Signs of Failure to thrive

Description

A general description applied to children who fail to gain weight at the appropriate rate. Most infants double their birth weight by 4 months of age and triple it by 1 year of age. Delays in achieving the correct height are many times also observed. The diagnosis is made when the child's weight falls lower than the 3rd percentile (compared to peers using a growth chart) or 20% below the ideal weight for their height. There are many causes of FTT including: psychosocial, prenatal complications, central nervous system abnormalities, muscular diseases, gastrointestinal disorders, hormonal imbalances, and metabolic problems. Treatment is aimed at identifying and reversing the cause while improving the child's nutrition.

Symptoms

Infants display developmental delays such as problems rolling over, sitting, standing and walking. Lack of interest in feeding, and low energy are also observed. Later in life patients may exhibit poor mental and social skills, and delays in displaying secondary sexual characteristics.

Tests

A history and physical exam will be performed. The goal is to identify the failure to thrive and determine the cause of the poor growth. The provider will check the child's height, weight, and head size, and track these measurements using growth charts. Evaluation of the prenatal history, birth history and the home environment will be done. Specific developmental tests such as the Denver Developmental Screening Test may be performed. Other blood and imaging tests are done to identify an underlying disorder.

Standard Workup

CBC
Chem 12
UA
X-Ray

Treatment

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. Hospitalization may be necessary to reverse the nutritional problems and complete the work-up.