Failure to Thrive

Aka: Failure to Thrive, Failure to Thrive in Children, Pediatric Failure to Thrive, Weight Faltering, FTT

1. See Also
   1. Delayed Growth (Short Stature)
   2. Failure to Thrive Causes
   3. Failure to Thrive Diagnosis
   4. Failure to Thrive Red Flags
   5. Failure to Thrive Evaluation
   6. Failure to Thrive Management
   7. Failure to Thrive in the Elderly
2. Definition
   1. Inadequate weight gain (or Weight Faltering) over time
   2. Malnutrition due to inadequate Caloric Intake or absorption or excessive caloric expendature
3. Epidemiology
   1. Incidence
      1. Hospitalized children <2 years: 1-5%
      2. Families with Medical, Psychosocial problems: 10%
4. Causes
   1. Failure to Thrive Causes
5. Signs
   1. Weight is affected first by Malnutrition
   2. Length and Head Circumference affected in severe cases
   3. Cognition and failure to meet Developmental Milestones may occur in very severe cases
6. Diagnosis: Failure to Thrive
   1. See Failure to Thrive Diagnosis
   2. Relies on accurately recorded weight and height on growth chart over time
      1. Weight below 5th percentile for gender and Corrected age OR
      2. Weight for Length <5th percentile OR
      3. BMI for age <5th percentile OR
      4. Decreased Growth Velocity with Weight for Length falling by more than 2 major percentile lines
7. Evaluation
   1. See Failure to Thrive Evaluation
   2. See Growth Assessment
8. Management
   1. See Failure to Thrive Management
9. Prognosis
   1. Nonorganic Failure to Thrive risks poor outcomes
      1. Risk of cognitive delay and school difficulty
         1. Lower Wechsler Intelligence Scale for Children
         2. Poorer language development and reading skills
      2. Social immaturity
         1. More frequent behavior problems
   2. References
      1. Oates (1985) Pediatrics 75:36 [PubMed]
10. References
    1. Cole (2011) Am Fam Physician 83(7): 829-34 [PubMed]
    2. Gahagen (2006) Pediatr Rev 27(1): e1-11 [PubMed]
    3. Homan (2016) Am Fam Physician 94(4): 295-9 [PubMed]
    4. Shah (2002) J Clin Gastroenterol 35(5):371-4 [PubMed]