Failure-to-thrive is a term used to describe a child who is not growing as expected. But, it is not the same as normal growth in a child who is small for his or her age. The exact definition is not completely agreed upon.
In general, failure-to-thrive means that a child:
Is at or below the 3rd to 5th percentile for height and weight, or
Has failed to grow as expected, as shown by dropping two growth percentiles (For example, the child goes from the 75th percentile to below the 25th percentile.)
Organic failure-to-thrive—caused by some other medical condition
Nonorganic failure-to-thrive—occurs in children with no known medical condition
Mixed failure-to-thrive—occurs when the child has features of both organic and nonorganic failure-to-thrive
Slowed growth in a young child, including height and weight
Slowed development, including late rolling, sitting, crawling, standing, walking, and talking
Weakness, low energy
Loose folds of skin
Other symptoms related to an underlying medical condition
Failure-to-thrive is diagnosed based on tracking a child's growth. The doctor will plot a child's weight, height, and head circumference on standard growth charts. If the child falls below a certain weight range or drops two percentiles on the growth chart, the doctor will evaluate the child further.
If a medical condition may be the cause, the doctor will order further tests. Tests may include:
X-rays of the gastrointestinal tract, skeletal survey, bone age
Sometimes, a child must be hospitalized for a period of time to find the cause of failure-to-thrive. During this time the doctor will:
Monitor the relationship between parent and child, paying particular attention to their behavior around feeding
Set up a feeding schedule with an adequate amount of calories
Make sure that an appropriate feeding technique is used
If the child can gain weight under these circumstances, this supports the diagnosis of nonorganic failure-to-thrive.
Treatment may include:
Treating a Medical Condition
Treating the underlying medical condition may correct failure-to-thrive.
Providing Extra Calories
Children who are malnourished may need liquid supplements to help boost their weight and nutrition.
When a child is hospitalized for diagnosis, the hospital staff can also provide treatment. Nurses can teach parents appropriate feeding techniques and how to best interact with their child. If the child isn't hospitalized, parents can still have training sessions with a nutritionist or a nurse.
Parents and children who are having difficulty with their relationship may benefit from counseling.
To help prevent failure to thrive:
Take children to the doctor regularly to have their growth checked. This helps detect and treat failure-to-thrive before it becomes severe.
Develop a good relationship with your child's doctor.
Ask the doctor about proper parenting and nutrition for early in a baby's life.
Encourage at-risk parents to attend parent-training sessions. At-risk includes:
Known depression in the parent
Lack of understanding about basic childcare issues
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a