What is failure to thrive?
Failure to thrive is defined as decelerated or arrested physical growth (height and weight measurements fall below the third or fifth percentile, or a downward change in growth across two major growth percentiles) and is associated with abnormal growth and development. The reason for failure to thrive is inadequate nutrition.
Previously, failure to thrive was categorized as either organic (underlying medical condition) or non-organic (no known medical condition). However, this categorization is considered outdated as the causes and effects of malnutrition are usually intertwined in most children.
Causes of failure to thrive
Failure to thrive has many different causes, and sometimes more than one cause may contribute to the condition at the same time. If an infant is not offered enough food or is not willing to eat enough food, or vomits repeatedly (such as with severe gastroesophageal reflux), there will not be enough calories to support growth. A child who is unable to absorb enough calories (such as with severe allergies or a medical condition like cystic fibrosis) will also not grow as expected. Any condition that causes a child to need more calories than normally expected may also lead to failure to thrive.
Symptoms of failure to thrive
Generally, an affected child’s weight falls below the 3rd percentile on standard growth charts. A change in the rate of growth, rather than specific numbers, is also an indicator. For example, if your child has been growing well, but their growth stagnates, they may have FTT.
Your child may have an unsteady rate of growth. Some children who fail to thrive exhibit the following symptoms:
- lack of weight gain
- delays in reaching developmental milestones such as rolling over, crawling, and talking
- learning disabilities
- lack of emotions such as smiling, laughing, or making eye contact
- delayed motor development
- fatigue
- irritability
- delayed puberty in teens
Diagnosing failure to thrive
Failure to thrive is usually discovered and diagnosed by the infant’s physician. Infants are always weighed and measured when seen by their physicians for well-baby check-ups. The physician initiates a more complete evaluation when the infant’s growth, development, and functioning are found to be delayed.
Tests can assess the effects of FTT on your child’s health and growth. These may include:
- blood tests
- urine tests
- X-rays
- developmental screenings
Causes Failure to Thrive in Children
A child is said to have failure to thrive when they don’t meet recognized standards of growth. Failure to thrive isn’t a disease or disorder. Instead, it describes a situation in which a child is undernourished and either doesn’t receive or is unable to process enough calories. An example of failure to thrive (FTT) would be a child who is persistently below the standard weight range for their developmental stage. Typically, a doctor will diagnose failure to thrive during a child’s infant years. A doctor determines a child’s ideal weight by comparing their weight, age, and gender to national averages. Children who fail to thrive usually fall well below their ideal weight. A child may also be diagnosed with FTT if their growth rate in terms of height stalls when it should be on an upward trend.
Ask your doctor for a chart that lists ideal height and weight ranges for children to help moni tor your child’s development.
Failure to Thrive Risk factors in Children
Risk factors for a child failing to thrive include underlying conditions, such as:
- acid reflux
- infections
- milk allergy
- cystic fibrosis
- Down syndrome
- cerebral palsy
- heart disease
- celiac disease
Children who have serious medical problems during the early years of their life can develop FTT. Children who are born prematurely and have low birth weight may also fail to thrive.
Other risk factors include:
- physical abuse
- mental trauma
- mental disorders, such as depression
- poor feeding habits
- neglect
- environmental factors, such as poverty
- poor nutrition
Who is affected by failure to thrive?
Infants born into families with inadequate support or understanding of infant needs may not provide the right kinds or amounts of food. For example, too much fruit juice, problems breastfeeding, or failure to introduce solids at an appropriate age may lead to too little calories being consumed. Babies and children with developmental delay or problems swallowing may consume too few calories. Conditions such as cystic fibrosis, celiac disease, or severe allergy or intolerance may consume enough food but not be able to absorb it properly. A child with a chronic medical condition, such as congenital heart disease or a genetic syndrome, may need more calories than expected. In severe cases, neglect or abuse may be associated with failure to thrive if food is purposely withheld from a baby.
Diagnosing failure to thrive
Tests can assess the effects of FTT on your child’s health and growth. These may include:
- X-rays
- developmental screenings
- blood tests
- urine tests
Caregivers may need counseling if the doctor suspects that unhealthy practices in the family are a cause.
Symptoms of failure to thrive
Generally, an affected child’s weight falls below the 3rd percentile on standard growth charts. A change in the rate of growth, rather than specific numbers, is also an indicator. For example, if your child has been growing well, but their growth stagnates, they may have FTT.
Your child may have an unsteady rate of growth. Some children who fail to thrive exhibit the following symptoms:
- learning disabilities
- lack of emotions such as smiling, laughing, or making eye contact
- delayed motor development
- delays in reaching developmental milestones such as rolling over, crawling, and talking
- irritability
- delayed puberty in teens
- fatigue
- lack of weight gain
Failure to Thrive Prevention
Regular checkups can prevent failure to thrive. These should begin during your pregnancy and continue through adulthood. Your doctor should regularly plot your child’s growth on growth charts.
A child with FTT may be small compared to other children of the same age and gender. Their growth pattern may not be steady. Have regular checkups with a pediatrician to get the most accurate analysis of your child’s growth.
Because failure to thrive can lead to permanent mental, emotional, and physical delays, it’s important to have regular checkups so that doctors can monitor your child’s health.
Failure to thrive treatment
Treatment options vary depending on:
- the family environment
- the cause of condition
- the overall health of the child
- the severity of symptoms
- the preferences of parents or caretakers
Some cases of failure to thrive may be resolvable once a doctor treats the underlying condition. If FTT requires further care, the child’s doctor may prescribe nutritional supplements or a special diet.
When FTT has a connection to problems at home, your doctor may consult social services. Hospital care, including the use of feeding tubes, can provide extra nourishment in cases of severe FTT.
After your child’s growth has reached normal levels, they may need help to keep physical and mental growth on track. Physical therapists, speech therapists, occupational therapists, dietitians, and other specialists may be able to help your child.