Failure to thrive (FTT) is a term used by pediatricians to describe a condition where a child abnormally loses weight or is underweight for the child’s age. FTT is not a disorder or illness, but a sign of insufficient nutrition intake by the child. Weight loss in newly born infants is considered normal and they should regain weight and progressively adding weight within three weeks after birth. In case infants don’t regain weight in three weeks and have lost more weight, parents must consult their pediatrician immediately for assessment. If not given proper attention, undernourishment may also affect brain development.
Failure to thrive is commonly used in referring weight deficiency but some pediatricians also used this term to describe poor physical growth in children. We may hear the term failure to grow instead of failure to thrive, to describe poor growth development. Or the pediatrician may use both.
The term failure to thrive was first used in the early 20th century. It was used to describe growth and weight under development among deprived orphans. FTT is a common problem in third world countries, where cases of poverty are prevalent. Although we may also find a few cases in first world countries like the United States that has six to eleven percent of outpatient children’s due to FTT. About three to five percent of children hospitalization worldwide can be traced back to undernourishment. Research says that FTT leading to hospitalization appears to be more common to male children than female.
Failure to thrive is not a disease or disorder but because it is characterized by undernourishment and if the cause is not exogenous, it may be a sign or symptom of other conditions.
The cause of failure to thrive is commonly divided into two groups:
- Endogenous (another term use is organic) – in this classification, the cause is believed to be internal or inborn defects.
- Exogenous (another term use is nonorganic) – the cause of FTT is more of irresponsible or deprived caregiving.
- Other possible reasons may include:
- Intentional or unintentional deprivation of a child’s basic needs
- Improper preparation of foods
- Maternal depression
- Food intolerance
- Metabolic problems
- Premature birth
If FTT is not given proper attention it may lead to long-term complications in the physical, social, and cognitive development of the child. They are at risk of carrying these complications up to adulthood. Research shows evidence that children with FTT have lower IQ, extremely shy, and likely not to achieve his full height potential. They also tend to have difficulties even in simple arithmetic procedures. This condition is very manageable. Once the problem is detected, the pediatrician and parents must work hand and hand to improve the child’s condition.
Early treatment is the key to effectively manage this condition, however, there are studies that show that intervention may render ineffective and behavioral problems may still persist. In this case, FTT may not be the culprit and behavioral problems may be caused by other factors. Consult your pediatrician for assessment.
In some cases, the infants’ weight problem can also be attributed to genetics. If one of the parents is thin, the infant may have a tendency of a slow progression of gaining weight.
Normally, failure to thrive will be apparent before the infant turns to two years old—when growth hormones are most active. However, there are instances when it would present itself after two years of age. One example is growth stagnation.
The primary signs of failure to thrive include poor eating habits and insufficient height and/or weight in relation to the same age group.
FTT is a sign of nutrient deficiency. It may not only affect weight or height but may also affect social behaviors and cognitive ability. Children who lack nutrient intake may exhibit the following behaviors:
- Lack of enthusiasm
- Avoids eye contact
- Frequent tantrums
- Learning and attention difficulties
- Gets tired easily
- Doesn’t talk much
- Delays in cognitive development (crawling and talking)
The doctor will closely evaluate the child’s condition every visit. Assessments may continue until pediatrician can definitively conclude the problem. Other than behavioral symptoms, the pediatrician will also look at signs of neuropathy, spoon nails, cheilitis, and roughing skin.
A regular visit to the doctor will likely prevent FTT. It should start during pregnancy until preteens. Evaluations will be conducted every visit to assess the overall well-being of the child. Also, during these periods, the doctor will continually monitor the child’s progress through a growth chart. The child may also be diagnosed with failure to thrive if his growth suddenly stagnates.
It’s important to maintain regular visits to the pediatrician. Failure to thrive may not be a disorder or disease itself but it may lead to a more serious condition or permanent disabilities in physical, mental, or emotional aspects. Regular check-ups will ensure the healthy development of the child.
The evaluation process may start with the pediatrician asking information about eating habits and social behaviors of the child.
Next process would be a physical examination. The pediatrician will record the child’s weight and height. These data’s will be used for the next visits, to monitor any abnormality in their development. And they’ll look into breathing patterns, heartbeat, and any signs of nutrient deficiencies. They’ll also look for any signs of physical abuse.
The pediatrician or doctor may also order the following laboratory tests:
- X-rays – this is to check bone condition.
- CBC – this is to check the proper distribution of nutrients in the bloodstream.
- Urinalysis – test if there are any existing infections.
- Electrolyte tests – to check any electrolyte imbalance.
- Hormone blood test – is a type of blood test to determine whether hormones are properly distributed to the entire body.
Forced eating a child is not advisable. Instead of improving the situation it may become even worst. It may create unnecessary stress on both the parents and especially the child. The experience may create a negative association on eating. It is recommended to seek counseling therapy to encourage the child to eat properly. For the parents, make mealtimes a positive experience to develop a good eating routine.
If negative eating behavior persists, the parents may seek help from the:
- The family pediatrician or doctor
- Or a social worker
There are instances when doctor consultation may be conducted at home. This is also to evaluate the home environment of the child.