Information From Your Health Care Provider

FAILURE TO THRIVE

Basic information

description

Failure to thrive is actually a group of symptoms, rather than a specific disorder. The term is used to described infants or children who do not grow or gain weight at the expected rate. There are many possible causes.

FREQUENT SIGNS & SYMPTOMS

Height and weight do not progress normally, as measured on standard growth charts.
Physical skills may be slow to develop. This includes rolling over, sitting, crawling, standing, or walking.
Mental and social skills may be delayed. This includes talking, social interaction, or self-feeding.
Child lacks energy, has small muscles, rash or other skin changes, swollen arms or legs, and changes in hair.
Other symptoms (they may be due to a medical condition).

causes

It may be due to medical conditions (sometimes called organic failure). It may involve psychosocial and environmental causes, such as family concerns or problems in the home (sometimes called nonorganic failure). It may also be a combination of the two.

risk increases with

Pregnancy problems (such as alcohol use or intrauterine growth restriction) or premature infants or children with chromosomal abnormalities.
Children who have trouble eating, are unable to suck, have vomiting or reflux problems, or have infections.
Children who are unable to absorb nutrients or need extra nutrients, due to certain medical disorders.
Children with chronic illness (cystic fibrosis, asthma).
Child neglect, abuse, or lack of attention by parents.
Not providing enough food for a child. Child who refuses to eat, or problems with weaning a child.
Parents who lack parenting skills.
Dysfunctional family, difficult parent-child interactions, or lack of support (family or friends).
Depression, alcohol or drug abuse in a parent.
Poverty of parents (unable to provide needed foods).

PREVENTIVE MEASURES

Get instructions on proper nutrition for a new baby.
Take your child regularly to "well-baby" checkups.
Arrange for parenting classes if you are new parents.

expected outcomes

If the problem is short-term and the cause can be corrected, normal growth and development may resume. Recovery may take several months. In other cases, the outcome will depend on the underlying condition.

possible complications

Ongoing mental, emotional, and physical delays.

diagnosis & treatment

general measures

Your child's health care provider will do a physical exam. The child's height and weight will be compared to standard growth charts to determine if there is delayed growth. Medical tests may include blood and urine studies. To help pinpoint a cause for growth delay, questions may be asked about the pregnancy and birth, the child's behavior and eating habits, other family members, stress problems, and other concerns.
Treatment will depend on the cause. Organic causes may be treated medically. Nonorganic causes may be treated with counseling, education, and other help for the parents. The main goal of any treatment is to be sure your child has the proper nutrition.
Hospital care may be needed for some children.
Home visits from a nurse may be recommended.
Community programs that help mothers and children are available. Other help can be provided to get financial aid (such as food stamps), medical benefits, parenting classes, or counseling for emotional problems.
If child neglect or abuse is suspected, child protective services or other authorities may become involved.

medications

Drugs may be prescribed for an underlying disorder.

activity

No limits.

diet

Changes in your child's diet will be prescribed. They may include special formulas for infants, high-calorie foods for older children, and high-energy shakes (such as Pediasure or Boost). Specific instructions will be provided. Be sure to follow the instructions carefully.
Tube feedings may be needed for severe cases. These can often be done at home.

notify our office if

You are concerned that your child is not developing properly or growing as expected.
You have any questions and concerns about the diet instructions for your child or other symptoms occur.