Clinical Cases

Failure to Thrive

Written by Bernie Smyth

A young boy with ‘failure to thrive’ evolves through three remedies.

BOY, “J”, aged 9 years.

Presenting Complaints: Failure to Thrive, Learning Difficulties, Anxiety.

History: J was adopted from a foreign country, together with his twin brother.

He was born at 30 weeks, and suffered from intraventricular hemorrhaging.

He spent the first two months of his life in hospital, the next eight in an orphanage, and was adopted and brought to Ireland at 10 months old.

The family moved to the UK for a couple of years; they were told by a doctor there that J was “suffering from malnutrition”. He was referred to a specialist, who said he was “borderline” for growth hormones and very underweight. He also had been tested for learning difficulties and had been assessed as being “borderline” for learning and cognitive difficulties.

1st Visit, 23/06/09


J came to the consulting room, accompanied by his mother. He looked extremely thin, and his head seemed to be very large for his tiny frame. He would not look me in the eye. Whenever I asked him a question, he would look at his Mum and give the answer to her.

His Mum said “failure to thrive” is his biggest difficulty; he has very definite food tastes and will not be persuaded to eat anything he doesn’t want.

His favorite foods are:


+++Smoked salmon, fish.

+ ++ lobster and squid, if he could get them!

+++bitter, eg olives

A recent desire is +++beef..

A strong aversion to milk.

She said it was really difficult to persuade him to eat anything else.

J says “I love Fish! I want to be a fish”!

He has a fascination with fish; he has goldfish, tropical fish as pets etc. He’s also incredibly interested in tortoises, turtles, frogs and lizards and is saving up to buy a lizard. His Mum says he’s “very good at looking after animals”. However, it’s always fish or amphibians; he has no interest in puppies or “fluffy” things.


He’s afraid of the dark and gets very afraid of being lost when the family visits a local forest. He comes into his parents’ bed every night around 2 am, and “wraps himself” around them.


“Bad dreams, of sharks coming to eat him”,

He “hates” school with a passion. He has huge difficulties concentrating on words and reading, and in math, the actual numbers don’t mean anything to him.

However, he is very visual, loves art and music, and is trying to learn to play the banjo. He doesn’t socialize well, and prefers shy children. He gets quite jealous if he makes a friend and then he sees this friend playing with another child.

Recently, J seems to be grieving his birth mother. He keeps asking “how come she didn’t want me?” He also has an obsession with musical baby toys, and plays with them a lot, when he has a chance. When he turned 7, he was really upset, saying “why do I have to grow up?” I want to stay a child forever”. He has taken to watching DVD’d of his native country and sometimes cries after them. The past few months in particular he watches “Abandoned Animal Rescue” programs and seems to identify greatly with the affected animals.

His teacher had commented that J seemed to have an odd “coldness” about him, yet

he seems to have an enormous empathy with disabled or physically challenged people, especially if they are in wheelchairs. He met a Downs’ Syndrome girl 2 years ago and he still talks about her. J is also “very obstinate” . “You couldn’t bribe him, he only eats what he wants.”


  • “Tummyaches”, especially before school. “Sharp” and has to “press on tummy” to make them go away.
  • Cough: He has a “chronic” cough; it has been coming and going for months. A “choking” cough, sometimes it makes him feel sick.
  • Constipation: He has “chronic” constipation also. It has “always” been a problem.
  • Sleep: He finds it very hard to fall asleep. “I’m nocturnal”, he says consequently he’s exhausted in the mornings and finds it very difficult to get out of bed.


I found this to be quite an unusual case; there was a “fish” theme running through the case, but it was very difficult to put it into context. I looked at “fish” remedies, but nothing seemed quite right. I felt also there was a lot of Carbon in the case, so looked at Calc Carb. Being the oyster, it might cover the “fishy” theme, but not quite right either. I also thought about Silica, which would cover the poor assimilation, large head and the timidity, but it wasn’t quite right either. I then thought about the Lac remedies, because of the mother issues…

I repertorised the case and felt the strongest feature was the theme of being “abandoned”, grieving for his birth mother, watching DVD’s of his native country, wanting to remain a child forever, etc…. and all of this in spite of the fact that his adoptive parents were so attentive and loving towards him…


MIND, Forsaken feeling, feels is not beloved by his parents.

