Definition of "Failure to thrive"

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Failure to thrive (aka faltering weight) is low weight for an infant/child's age, due to insufficient weight gain, or inappropriate weight loss.

Patient information

What is failure to thrive?
It's where bub has a low weight, or there is insufficient weight gain.

Wait... how's that different from low birth weight?
Low birth weight is more so weight when born. Failure to thrive is weight some time after being born.

Dx

FTT has numerous definitions, including:

  • Low rate of increase in weight, indicated by weight that crosses 2 percentile lines
  • Low weight for a child's age, as indicated by either:
    • Weight <5th percentile on more than 1 occasion
    • Weight <80% of the ideal body weight for age

Patient information

How do we define low weight or insufficient weight gain after being born?
So low weight rise, which we see by crosing 2 percentile lines. Or where on more than 2 occasions, bub is <5th percentile, or <80% of the ideal body weight for their age.

Cause
  • Endogenous (organic), due to physical or mental issues with the child themselves, including:
    • Various inborn errors of metabolism
    • Problems with the GI system, e.g. gas and acid reflux, which may make the child unwilling to tkae in sufficient nutrition
    • Cystic fibrosis, diarrhea, liver disease, and celiac disease, make it more difficult for the body to absorb nutrition
    • Physical deformities, e.g. cleft palate, tongue tie
    • Milk allergies
    • Metabolism, may be raised by parasites, asthma, UTI, and other fever-inducing infections, or heart disease sot hat it becomes difficult to get in sufficient calories to meet the higher caloric demands
  • Exogenous (nonorganic), caused by caregiver's actions, including:
    • Physical inability to produce enough breastmilk, using only babies' cues to regulate breastfeeding so as not offer a sufficient number of feeds (sleepy baby syndrome)
    • Inability to procure formula when needed
    • Purposely limiting caloric intake (often for what the caregiver views as a more aesthetically pleasing child)
    • Not offering sufficient age-apropriate solid foods for babies and toddlers over 6mo
    • Recent studies suggest, difficulties with sensoring processing, in kids who have a Hx of growth deficiency and feeding problems
    • In developnig countries:
      • Chronic food insecurity
      • Lack of nutritional awareness
  • Mixed, e.g.:
    • Child who is not getting sufficient nutrition may act content, so caregivers don't offer feedings or sufficient frequency or volume
    • Child with severe acid reflux who appears to be in pain while eating, may make a caregiver hesitant to offer sufficient feedings

Patient information

What makes bub have a low weight, or have poor tracking of weight?
So it can be an issue, whether physical or mental, with the child themselves. Caused by their parents. Or a mix of both. The child themselves can have problems with their tummy system, difficulties of absorbing nutritions, physical deformities making it more difficult to eat, allergies, or have increased caloric needs because of disease. It can also be due to the parents, for eample, mom can' tmake enough breast milk, can't get formula when they need it, not shifting from milk to solids over 6 months. And in developing countries, there's things like unable to get food, or just general lack of knowledge around nutrition.

Prognosis
  • Due to underlying pathologies, can imply abnormal intellectual, social, or emtoional development
See also

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Definition of Failure to thrive | Autoprac


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