Failure To Thrive: Mommy Doesn't Always Know Best

What would you think if I told you I have a one month old boy who nurses throughout the day, sleeps soundly in the night waking only once to be changed and fed, rarely cries, and smiles often? It sounds like a perfectly healthy little baby, doesn't it?

We thought Rafael couldn't be happier and healthier. Sure, he drank all day long with only very short naps of about 15 minutes in between, but I had informed myself about cluster feedings and growth spurts, and assumed that's what was going on. Besides, everyone says 'breast is best,' and I was following the feeding-on-demand routine that I had heard such good things about. Sure, it was all-consuming and was all I did, day in and day out. But that's what the first few weeks are like, right?

My friend Daniela had her baby just a few days after me, and when she said her daughter slept between two and four hours between feedings, I was surprised. I barely had time to go to the bathroom or pour a fresh glass of water before my little one was awake again, fussing for milk. I just thought he needs to be nursed a lot right now, was having a growth spurt, and didn't think anymore of it. After all, you hear from mothers all the time about never getting to do anything because they are consumed with nursing.

That's why I was upset when I brought my son in for his 5 week check-up and heard the doctor say with dismay, "Why are you so skinny, little man?" She weighed him and I was utterly shocked to learn that he weighed less now than he did when he was born.

"Your baby has acute failure to thrive and must be supplemented immediately. If he doesn't gain weight quickly, it could have very bad consequences for his health."

Meanwhile Rafael was screaming, naked, on the doctor's changing table, and for the first time, I could see that he was, indeed, thin. I had assumed that, since I was feeding him all day, he was having a growth spurt, and was stretching out longer, accounting for the fact that he wasn't round. But now I understood that I was so terribly wrong. I held back my own tears, looking at him, so small, and feeling like I had truly failed him.

The doctor told me to begin a new daily rhythm: Nurse him from both breasts, note the time he stopped nursing, then give him a bottle of formula and let him drink until he is full. Two hours after he stopped nursing the last time, repeat this. At first this sounded impossible to me, because Raffi had never had a two hour pause, whether sleeping or awake, between feeding during the day. This, I came to understand, was the root of the problem. He would drink, doze off after a little while, rarely getting to the fatty hindmilk and never drinking until he was really full, and then would wake up unsatisfied a short while later. Not only was he not getting sufficient nutrition, my breasts also didn't have time to recover and build nutrient-rich, fatty milk. So it was a very new experience for me (and certainly for him) when he drank from my breasts and then had formula, and was truly FULL. He slept peacefully for two hours, and would have slept longer if I hadn't woke him up to be fed again. So THIS was how it was supposed to be! He was now getting real meals, instead of snacking all day.

Not only was Rafael getting his fill of nutrients, but now the days actually had a schedule, a routine. I was able to take walks, go grocery shopping, clean the apartment, or eat a meal.

As nice as this new rhythm is, and as absolutely relieved and overjoyed I am that Raffi is now thriving (he gain over 100 grams in two days), I am constantly haunted by how my 'motherly instinct' failed me, and by how I in turn failed my baby. I still can't fully understand how it could get so far without me realizing something was wrong. Of course, one of the main reasons I believed I had a totally healthy child was because he acted like one, including giving me me big sunny grins every time he woke up or when I stroked his cheek or belly.

This whole ordeal has really put a dent in my confidence as a parent. I always thought I would instictively know what to do, and would automatically feel what is best for my child, but I was so wrong. It's hard to know how to continue now that I have experienced just how off-track my sense of how things are can be.

It's very little comfort that no one else ever commented on Rafael being to thin or looking like he was in poor health.

In any case, we are on the road to recovery...Raffi is recovering physically, and I am trying to recover emotionally, trying to build back my confidence as a mother.