Failure to thrive (FTT) is a term used to describe infants and young children who are not gaining weight or growing as expected. While not a diagnosis in itself, FTT is a sign that a child is not receiving or utilizing adequate nutrition for proper growth and development. Identifying FTT is the first crucial step towards understanding and addressing the underlying issues affecting a child’s health. Diagnosis of the cause of failure to thrive is the ultimate goal, and the process begins with recognizing the growth patterns and conducting thorough evaluations.
Monitoring a child’s growth is paramount in identifying potential issues early on. Weight is considered the most sensitive indicator of a child’s nutritional status. Healthcare providers meticulously track a child’s weight at each check-up. While a single height measurement provides a snapshot, tracking height over time, known as linear growth, is more informative when assessing for FTT. Consistent and inadequate linear growth, though typically evident in more prolonged cases of undernutrition, also raises concerns. Growth charts are essential tools used to plot these measurements and compare a child’s growth against established norms for their age and sex. Significant deviations from these growth curves can signal FTT.
When failure to thrive is suspected, healthcare professionals initiate a comprehensive evaluation. This begins with a detailed discussion about the child’s symptoms and medical history, coupled with obtaining a thorough dietary history from the parents or caregivers. Understanding the child’s feeding habits, types of food consumed, and feeding patterns is critical. A complete physical examination is then performed to assess the child’s overall health and identify any potential physical signs contributing to poor growth.
Following the initial assessment, doctors often request parents to maintain detailed food records. These records provide a clearer picture of the child’s daily caloric intake and nutritional balance. A registered dietitian frequently becomes involved at this stage to meticulously assess the child’s nutritional needs and dietary adequacy. Often, the initial intervention involves implementing an appropriate, calorie-dense diet under the guidance of a dietitian. This dietary adjustment aims to facilitate “catch-up” growth, allowing the child to regain a healthy growth trajectory. In cases where breastfeeding difficulties are identified, a lactation consultant may be consulted to provide specialized support and strategies. Furthermore, specialists in developmental pediatrics or feeding therapy might be brought in to evaluate the child’s developmental milestones and feeding skills, addressing any potential oral motor or sensory issues impacting feeding.
If a child continues to exhibit failure to thrive despite initial dietary interventions and support, further investigations become necessary. Physicians tailor subsequent laboratory tests and diagnostic studies based on the child’s specific symptoms, physical examination findings, and response to the initial dietary therapy. Blood tests and other lab work can help rule out underlying medical conditions that may be contributing to FTT. In certain situations, hospitalization for observation and intensive dietary therapy may be recommended. This allows for close monitoring of the child’s feeding patterns, weight gain, and overall response to treatment, helping to pinpoint the nature of the problem and optimize the therapeutic approach. Ultimately, recognizing failure to thrive is the beginning of a process aimed at uncovering any underlying medical, nutritional, or environmental factors and ensuring the child receives the necessary support to thrive.
