Failure to thrive

General or Other | Paediatrics | Failure to thrive (Disease)


Failure to thrive (FTT) refers to a child whose physical growth is significantly less than that of peers.

Children that fail to thrive seem to be much smaller or shorter than other children the same age. Teenagers may not appear to have the usual changes that occur at puberty. However, its important to remember that the way children grow and develop varies quite a bit.

Symptoms of failure to thrive include: height, weight, and head circumference do not match standard growth charts; weight is lower than 3rd percentile (as outlined in standard growth charts) or 20% below the ideal weight for their height; growth may have slowed or stopped after a previously established growth curve.

Causes and Risk factors

Failure to thrive results from medical problems (chromosome problems, thyroid hormone deficiency, organ problems, damage to the brain or central nervous system, heart or lung problems, anemia or other blood disorders, gastrointestinal problems, long-term gastroenteritis, cerebral palsy, long-term (chronic) infections, metabolic disorders, complications of pregnancy and low birth weight) or factors in the environment, such as abuse or neglect.

In general, the childs rate of change in weight and height may be more important than the actual growth measurements. Children who fail to thrive may have the following delayed or slow to develop: (1) Physical skills such as rolling over, sitting, standing and walking; (2) Mental and social skills; (3) Secondary sexual characteristics (delayed in adolescents).

Failure to thrive in early infancy sometimes results in death, and in older infancy or childhood is an important marker for underlying disease. Causes of failure to thrive are probably many, including unrecognized food allergies leading to refusal of food and vomiting, undiagnosed metabolic disorders, and disease.

Diagnosis and Treatment

The goal is to identify the failure to thrive and determine the cause of the poor growth. The doctor checks the childs height, weight, and head size, and track these measurements using growth charts. Evaluation of the prenatal history, birth history and the home environment is also performed. Specific developmental tests may also be performed. Other blood and imaging tests are done to identify the disorder.

Therapy is aimed at improving the nutritional status and reversing the underlying cause. If psychosocial factors are involved, treatment involves educating the parents and improving the home environment. ...