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Failure to thrive is a descriptive term for those children less than 5 years of age who have poor weight

gain.
Classically failure to thrive has been described as weight less than the 3rd centile on two or more
separate occasions, or weight which crosses two centile lines over time.

Failure to thrive refers to children whose current weight or rate of weight gain is much lower than that
of other children of similar age and gender.

Failure-to-thrive can occur when a child:

Is at or below the third to fifth percentile for height and weight.


Has failed to grow as expected. This is shown by crossing two percentile lines on the
growth chart.

Failure-to-thrive is split into three different types. These types include:

Organiccaused by some medical condition


Nonorganicoccurs in children with no known medical condition
Mixedoccurs when the child has features of both

Failure to thrive may be caused by medical problems or factors in the childs environment, such
as abuse or neglect.
There are many medical causes of failure to thrive. These include:

Problems with genes such as Down syndrome


Organ problems
Hormone problems
Damage to the brain or central nervous system, which may cause feeding difficulties in
an infant
Heart or lung problems, which can affect how nutrients move through the body
Anemia or other blood disorders
Gastrointestinal problems that make it hard to absorb nutrients or cause a lack of
digestive enzymes
Long-term (chronic) infections
Metabolism problems
Problems during pregnancy or low birth weight

Factors in the childs environment include:

Loss of emotional bond between parent and child


Poverty
Problems with child-caregiver relationship

Parents do not understand the appropriate diet needs for their the child
Exposure to infections, parasites, or toxins
Poor eating habits, such as eating in front of the television and not having formal meal
times

Many times the cause cannot be determined.

Symptoms
Failure-to-thrive may cause:

Slowed growth in a young child, including height and weight


Slowed development, including late rolling, sitting, crawling, standing, walking, and
talking
Small muscles
Weakness, low energy
Hair loss
Loose folds of skin
Other symptoms related to an underlying medical condition

Diagnosis

Failure-to-thrive is diagnosed based on following a child's growth. Your child's weight, height,
and head circumference will be potted on standard growth charts. If the child falls below a
certain weight range or crosses two lines on the growth chart, the doctor will evaluate the child
further.
Based on your child's symptoms, additional tests may be ordered.
Rarely, a child must be hospitalized for a period of time to find the cause of failure-to-thrive.
During this time, the doctor will:

Monitor the relationship between parent and child, paying particular attention to their
behavior around feeding
Set up a feeding schedule with an adequate amount of calories
Make sure that an appropriate feeding technique is used

This will also be done in an outpatient setting and often require referrals to feeding specialists.
If your child can gain weight under these circumstances and no underlying disease is found, this
supports the diagnosis of nonorganic failure-to-thrive.

The doctor will perform a physical exam and check the child's height, weight, and body
shape. Parents will be asked about the child's medical and family history.
A special test called the Denver Developmental Screening Test will be used to show any delays
in development. A growth chart outlining all types of growth since birth is created.
The following tests may be done:

Complete blood count (CBC)


Electrolyte balance
Hemoglobin electrophoresis to check for conditions such as sickle cell disease
Hormone studies, including thyroid function tests
X-rays to determine bone age
Urinalysis