FAILURE TO THRIVE

General Information

DEFINITION--Failure of infants or children to grow and develop normally. This term is used until a specific diagnosis can be established.

BODY PARTS INVOLVED--All.

SEX OR AGE MOST AFFECTED--Children under 5, usually infants, ages 3-6 months.

> Normal growth and development vary widely. The rate of change--as measured at regular medical checkups--is more significant.

CAUSES

• In about 20% of these children, the cause is organic, usually gastrointestinal problems or neurological problems.
• In about 70% of the children, the cause is environmental, such as incorrect feeding.
• Another 10% are normal small children who are not diagnosed as failure to thrive.

RISK INCREASES WITH

• Malnutrition; parental inexperience; a negative emotional environment (neglect, abuse or rejection).
• Chronic disease (e.g., kidney failure).
• Fetal Alcohol Syndrome.
• Genetic disorders, such as Down syndrome or cystic fibrosis.
• Endocrine diseases, including disorders of the thyroid, pituitary, adrenal, pancreas and sexual glands.
• Poverty.
• Parents who were raised in a negative emotional environment or are poorly educated.
• Crowded or unsanitary living conditions.
• Premature or sick newborn.
• Infant with physical deformity.

HOW TO PREVENT

• Arrange for parenting classes if you are an expectant mother or father.
• Take your child regularly to the doctor for "well-baby" checkups.
• Provide a stable home life with caring parents.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Diagnostic tests: Repeated measurements of height, weight and head circumference; psychological tests, such as the Denver Developmental test, which measures growth and development; laboratory blood tests, including hormone studies; x-rays of the wrists (bone age), which measure body growth.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Psychotherapy or counseling, if parents have emotional problems that prevent a healthy relationship with the child.
• Hospitalization (short-term), if complicated diagnostic procedures are necessary or food intake must be verified.

POSSIBLE COMPLICATIONS

• Permanent mental, emotional or physical disability.
• Child remains small and developmentally slow.
• If proper care is not provided in the home, foster care may be necessary.

PROBABLE OUTCOME--

• If failure to thrive is caused by parental inexperience or psychological problems, recovery is possible with education and counseling for the parents.
• If failure to thrive is caused by an underlying physical illness or disorder, including malnutrition, recovery depends on whether the condition can be corrected.

How To Treat

GENERAL MEASURES--

• Read books and pamphlets on child-rearing or attend parenting classes.
• Ask a visiting nurse for guidance.
• Provide as much love and support as possible for your child. Examine your feelings and behavior toward your child. If you don't think they are what they should be, arrange for psychological counseling.

MEDICATION--If an underlying disorder is causing failure to thrive, your doctor may prescribe medication to treat the condition.

ACTIVITY--No restrictions.

DIET--

• Provide your child with an adequate, well-balanced diet.
• If malnutrition is causing failure to thrive, your doctor may prescribe a special diet.

Call Your Doctor If

You are concerned that your child is not developing properly.