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Failure to Thrive

What is Failure to Thrive? 

Children are diagnosed with failure to thrive when their weight or rate of weight gain is significantly below that of other children of similar age and gender. Infants or children that fail to thrive seem to be dramatically smaller or shorter than other children the same age. Teenagers may have short stature or appear to lack the usual changes that occur at puberty. However, there is a wide variation in what is considered normal growth and development. 

Symptoms 

In general, the rate of change in weight and height may be more important than the actual measurements. 

Infants or children who fail to thrive have a height, weight, and head circumference that do not match standard growth charts. The person's weight falls lower than 3rd percentile (as outlined in standard growth charts) or 20% below the ideal weight for their height. Growing may have slowed or stopped after a previously established growth curve. 

The following are delayed or slow to develop:

  • Physical skills such as rolling over, sitting, standing and walking
  • Mental and social skills
  • Secondary sexual characteristics (delayed in adolescents)

Diagnosis 

It is important to determine whether failure to thrive results from medical problems or factors in the environment, such as abuse or neglect.

There are multiple medical causes of failure to thrive. These include:

  • Chromosome abnormalities such as Down syndrome and Turner syndrome
  • Defects in major organ systems
  • Problems with the endocrine system, such as thyroid hormone deficiency, growth hormone deficiency, or other hormone deficiencies
  • Damage to the brain or central nervous system, which may cause feeding difficulties in an infant
  • Heart or lung problems, which can affect how oxygen and nutrients move through the body
  • Anemia or other blood disorders
  • Gastrointestinal problems that result in malabsorption or a lack of digestive enzymes
  • Long-term gastroenteritis and gastroesophageal reflux (usually temporary)
  • Cerebral Palsy 
  • Long-term (chronic) infections
  • Metabolic disorders
  • Complications of pregnancy and low birth weight

Other factors that may lead to failure to thrive:

  • Emotional deprivation as a result of parental withdrawal, rejection, or hostility
  • Economic problems that affect nutrition, living conditions, and parental attitudes
  • Exposure to infections, parasites, or toxins
  • Poor eating habits, such as eating in front of the television and not having formal meal times

Many times the cause cannot be determined.

Treatment 

The treatment depends on the cause of the delayed growth and development. Delayed growth due to nutritional factors can be resolved by educating the parents to provide a well-balanced diet. 

If psychosocial factors are involved, treatment should include improving the family dynamics and living conditions. Parental attitudes and behavior may contribute to a child's problems and need to be examined. In many cases, a child may need to be hospitalized initially to focus on implementation of a comprehensive medical, behavioral, and psychosocial treatment plan.

Do not give your child dietary supplements without consulting your physician first.

Failure to Thrive is treated at Hopkins Children's by the division of Gastroenterology and Nutrition.  

External Links:

U.S. National Library of Medicine 

National Institutes of Health