Failure to thrive

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Failure to thrive
Growth chart for boys, birth to 36 months
Synonyms	Growth failure, weight faltering
Pronounce	N/A
Specialty	N/A
Symptoms	Poor weight gain, malnutrition, developmental delay
Complications	Developmental delay, immune deficiency, short stature
Onset	Infancy or early childhood
Duration	Variable, depending on cause and treatment
Types	N/A
Causes	Inadequate caloric intake, malabsorption, chronic illness, neglect
Risks	Premature birth, low birth weight, chronic medical conditions
Diagnosis	Growth chart analysis, medical history, physical examination
Differential diagnosis	Celiac disease, cystic fibrosis, hypothyroidism, congenital heart disease
Prevention	N/A
Treatment	Nutritional support, addressing underlying causes, multidisciplinary approach
Medication	N/A
Prognosis	Varies; better with early intervention
Frequency	Common in pediatric practice
Deaths	N/A

Failure to thrive (FTT) is a medical condition observed in infants and children who do not gain weight or grow as expected. It is not a disease or disorder itself, but rather a sign of underlying issues that may be nutritional, medical, or psychosocial in nature.

Definition

Failure to thrive is typically defined by a child's weight being below the 3rd or 5th percentile for their age and sex on standardized growth charts, or a significant drop in growth percentiles, such as crossing two major percentile lines. It is important to note that FTT is a descriptive term and not a diagnosis.

Causes

The causes of failure to thrive can be broadly categorized into three groups:

Organic Causes

Organic causes are related to medical conditions that affect a child's ability to take in, absorb, or utilize nutrients. These may include:

• Gastroesophageal reflux disease (GERD)
• Cystic fibrosis
• Congenital heart disease
• Chronic infections
• Metabolic disorders

Non-Organic Causes

Non-organic causes are often related to environmental or psychosocial factors, such as:

• Inadequate caloric intake due to improper feeding techniques
• Neglect or abuse
• Parental mental health issues
• Poverty or lack of access to food

Mixed Causes

In many cases, failure to thrive results from a combination of organic and non-organic factors. For example, a child with a mild medical condition may not receive adequate nutrition due to parental misunderstanding or lack of resources.

Diagnosis

Diagnosis of failure to thrive involves a comprehensive evaluation, including:

• Detailed medical history
• Physical examination
• Growth measurements plotted on standardized growth charts
• Laboratory tests to rule out underlying medical conditions

Management

Management of failure to thrive depends on the underlying cause. It may involve:

• Nutritional interventions, such as high-calorie diets or supplements
• Treatment of underlying medical conditions
• Psychosocial support for the family
• Education on proper feeding techniques

Prognosis

The prognosis for children with failure to thrive varies depending on the cause and the timeliness of intervention. Early identification and management can lead to significant improvements in growth and development.

See also

• Malnutrition
• Pediatric nutrition
• Growth chart
• Child development