MIND: Ailments from grief.

MIND, Concentration difficult, on reading/studying.

GENERALS: Emaciation, in children

COUGH: Choking



Food: Milk aversion/aggravation.

The remedy which came up strongest was Magnesium Carbonate, which Kent called the “Orphans remedy”. This seemed very much to fit J’s feelings of isolation and abandonment. Also, Mag Carb patients show “failure to thrive and delay in muscular development”. (Boed) Interestingly, I found that Mag Carb patients often dream of being lost in a forest; J didn’t actually dream of this, but was very fearful of getting lost in a forest. Other symptoms covered by Mag Carb included the stomach pains, constipation, and aggravation from milk.

Prescription: Mag Carb 200c, split dose.

First Follow-up 16/09/09

OBSERVATIONS:Still very thin, but definitely not as emaciated as three months previously. Still won’t make eye contact with me. Mum says: He has been much better, physically and emotionally. The nostalgia is much less, not watching the DVD’s of native country anymore. Much more solid in himself, happier. Is now clashing with his twin brother, more able to stand up for himself. At School he is coping much better with the schoolwork, but still hates math and can’t understand the concepts.Not waking at night and easier getting to sleep.


COUGH: Went away after the Mag Carb, and chest clear until 2 weeks ago, when he started coughing again, this time quite badly. Mum repeated Mag Carb 200c, but it had no effect, He’s coughing a lot in the mornings, a loose cough, brings up phlegm, has to spit it out.

CONSTIPATION; Completely gone, no complaints since.

TUMMY PAINS: None at all since the 1st dose of Mag Carb.

APPETITE: Big improvement, is still craving fish, but is now eating eggs, salad,

feta cheese and lots of vegetables and salads. The big desire for beef is gone.

J still HATES milk, and feels sick if he drinks it at all.


While he has improved with reading and schoolwork, he still has great difficulty

in connecting with other children. J says “I feel really dumb, really stupid; I feel like “Patrick” from the cartoon, “Spongebob”. (Patrick is a starfish!) I feel like I’m invisible, nobody sees me, I’m invisible, I stand in the playground and it’s like nobody can see me.”

His Mum says he complains every day about being “invisible”.The fascination with fish is getting stronger; he now has a pet lizard, which he cuddles and strokes, carries around in his pocket . Towards the end of the consultation, J says “I remember when I was born, there were people there who took me away, I never saw my real mother again. Maybe she couldn’t see me because I’m invisible”. He asked me: “Can you see me?” Am I invisible?” Sometimes I feel not real.”

He has recently become very interested in the baby toys again.,This had cleared after the 1st dose of Mag Carb.

ANALYSIS: On studying the case, I could see that Mag Carb had brought about a huge improvement, however the cough had returned and this time the repeated dose of Mag Carb had not helped. Also there were some new symptoms, such as the feeling of invisibility. I decided to do a word search on “invisible” in Mac Repertory Reference Works Program. One remedy which appeared was Lac Maternum. I felt excited! On reading the proving I felt it covered much of J’s picture.

A quote from Tinus Smits’ Lac Maternum proving:

“The basic problem in this remedy is a lack of incarnation from several deeper causes, such as..unacceptance of the child by its parents during pregnancy, etc,…”

“”Essence: lack of incarnation, as if not participating, as if INVISIBLE to other people, feeling unaware of one’s own boundaries, a feeling of unreality”

Lac Maternum also covers the forsaken feeling, and the aversion to/aggravation from milk., and the cough. I also looked up “Mind behavior childish”, and Lac Maternum was indicated. (playing with baby toys etc). Overall, I felt it was a good match for J

Prescription : Lac Maternum 200c, split dose.

Follow up 2: 09/03/10 (six months later)

OBSERVATIONS: Looks much better, is gaining weight; head much more in proportion to his body. J still won’t make eye contact with me, but is much more mischievous and playful with his Mum. Mum says: “he’s been great”.

