Failure to Thrive, Suboptimal Weight Gain, and the Lactation Savvy Therapist

 

In this 4.5-hour, self-paced continuing education course, you will learn the various etiologies of failure to thrive and walk through multiple, in-depth, case studies to solidify critical thinking.

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Working in feeding there’s no doubt you’ll work with infants with suboptimal weight gain. 

The challenge isn’t whether you’ll see these cases—it’s knowing how to assess them accurately, without over- or under-intervening.

 

These cases are rarely straightforward.

Clinicians are often navigating:

  • Conflicting growth charts and intake reports
  • Pressure to supplement without a clear etiology
  • Family anxiety, guilt, or mistrust of prior care
  • Limited training in clinical reasoning around weight gain

Failure to Thrive Learning Objectives:

  • Identify optimal vs. suboptimal/abnormal growth patterns for infants
  • Recognize the characteristics of a baby who is not gaining weight in an optimal manner
  • Identify potential causes of failure to thrive or suboptimal weight gain
  • Recognize the impact on the family and/or maternal mental health when weight gain is of concern
  • Identify strategies for supplementation to increase intake for the infant with suboptimal weight gain
  • Recognize the therapist’s role in managing suboptimal weight gain or Failure To Thrive
  • Identify actions that a therapist might take in challenging/difficult situations when treating a baby with suboptimal weight gain patterns

What if complex infant cases felt manageable—not overwhelming?

Most clinicians encounter infants with suboptimal weight gain early in their feeding work—but few are taught how to reason through these cases. Instead, we’re often left piecing together growth charts, intake data, and family reports without a clear framework for decision-making.

This course was built around what actually shortens the learning curve: seeing how experienced clinicians think.

 

Through varied, real-world case studies, you’ll learn how evaluation findings translate into different plans of care depending on etiology, context, and the infant–caregiver dynamic.

It took years of practice, mentorship, and hundreds of complex cases to develop this level of clinical judgment. This course is designed to help you build it faster—without relying on guesswork, rigid algorithms, or one-size-fits-all feeding advice.

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HERE'S WHAT'S INSIDE

RECORDED VIDEO LESSONS
PDF DOWNLOADS
visual aid etiology chart 

Timed Agenda

Below you’ll find exactly what’s covered in this online continuing education course. This course allows you to review the material as much as you’d like for 6 months so you can continue to apply your knowledge to your caseload each time an infant demonstrates suboptimal weight gain. 

Module One: 2 hours 2 minutes

Introduction

  • Introduction
  • Suboptimal Weight Gain Etiology
  • Typical Output & Growth Charts (CDC vs WHO)
  • Medical and Feeding History
  • Interventions to Improve Weight Gain
  • Intervention: Postural Stability & Positioning
  • Intervention: Supplementation
  • Managing Emergent Situations
Module two: 1 hour 3 minutes

Case Studies

  • Case Study A
  • Case Study B
  • Case Study C
Module three: 27 minutes

Infant Weight Gain Considerations

  • Mini Case Study: Low Milk Supply
  • GI Red Flags & Cow's Milk Protein Allergy (CMPA)
  • Case Study D
Module four: 1 hour 24 minutes

Additional Weight Gain Considerations

  • Mini Case Study: Complex Presentation
  • Case Study E
  • Red Flags: Cardiac & Respiratory
  • Case Study F
  • Mini Case Study: Enlarged Adenoids and Tongue Tie
  • Mini Case Study: Neurological
This course covers the essential principles clinicians need to evaluate infants with suboptimal weight gain, including normal feeding patterns in the first six months of life, expected intake and output, common etiologies of poor growth, accurate growth-chart interpretation, and the ripple effects feeding challenges have on infants and their families.
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Course Instructor

 

Jeanne Pichoff, LOTR, IBCLC

Jeanne Pichoff has been a pediatric occupational therapist since 2004. She has worked in a variety of pediatric settings including the NICU, outpatient clinic, and the state early intervention system.

