Failure to thrive (FTT) is a description applied to children whose current weight or rate of weight gain is significantly lower than that of other children of the same age and sex.  It usually affects children in the age range from 0 to 5 years of age.  Several different factors can be the cause of FTT such as medical problems due to disease or psychosocial environmental problems such as parental inexperience, abuse and neglect.  3 to 5% of all children admitted to specialized care facilities and 1% of all children admitted to any hospital have failure to thrive.

One of the first signs of FTT is persistent vomiting in an infant between 0 to 6 months of age.  In addition, their height, weight and head circumference do not progress normally, as measured on doctors' growth charts.  The development of physical skills are slow, as in, turning over in bed, sitting, standing and walking.  Also, their mental and social skills are delayed, such as talking, social interaction, self-feeding, and toilet training.  Some other factors that may cause FTT are malnutrition, chronic disease, kidney failure, chronic infection, and genetic disorders such as Down's Syndrome or Cystic Fibrosis.  Endocrine diseases including disorders of the thyroid, pituitary, adrenal, pancreas and sexual glands can be the cause of FTT. Normal growth and development vary widely.  The rate of change as measured at regular medical checkups is more significant in diagnosing this illness.

Major risk factors include poverty, parents who were raised in a negative emotional environment or are poorly educated, and crowded or unsanitary living conditions.  To prevent complications or recurrence you should arrange for parenting classes if you are an expectant mother or father.  Also, take your child regularly to the doctor for "well-baby" checkups.

Basic information and medical tests can alert you as to whether your child has FTT or not.  First and foremost are your own observations of symptoms.  Know your child's medical history.  Physicians may perform tests on your child such as the Denver Developmental Test which measures the child's growth and development, laboratory blood tests, hormone studies, and x-rays of the child's hands which provide a good measure of body growth.

If not treated immediately FTT can cause permanent mental, emotional and physical disability.  If a child's failure to thrive is caused by parental inexperience or psychological problems, recovery is possible with education and counseling for the parents.  If a child's failure to thrive is caused by an underlying physical illness or disorder, including malnutrition, recovery depends on whether the condition can be corrected.

Griffith, M.D., H. Winter. Complete Guide to Pediatric Symptoms, Illness & Medications. : , 1998.

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