Failure to thrive

Alternative names:

FTT; growth failure

Definition:

Failure of growth and development in infants, toddlers, preschoolers, schoolage children, or adolescents to meet realistic expectations due to genetic, physical, psychological, or social factors.

Causes, incidence, and risk factors:

Failure to thrive in infants and children is usually noticed by failure to gain height and weight. In teenagers, short stature and lack of sexual development is present. There is a wide variation in normal growth and development, and in general, the rate of change may be a better indicator of a problem than the actual measurements.
An important factor is determining whether the failure to thrive results from problems intrinsic to the patient or from problems within the environment. Problems intrinsic to the patient are usually medical problems. Problems within the environment are usually psychosocial.
There are multiple causes of failure to thrive that will disturb the body's metabolism enough to result in delayed growth. Chromosome abnormalities such as Down syndrome and Turner's syndrome will delay growth. Defects in major organ systems also can delay growth. Abnormalities of the endocrine system such as thyroid hormone deficiency, growth hormone deficiency, or other hormone deficiencies can cause delayed growth or sexual development. Damage to the brain or central nervous system may cause feeding difficulties in an infant that result in delayed growth. Abnormalities in the cardiac and respiratory systems can result in disturbed mechanisms to deliver oxygen and nutrients to the body. Children with anemia or other blood disorders may have growth delay. Abnormalities in the gastrointestinal system may result in malabsorption or absence of digestive enzymes resulting in inadequate nutrition. Some diseases that can lead to this failure include cerebral palsy, chronic gastroenteritis, and gastroesophageal reflux (usually temporary).

Psychological and social causes may include emotional deprivation as a result of parental withdrawal, rejection, or hostility. Economic factors can affect nutrition, living conditions, and parental attitudes. Environmental factors may include exposure to infections, parasites, or toxins. Sometimes the cause is undetermined.

Risk factors for failure to thrive are related to the causes and may include underlying undiagnosed diseases, poverty, negative emotional environments, and crowded or unsanitary living conditions.