FAILURE TO THRIVE

"Failure to thrive? Failure to thrive???" my mom said in disbelief. I, of course, at that time, didn't know what FTT means, although I didn't have a good feeling about it too, seeing mom's reaction when she read Nunu's file after the doctor left. I heard she muttered something like, "Apalah these young doctors nowadays..."

Only after Nunu was discharged (and when I looked at the discharge slip that Nunu was hospitalised for bronchiolitis AND poor weight gain) did I asked mom what the doctor meant by 'failure to thrive'. Momma was careful with her words, and chose the best definition just enough for me to understand. It simply means that Nunu isn't gaining weight well.

I said, "What the..? Didn't they look at her growth chart? She was on the normal growth percentile, what?" Mom just shrugged. It bugged her when she read the report, surely she had a different opinion. So should I be bugged too?

Nunu was 7.2kg when she was admitted. Frankly, I was worried sick because she was 7.5kg just 3 days before that, and 7.8 kg a little over a week before that. Worried that the weight was dropping too fast, but I knew it's gonna go back up once she's back on her feet. But it never occured to me that she's has poor weight gain, considering she was only 2.82kg at birth (as compared to most of the 3kg++ I know) , and it's normal for a baby's weight to fluctuate if he/she falls sick.



This was Nunu on the night she was admitted. Frankly, I didn't have the time to feel all so excessively 'kesian' for her & emotional.

I have mixed feelings about this issue. FTT. As if there's some consolation for me (and mom), there is never an exact or agreeable medical definition for FTT anyway. A quick research revealed to me that FTT is more of a descriptive term rather than a diagnosis. However, most of the sites I visited concluded that FTT means that the child:

- Is at or below the 3rd to 5th percentile for height and weight; or
- Has failed to gain weight as expected, as shown by dropping two growth percentiles

FTT also means that a child is undernourished, which could have been caused by not only organic factors in terms of nutrition but emotional factors as well. Some have underlying medical conditions which contributed to the arrested physical growth.

Ada rupa budak kwashiorkor tak?

I understood why mom was aghast at the young doctor for writing 'failure to thrive'. She must have been really offended, a grandchild of a doctor to be called FTT. Not only that it's a wrong diagnosis, the doctors should have tracked her charts, plot them nicely and monitor how she'll do in a couple of weeks. You don't just look at a small & skinny kid & declare them FTT.

What she did RIGHT was asked me a lot of questions, that ranges from what she eats for breakfast (I answered bread & cheese & she gave me an incredulous look!) to how much milk she's taking & how her formula is prepared.

So I had this issue slowly eating my brains out for two whole days - Saturday & Sunday. When the paed came on Monday, he said nothing of Nunu's small stature. He just concentrated on her condition and decidedly said she requires no medication at all for bronchiolitis. We were relieved that it wasn't pneumonia as the on-call doctors suspected earlier. Can you imagine, if someone is sick with pneumonia & you only treat him/her with antibiotics 2 days later??? It's weird here in Malaysia that the government hospital's (read: poor people hospital) pharmacy is closed on weekends.

So, I'm targeting that Nunu should triple her birth weight by the time she reaches 1. That's *taptap calc* 8.4kg, right? 1.2kg in less than a month's time. Will she be able to do it? Even now, I'm still dazed with all sorts of (mis)information & advise people felt free to dispense about her diet.

Don't give defrosted BM or food, nanti sejuk dada. No potatoes, they say, nanti budak penat. No butter, nanti lungs berkahak. No fruits or juices. No nestum or cereal. No chicken or anchovies, nanti batuk. No biscuits too. Habis anak aku nak makan apa???? Takkan nasi & carrot jek???

Well, Nunu's doing very well. She's eating non-stop. She's terrorizing everyone and turning the house upside down (but she's very 'malas' to walk/tatih!). Definitely getting cleverer (dah cerdik sekarang ni, dorang kata) in sooooo many ways, I don't know where to start.

Yeah, she even takes her syrup with a smile these days.