a whopping pound and a half! You can clearly see just how much he jumped up on the chart. He’s been wanting to eat nonstop lately and apparently it’s been working.

A Sweat Test for Cystic Fibrosis

The not-so-great news is the doctor wants him to go to Seattle Children’s Hospital to get a sweat test for cystic fibrosis.

Let me try to explain the doctor’s reasoning. As you know Apollo has been having breathing trouble this week. It’s not his normal “noisy rattling in the throat” but more of a “deep wheeze”. I was so glad the appointment coincided with this so the doctor could hear what I was talking about. The doctor listened for a very long time and said he can hear mucus settled low in his lungs. He said he’s heard this before in Apollo’s lungs and it seems to move around to different spots. Apollo has had a scope stuck down his throat which tells the doctor everything is structurally fine and rules out several causes of the noisy breathing. He said his wheezing does not sound asthmatic. He said with asthma the noise comes from the exhale, Apollo’s noise is when he inhales. The fact that he is off milk, on reflux medicine, gaining weight, and doing well but STILL has this wheezing/trouble breathing points toward a mucus issue. Cystic fibrosis is essentially mucus that is so thick a person can’t remove from their body…it gums everything up.

So that’s where we are right now. I will be taking Apollo in today for a blood draw for a celiac panel and then we wait for a call about his appointment in Seattle.

18 Comments

  1. Lindsey

    Really praying for this little guy. My daughter was tested for cystic fibrosis. And a week later we were in another city with a premie. Trying to get ahold of dr.’s with her results. Thank the LORD it wasent what she had. But they have just credited it to asthma. I hope you get some answers. Would never wish for a little one to have something. But if you know whats going on then you can deal with it. Your a good mama. Hard watching these little ones not feel well.

  2. Jennifer

    I’m so sorry Renee, how worrisome to wait for this test and results. I’ll be praying for something other than CF, and continued prayer for a more friendly diagnosis and treatment.

  3. Lisa

    Oh Renee I’m sure you are anxious to find out the answers. I will pray for peace as you wait for the appointment and results and for God’s healing touch to flow through Apollo and bring total healing to every inch of him.

  4. Kristi

    I’m sorry about all of this. I would be shocked if he has CF considering none of your other children do. That is unheard of- all the families I know who have children with CF have at least 1 in 4 children with it, many times the odds are higher than that. That correlates with the statistics, I believe if you and your husband are carriers, 1 in 4 of your children would have it as a dominant trait. I hope you all are able to get some answers though!

  5. Sarah Rose

    Wow… praying for you and the family and the Dr.’s. On a photoshop note, I just learned this trick a bit ago, but if you hold down the shift button as you draw the line, it will make it straight for you. Also if you make a point (dot) using the drawing tool, then hold the shift and make a point where you would like the line to end, it will automatically fill that line in straight for you. Hope that makes sense… =)

  6. Mary Grace

    At least the sweat test isn’t awful. BTDT with my refuses-to-grow guy. Like you, I could care less if he’s tiny. I just want him to have *something*. At this point, our ped. is tossing around the term “proportional dwarfism” …

  7. Heather B

    I’m so excited to see that jump back towards being on track on the growth chart. It looks like your dietary changes are helping. I hope your little man does not have CF and they are able to come up with some answers for you.

  8. Laura

    While I’m of course hoping it’s not CF, it’s not as impossible as you would think. If both you and Chuck are carriers, the probability of any one of your kids being born with CF is .25. The complement, the probability of any one kid not having CF, is .75. Probabilities are multiplicative, so this means that the probability of having 8 natural-born kids without CF when you’re both carriers is .75^8 (which equals .1). In other words, there’s about a 10% chance that you could both be CF carriers yet none of your first 8 genetic kids have the disease – unlikely, but not unheard of.
    (I’m not trying to be a downer, I just know that when I’m in this sort of situation I like to have the facts.)

  9. Renee

    Laura, very true. If Apollo has CF that puts the odds of any of our children having it one in four. Exactly the same odds that we would have a blue eyed child….we have one set of blue eyes and seven of brown. I also read this rather disturbing quote: most children diagnosed with CF have no family history of the disease. I just want to get the test over with so we know.

  10. Katelyn

    Good luck getting to the bottom of this. Our daughter has struggled gaining and maintaining weight since about 6 months. It is difficult for people to understand that it’s not that she’s “petite” that is the problem, it’s her erratic growth pattern losing weight. She has also done the CF and celiac testing. Both were negative. They FINALLY did a sleep study, and my suspiscions were confirmed. She DOES have obstructive sleep apnea. Something you might want to consider since he has noisy breathing and such. I’m very disappointed she’ll have to have surgery at such a young age (three) but I hope it can help her sleep and grow properly. Good luck! I hope you get answers soon, it is so frustrating to know something is wrong, but not know what…you’re in my thoughts.

  11. Brenda Arend

    He is doing exactly what my girls did… a stalling of growth from about 8 months through, well, they didn’t catch up really until they were about 10 years old. Now my Amanda is 5’5″ (they said she would grow to maybe 5′. We did lots of tests too, Turner’s syndrome, growth hormone studies, bone growth studies (the wrist x-ray showed Amanda’s “bone age” to be between 0 and 3 months when she was a year!). It was all inconclusive and chalked up to “familial growth pattern” I guess because I continued to grow in my early 20s and didn’t start periods until I was about 15 (all pointing to a genetic influence for later physical maturation). Do the studies, and hang in there. I remember being in your shoes, watching that 50th percentile grow further and further from my daughters’ height/weight. I’ll pray for calm peace for you! You’ll feel better when you get some answers.

  12. Quinault

    Which growth chart is that on? The WHO breastfeeding or formula feeding chart?
    http://www.kellymom.com/babyconcerns/growth/chart1.html
    I imagine this is pretty frustrating for you. I have been there before. It is especially hard when you have had other children and know what they grew/gained link. My second daughter is at this moment 35 lbs and almost 6. To put this in perspective, her younger brother is 4 and weighs 37 lbs. Boys often weigh more than girls. But those two have been the same weight for years now. That chart looks just like hers was. She was hospitalized with RSV for a week at 5 months. She wasn’t a premie, but she was born tongue tied. The only theory we had for her slow growth was that she simply had a weakened immune system for the first 4 years of life. Anytime she became ill with anything it would go straight to her lungs and she would lose weight. I finally just invested in a UV wand, shopping cart cover and made everyone around her use hand sanitizer before they could come near her. We toughed out the first 4 years of illness and now she is doing as well as any “normal” child.
    Childrens is awesome, you couldn’t be in better hands. My close friend had a child that chronically had a problem with having a prolapsed bowl that was evaluated for CF at Childrens as well. I was there for the RSV with my second. I went there for the hearing test for possible deafness for my 3rd. I was there for the possible hip dysplasia with my 4th. And I will be dealing with them in the future if my 4th indeed has neurofibromatosis. (we have to wait that diagnosis out until she is older. I am NOT very good at waiting for possible bad news. I am a rip the bandaid off and get on with making life manageable person)

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