Failure To Thrive

General Illness Information

Medical Term:
FAILURE TO THRIVE

Common Name: None Specified

Description: This term is usually reserved for children, who for various reasons, fail to gain weight. Length and head circumference may also be affected in which case, the underlying condition may be more severe.

Most commonly affected children are between ages of 3-6 months and almost all are under 3-5 years. It is more predominant in males than females.

Causes:

  • About 70% are due to environmental causes – improper or inadequate feeding.
  • About 20% due to organic causes – usually gastrointestinal or neurologic abnormalities.
  • 10% are normal small children ,therefore not classified as failure to thrive.

Prevention:

  • Provide a stable home life with caring parents.
  • Arrange for parenting classes if you are an expectant mother or father.
  • Take your child regularly to the doctor for “well-baby” checkups. This is very important because failure to thrive in the first year of life may affect brain development ,and these children may never catch up developmentally and socially with their peers, even though their physical growth may improve.

Signs & Symptoms

  • Failure to progress normally according to the doctors growth charts for length, weight, and head circumference. Normal growth and development vary widely – rate of changes as measured at medical checkups is more significant.
  • Physical skills (milestones) may be delayed – e.g.. sitting, standing, walking, talking, self feeding and toilet training
  • Difficult personality, feeding and sleep problems.
  • Poor hygiene.
  • Apathetic and withdrawn or watchful and alert.

Risk Factors

  • Malnutrition.
  • Parental inexperience.
  • A negative emotional environment (neglect, abuse or rejection). Parents who were raised in a negative emotional environment or are poorly educated.
  • Chronic disease (e.g. HIV, kidney failure or chronic infection).
  • Genetic disorders, such as Down Syndrome or cystic fibrosis.
  • Endocrine diseases, including disorders of the thyroid, pituitary, adrenal, pancreas, and sexual glands.
  • Poverty.
  • Crowded or unsanitary living conditions.
  • Premature or sick newborn.
  • Infant with physical deformity.

Diagnosis & Treatment

  • Careful detailed history and physical examination are most important in making the diagnosis. Growth charts for length, weight, and head circumference help in confirming the diagnosis of failure to thrive.
  • Laboratory tests: Blood tests including hormone studies, urine tests and stool tests for malabsorption of fat and fats present.
    X-rays of wrist (to assess bone age) provides measure of body growth.
  • Psychological tests – such as Denver Developmental tests.

General Measures:

  • Psychotherapy or counseling, if parents have emotional problems that prevent a healthy relationship with the child.
  • Hospitalization (short-term), if complicated diagnostic procedures are necessary or food intake must be verified.
  • Provision of stimulation, cuddling, affection as in-patient or out-patient.
  • Parents should read books and pamphlets on child-rearing or attend parenting classes.

Medications:

  • None routinely.
  • If an underlying disorder is causing failure to thrive, medication to treat the condition may be prescribed.

Activity:

No restrictions.

Diet:

  • Provide your child with an adequate, well-balanced diet.
  • If malnutrition is causing failure to thrive, a special diet may be required.

Possible Complications:

  • Permanent mental, emotional or physical disability.
  • Child remains small and developmentally slow.
  • If proper care is not provided in the home, foster care may be necessary.

Prognosis

If failure to thrive is caused by parental inexperience or psychological problems, recovery is possible with education and counseling for the parents. If failure to thrive is caused by an underlying physical illness or disorder, including malnutrition, recovery depends on whether the condition can be corrected.

Long-term prognosis in children with failure to thrive due to environmental deprivation is not encouraging. Many children remain small, and may present with developmental and educational deficiencies. Only one-third will ultimately become normal.

Other

‘Nothing Specified’.