Failure-to-Thrive is a term used to describe a child who is not
growing as expected. But it is not the same as normal growth in a child who is
small for his or her age. The exact definition is not completely agreed upon.
In general, failure-to-thrive means that a child:
- Is at or below the 3rd to 5th percentile for height and weight; or
- Has dropped two growth percentiles (For example, the child goes from the
75th percentile to below the 25th percentile.)
Types include:
Organic Failure-to-Thrive – caused by some other medical condition
Nonorganic Failure-to-Thrive – occurs in children with no known medical
condition
Mixed Failure-to-Thrive – occurs when the child has features of both
organic and nonorganic failure-to-thrive
Risk Factors
A risk factor is something that increases your chance of getting a disease or
condition.
- Untreated medical conditions
- Poverty, including lack of available food
- Poor parenting skills
- Depression in the parent
Diagnosis
Failure-to-Thrive is diagnosed based on tracking a child's growth. The
doctor will plot a child's weight, height, and head circumference on standard
growth charts. If the child falls below a certain weight range or drops two
percentiles on the growth chart, the doctor will evaluate the child further.
If a medical condition may be the cause, the doctor will order further tests.
Tests may include:
- Blood tests
- Urine tests
- Blood lead level
- HIV test
- Thyroid tests
- Sweat-chloride test
- Gastrointestinal x-rays
Sometimes, 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
If the child can gain weight under these circumstances, this supports the
diagnosis of nonorganic failure-to-thrive.
Treatment
Treatment may include:
Treating a Medical Condition
Treating the underlying medical condition may correct failure-to-thrive.
Providing Extra Calories
Children who are malnourished may need liquid supplements to help boost their
weight and nutrition.
Parent Training
When a child is hospitalized for diagnosis, the hospital staff can also provide
treatment. Nurses can teach parents appropriate feeding techniques and how to
best interact with their child. If the child isn't hospitalized, parents can
still have training sessions with a nutritionist or a nurse.
Counseling
Parents and children who are having difficulty with their relationship may
benefit from counseling.