The first years of life are crucial for physical and mental development. Children gain weight and grow faster in these years. However, delay in physical growth and weight gain is a common problem among young children. Failure to thrive in the early years, even if the physical growth improves, can lead to mental, emotional and social problems in adulthood.
What is failure to thrive?
Growth failure or ‘failure to thrive’ is a term used for describing inadequate growth in early childhood. It is applied to children whose current weight or rate of weight gain is significantly below (less than the fifth percentile) other children of similar age and sex.
What are the symptoms?
Many children may not gain weight or even lose a little weight for a brief period of time. However, if your child does not gain weight for three consecutive months during the first year of life, it’s a matter of concern.
The most common symptoms of failure to thrive are irritability, excessive sleepiness, lack of interest in their surroundings, lack of age-appropriate social response, thin and wasted appearance, pale skin, swollen stomach, avoiding eye contact, delayed motor development and absence of vocal sounds. Since these symptoms may look like other conditions, you need to consult your child’s health care provider to check and see if your child meets the developmental milestones.
Who is affected by failure to thrive?
Infants from families with social, economic, or mental health, problems are at higher risk of developing failure to thrive. Other risk factors include depression in a mother or primary care giver, stress, alcohol or drug abuse, and lack of warmth toward the infant.
What causes failure to thrive?
There are many causes for failure to thrive. Most cases involve environmental and social factors that keep the child from getting proper nutrition. Examples include parental neglect or abuse, parental mental health disorders, the amount of money spent on food and the nutritional value of food they buy. Sometimes failure to thrive is caused by medical disorders such as conditions involving the gastrointestinal system, chronic illness, milk protein intolerance, infections and hormonal or metabolic disorders.
How is failure to thrive diagnosed?
Health care providers, during well-baby exams, use standard growth charts, and weight, length and head circumference measurements to determine if there is any problem with growth. If a child falls below his or her weight range for age, or does not gain weight at the expected rate, the health care provider will do a careful history and exam. The provider will ask parents some specific questions about feeding, bowel habits, and the social, emotional and financial stability of the family that might affect the child’s access to food; as well as illnesses that the child or family has had. The provider will do a thorough physical examination and may do selective tests in order to make a proper diagnosis.
Treatment depends on the cause. In case of medical problems, specific treatment is given. In case of environmental factors and poor nutrition, the child can be treated at home with nutritious high-calorie feeding. More severe cases may require tube feeding; and a child with extreme failure to thrive may need to be hospitalized.
When to seek help?
The best way to prevent failure to thrive is by early detection at routine well-baby examinations and periodic follow up with older children. If your child is consistently underweight or does not gain weight for unclear reasons, or you are worried about your child’s development, or think there is a problem, please contact your child’s health care provider.
References and Resources:
The American Academy of Pediatrics
Medline Plus, A service of the U.S. National Library of Medicine and the National Institutes of Health