Jeanne owns and operates a private practice in Louisiana, Flourish Pediatric Therapy and Lactation LLC, which is focused on the niche areas of infant feeding, lactation support, and early intervention services.

Jeanne pursued the additional credentials of Certified Lactation Counselor (CLC), Certified Lymphedema Therapist (CLT), and International Board Certified Lactation Consultant (IBCLC). She continually strives to offer the highest quality service to families in her care.

In addition to her clinical work, Jeanne serves her community as a member of the Acadiana Breastfeeding Coalition, where she promotes breastfeeding advocacy in her region.

Frequently Asked Questions

What makes this course different from other CEU courses? 

Rather than covering pediatric feeding broadly, this course focuses on how clinicians reason through complex infant weight-gain cases. You’ll work through evaluation and plan-of-care development using varied case examples that reflect different etiologies, presentations, and caregiver dynamics.

 

Who is this CE course intended for?

  • Occupational Therapist & Occupational Therapy Assistant
  • Speech-Language Pathologists
  • Physical Therapists & Physical Therapy Assistants
  • International Board Certified Lactation Consultants (IBCLCs)
 

Are there prerequisites for this course?

There are no required prerequisites. 

 

Can I count this course towards my 90 hours of lactation-specific education?

Yes, please review the IBCLC Commission page for further details on lactation-specific education hours. To receive credit for completion, the course must be completed with 100% watch time and each participant will need to complete a post-assessment with a passing score of at least 80% to ensure all learning objectives are met.

 

Information about AOTA CEUs

This course is approved for 0.45 AOTA CEUs for occupational therapists and assistants. Participants will be required to:

  • Complete the course in its entirety (100% of the course watched)
  • Complete a multiple-choice post-assessment with a passing score of at least 80% (untimed test, 3 retakes)

 

Information about ASHA CEUs

This course is approved for 0.45 ASHA CEUs for speech-language pathologists. To receive ASHA CEUs, participants will be required to:

  • Ensure you are eligible to receive ASHA CEUs! Click here for more information
  • Complete the course in its entirety (watch time is tracked by the learning management system) 
  • Complete the multiple-choice post-assessment with a passing score of at least 80% (untimed test, 3 retakes)
  • There is no option for partial credit

 

CE Information for Physical Therapists

APTA does not approve individual providers. Please check with your specific state about PT online continuing education requirements. To best prepare you can save the following:

  • The certificate of completion that will be provided
  • List of references
  • A copy of the assessment questions

 

How long will I have access to the course?

6 months from the purchase date. This provides plenty of time for you to learn the information and apply it to different infants who end up on your caseload.

We know your understanding and ability to support infants with suboptimal weight gain will improve as you work with infants. We want you to be able to review the information and refine your skill set with a variety of infants while you have course access. 

 

What is your refund/cancellation policy?

Refunds must be requested within 14 days of purchase by emailing [email protected]. A full refund is available if no modules have been started. A partial refund is available once ANY portion of the course has been viewed. The amount refunded is at the sole discretion of The Lactation OT LLC. There is no refund available after 14 days of purchase OR if module one has been completed. Recipients will receive acknowledgment of refund requests within 3 business days. If the request is valid per the terms listed above, the refund will be processed within 7 business days. If for any reason the course is canceled by The Lactation OT before the course is started, a full refund will be provided. 

 

How do I request special accommodation?

Please send us an email at [email protected] at least 14 days before starting the course with further details of your request.

AOTA Approved Provider, ASHA Approved Provider

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Medically Fragile Infant bundle (19.5 hours)

  • Breastfeeding Assessment and Intervention for the Medically Fragile Infant
  • Failure to Thrive, Suboptimal Weight Gain, and the Lactation Savvy Therapist
  • Tube to Breast: Navigating the Transition from Enteral Feeding to Breastfeeding

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