He had had one episode of a cold and cough 6 weeks ago and Mum repeated the

Lac Maternum 200c and it cleared straightaway. Cough “went completely” within 24hours of taking the Lac Maternum. His energy also improved hugely; “He’s much happier, the yearning for his birth mother has stopped. The teacher says he’s much happier and much stronger in himself; he will “go for it” now at soccer, whereas he always would hang back before.”

“The feeling of invisibility went quite quickly after the remedy, he has made some friends at school, and is joining in more. A very noticeable thing is that he is much more playful, playing tricks on us etc. He’s very funny! He has lost all interest in the baby toys too.”

No mention of tummy pains, cough, constipation. Appetite is very good, but really big craving again for fish, above everything else.

New Symptoms:

“Stronger than ever fascination with fish, eating them, reading about them, looking after them as pets. New obsession: Swimming. Asked to go for swimming lessons after the Lac Maternum, and is so good at it, is now showing other children how to swim at the lessons. Mum says “He is so dying to swim in the sea, we have to buy him a wetsuit!” His Dad had given J and his brother money to buy themselves treats and J had bought himself scallops!

Nightmares:J has had some very “scary” ones recently; always the same theme, sharks coming to eat him, or other “big creatures” swimming in through his window . He also says he dreams he is swimming around in circles, surrounded by an electric wire fence, with enemies waiting to kill him!

“J” says he “likes” school now “There’s a “new boy in school, he’s handicapped”, also then went on to say how much he “liked” handicapped people, how he could understand them, and he wanted to help them. By the end of the consultation he was showing me his plans to have a tea party for Downs’ Syndrome children! His Mum says he s talking a lot about “helping handicapped people”.

I felt this time, yes, the Lac Maternum had been wonderful, but the fish/sea theme was becoming incredibly strong and decided to do some research on other Lac remedies. I found Nancy Herrick’s proving of Dolphins Milk and it fitted J very well!

I looked back over his case: Desire to eat fish, “I want to be a fish”, dreams of sharks, (the shark being the main predator of the dolphin). One theme of the Dolphin’s Milk proving was ” the feeling of danger”, and I thought that came through in the dreams of both the sharks, and being surrounded by an electric wire, with enemies outside.

What really was a deciding factor for me was the unusual fascination with physically and mentally challenged people and his desire to help them. I found in Nancy Herricks book: “Dolphins have a special affinity for the ill, especially children who are mentally or physically challenged. It has been reported that dolphins when confronted with a group of children will identify and linger with the unhealthy ones, especially when the children have emotional problems”.

I gave J Lac Delphinum 200c, a split dose.

Follow up 3 20/06/10

OBSERVATIONS: Looks great! Much healthier, has gained weight.

J walked in and looked at me, and spoke confidently all throughout the session.

His Mum said “:He’s doing really really well. Much happier, at home and at school”.

Finding the work easier, doing more socializing. The fascination with fish has eased; he still enjoys them, but is now asking parents if they would get a puppy. Appetite, much improved; still likes fish, but is eating meat, potatoes and trying lots of new foods. Is fighting more with brother, but Mum thinks it s because he’s asserting his boundaries. Swimming is still a big hobby for him.

No nightmares, sleeping well.

No return of cough or digestive disturbances.

No grieving for birth mother, or nostalgia.

Mum says “We are delighted!”

About the author

Bernie Smyth

Bernie Smyth LIC ISH, ISHom, PCHom, graduated at the Irish School of Homeopathy in 1999. She attended Dr Ramakrishanans Post Graduate Course in 2001, and went on to complete a further 3 year post graduate Course with Jeremy Sherr. She has a busy homeopathic practice at the Strand Road Clinic in Clonakilty, West Cork, Ireland, and works closely on several cases with Dr Fiona O Reilly. Bernie also works as a lecturer at the Irish School of Homeopathy in Cork and Dublin, where she is the clinical supervisor and mentor of third year students, and also teaches at the Welsh School of Homeopathy.


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