Let us discuss ‘Failure to Thrive’

Permit me a space in your respected and committed weekly health column to ask that you discuss the issue of ‘Failure to Thrive’. My child of about 12 months is not growing as expected compared to his peers. We took him to a doctor and confirmed he is suffering from ‘Failure to Thrive’. Kindly enlighten us.

–           Geraldine V

Thanks, Geraldine, for your question and wish your child happy growth and development. Children are considered as failing to thrive when their rate of growth does not meet the expected growth rate for a child their age.  The average full-term baby doubles its birth weight by six months and triple it by one year.

Children with failure to thrive are often not meeting those milestones. If a baby continues to lose weight or does not gain weight as expected, he or she is probably not thriving. Children who fail to thrive are either not receiving or have an inability to take in or retain adequate nutrition to gain weight and grow.

What are the causes?

The causes of failure to thrive are typically differentiated into organic and non-organic. Organic causes are those caused by an underlying medical disorder. Inorganic causes are those caused by a caregiver’s actions.

Organic causes of failure to thrive may include:

1. 1. Premature birth, especially if the fetus had intrauterine growth retardation
2. 2. Maternal smoking, alcohol use, or illicit drugs during pregnancy
3. 3. Mechanical problems present, resulting from a poor ability to suck or swallow, for example, presence of cleft lip and cleft palate
4. 4. Unexplained poor appetite that is unrelated to mechanical problems or structural abnormalities, for example, breathing difficulties that can result from congestive heart failure (any difficulty in breathing makes eating more difficult and can result in it. Inadequate intake also can result from metabolic abnormalities, excessive vomiting caused by obstruction of the gastrointestinal tract, or kidney dysfunction.
5. 5. Poor absorption of food, inability of the body to use absorbed nutrients, or increased loss of nutrients

Non-organic causes of failure to thrive are:

1. 1. Poor feeding skills on the part of the parent or caregiver.
2. 2. Dysfunctional family interactions
3. 3. Difficult parent-child interactions
4. 4. Lack of social support
5. 5. Lack of parenting preparation
6. 6. Family dysfunction, such as abuse or divorce
7. 7. Child neglect and emotional deprivation

What are the symptoms of failure to thrive?

1. 1. Delayed social and mental skills
2. 2. Delayed development of secondary sexual traits in adolescents
3. 3. Height, weight, and head circumference in an infant or young child not progressing as expected on growth charts
4. 4. Edema (swelling)
5. 5. Wasting and Enlarged liver
6. 6. Rashes or changes in the skin and hair texture

Diagnosis:

• If a child fails to gain weight for three months in a row during the first year of life, physicians normally become concerned. The most important part of a physician’s evaluation is taking a detailed history.
• Prenatal history is important, and the doctor will want to know if the pregnant mother smoked, consumed alcohol, used any medications, or had any illness during the pregnancy.
• The doctor will also want a dietary history, to determine if there have been any feeding problems.

Treatment options:

• Because there are numerous factors that may contribute to a failure to thrive diagnosis, children diagnosed with the disorder sometimes have an entire medical team working on the case and treating them.
• If there is an underlying physical cause, correcting that problem may reverse the condition.
• The doctor will recommend high-calorie foods and place the child on a high-density formula.