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Introduction

Failure to thrive is a generalized term used to describe a condition of poor growth in children; this can have multiple causes, and thus require a thorough evaluation. This condition takes into three important parameters, Height/ Length, weight and Head Circumference. There is no standard definition of failure to thrive. Nor is there a standard time frame for how long it should exist before taking action. General pediatric consensus states that generally patients who fall below 5%tile – 2%tile or those who fall of the growth curve by two curves. Numerous factors need to be considered, and can be subdivided into organic causes, or inorganic causes (psychosocial factors, eg poverty, or maternal inexperience, or neglect). Failure to thrive is a bit tricky because by itself it’s not a diagnosis but a symptom to warrant further evaluation to isolate the cause.

Causes of Failure to Thrive

The most common cause of failure to thrive, is insufficient nutritional/caloric intake, (inorganic cause) could be due to many causes, Mothers lack of knowledge, (seen in teenage pregnancy), poor socioeconomic status, abuse in the form of neglect.

Organic causes

Celiac disease, Pyloric stenosis, GI malformations, immune deficiencies, malignancy Thyroid disease,

Management

Because failure to thrive is mostly a psychosocial issue,  and both the care provider and the patient need to be evaluated, to identify the cause, often time’s blood tests will not yield the cause of the problem and are generally not the next step in management. Getting more details of the family dynamic and Childs feeding habits are more important then lab tests.

Treatment

Parental education, will be key to treatment in most cases, advice will be directed at the cause, for example.. cause is no money for food, suggest resources for free meals
If cause is parental depression, then psychotherapy and counseling services to treat parent.….If abuse/neglect is suspected, then hospitalization is warranted. If poor parental knowledge is the cause, provide nutritional support to educate parents on thickening meals.. ( cream sauces add gravy sauces, increase fat content) ..

In medicine doctors will come across patients of multiple backgrounds, some diets are plant and water based..ie south Indian diets,) so in patients who leave their country often times leave a support system and come to America with little knowledge of culture and dietary options.. People may not know about things like sour cream or, mayonnaise) so the doctor is the support system and should provide the proper nutritional counseling needed.If the condition is due to a a medical cause then treatment should be directed at the medical condition…

Was your child diagnosed failure to thrive? Do you feel your questions went unanswered?  Do you want to sit one on one with our pediatrian, and discuss your unique case? .. Contact us…

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