human
Could her delayed growth be a byproduct of the IUGR? Or is it more likely shes just not taking in enough calories per feed? Additionally, are there any questions that youd recommend I ask the pediatric GI doc? Thanks so much!
gpt
Both. IUGR babies are prone to have poor growth. Most continue to have slow growth in the months after birth, often leading to GI interventions such as increasing nutrient density of formula. This is to make up for the nutrient deficit present that an average infant's daily intake typically cannot surpass on its own.While the vast majority (80%) of IUGR and/or SGA (small for gestational age) do catch-up to reach sizes comparable to other children, this typically takes about two years. Many factors affect growth and stature, including any medical problems that led to her being small. For instance, this nutrient deficit and propensity to growth failure tend to be worse in infants who were also preterm (at 37+1 weeks, your daughter was born just two days further along than what we would consider "late preterm").The main things you can control and monitor at this point are her nutritional intake and feeding habits. For now, the baby's goal is to be improving in her percentiles, not worsening. I recommend working with the GI team on this goal. They will likely have you see a pediatric dietitian as well to help figure out how many calories she should be getting.Don't despair - this is more common than you would think. It doesn't mean you're doing anything wrong. You are working very hard and doing everything you can right now. Getting more hands on deck by bringing in a specialist's perspective only means more people in your daughter's corner trying to get her growing better.Most babies born with IUGR do catch up their growth by this age, so I agree with your pediatrician's concern. Increasing the concentration ("fortifying") her formula is a great first step, but it's worth seeing the pediatric GI to make sure there isn't something else going on. I'd suggest keeping track of about how much she eats in a 24-hour period as well, so the doctor can assess whether she's getting enough calories.
why does everything feel fake?history: im 16M, have no existing medical issues, nor am i using any medications, and i dont smoke, drink, or do drugs.occurrences: this has been getting progressively worse the past month, at first it was only something i could notice but it never really bothered me, but now it makes taking tests, reading (even this), and programming really difficult without full concentration. it kindof comes in waves where i can read whole chapters with no problem to having to re read a sentence multiple times to understand it (this happened in my ism test where i got stuck on a really easy problem because it felt like whenever i read one part of it, part before it disappeared). sometimes it gets so bad to where i get dizzy spells in the middle of class, and other times when im about to sleep it feels like im "slipping" and jump up (not the kind where you feel like your falling in a dream and wake up). also the past few days its kindof always been on very slightly.when it gets bad it feels like passing out without actually passing out, you know how you technically CAN see, but dont really understand anything? it feels like that, or like those pictures where you cant identify anything, or waking up suddenly from a deep dream, and my mind goes blank and i feel like im "spiraling", and it feels like im about to fall through the world? i dunno how to explain it, but i usually get jumpscared by it and it brings me back to normal, but if i focus i can point things out and describe things. another way i can describe it is it feels like im looking through my peripheral vision at all times, theres a certain lack of clarity to what everything looks like, and sometimes when im reading it feels like im being sucked into the monitor, if i really focus i can read, but it feels trying to read on a rocky boat, yeah i CAN do it, but im not really understanding it because im too focused on reading the words. sorry if im explaining this poorly, i dont really know what it is or whats causing it, im thinking its a mix of brain fog and anxiety? i wouldnt say im an anxous person but idk, and it feels kindof similar to the brain fog i get when i drink coffee, and ideas would be apreciated!
Needs detailed in person. Pediatric psychiatric evaluation.